Inflammation, Aging (and High-mileage Knees)

Aging is many things, though at essence it's the experience of inflammation. Inflammation is a natural and necessary physiologic response to the stressors that occur throughout the lifespan. Unfortunately, our capacity to manage inflammation tends to decline as the years go by, and inflammation tends to increase along with chronological age. As a result, we tend to become less resilient to stressors of all kinds due to the inflammation that generally accompanies aging.

Many scientists define resilience as "the rapidity in recovering from adverse events." In our youth, when we overdo a workout, we may feel tired and sore the next day. However, we generally bounce back from the soreness quite quickly and are back to full-capacity within a day or two. The recovery from the adverse event is rapid. With aging, on the other hand, a single overdoing episode may leave us feeling tired and sore for multiple days, if not longer. The recovery from adverse events is slow. Muscle soreness is one way that we experience inflammation, and what we may lament as getting older is at essence, the experiencing of chronically elevated levels of inflammation. With age, we tend to become less resilient to stressors, particularly physical stressors.

In working with my high-mileage knees, reducing inflammation is one of the primary levers that I pull in maintaining an active life. In addition to the Pilates practice and monitoring of body mass and composition that I mentioned in prior blog postings, I actively work to reduce levels of inflammation. By actively reducing inflammation in my body, I'm able to enjoy an active, virtually pain free life.

To reduce inflammation, I focus on four primary variables; cardio, Pilates, meditation and a whole-foods/plant-based diet. Each of these four variables (the orange ovals in the accompanying diagram) supports the joyful resilience to do what needs to be done.

Whole-Foods/Plant-Based Diet

The whole-foods/plant-based diet is at the center of the diagram, as I believe it's the first place to start in reducing levels of inflammation. The body naturally produces anti-inflammatory compounds in the gut, and what you eat largely determines the health of your gut. More fiber (prebiotics) feeds the microbiome (probiotics), which in turn manufacturers beneficial anti-inflammatory compounds (postbiotics).

Focus on fiber when planning your meals, particularly the non-soluble fibers that are contained in unprocessed plant foods. In addition to increasing consumption of non-soluble fiber, I also work to reduce my consumption of sweeteners, both caloric and non-caloric. Whether white sugar, stevia, fruit juice or aspartame, sweetness that isn't accompanied by fiber spikes insulin levels in the blood. This spiking of insulin levels not only has detrimental metabolic consequences, it also spikes levels of inflammation. Sweetness is just fine when accompanied by fiber (fresh fruit, for example), though generally detrimental when consumed in the absence of fiber.

What we experience as aging is primarily
the experience of inflammation.

Meditation

In addition to reducing inflammation through a whole-foods/plant-based diet, I also meditate each day. Colleagues at the Center for Healthy Minds have shown that working with the mind through a meditation practice is associated with reduced levels of inflammation. In addition to the myriad other benefits for wellbeing associated with meditation, reducing inflammation is near the top of my list of meditation's benefits. Your mind-state can make you sick (psychosomatic illness), though less appreciated is how your mind-state can also support your wellbeing. Meditation is a time-tested way to support mental and physical wellbeing, including reducing levels of inflammation.

Cardio

A little stress can be beneficial, or hormetic. Too much stress can cause di-stress. And too much stress over a long period of time can be toxic. The dose makes the poison, or more relevantly with regards to cardio, the dose makes the remedy. In my fitness regimen, I focus on low to moderate-intensity cardio, as determined by heart rate zone training. Heart rate zone training allows me to find the stress sweet spot - not too little, and not too much. This just-right (hormetic) stressor trains my body in managing stress, which supports greater resilience. Greater resilience, in turn, reduces inflammation. In aging bodies, too much high-intensity cardio can elevate levels of inflammation, just as too little cardio impairs resilience.

Pilates

In a previous blog posting, I mentioned how Pilates takes stress off my knees by improving my alignment. In addition to cultivating better alignment, core strengthening and mobilizing joints, Pilates can also be anti-inflammatory. Pilates works with the Five 'Shuns (circulation, respiration, proprioception, vestibulation and interoception), and these five systems are all pathways to reducing inflammation. Pilates uniquely engages with the Five 'Shuns to downregulate an overheated and inflamed system, which is particularly beneficial for aging bodies. (Stay tuned - I'm currently working on a book about Pilates and its interface with the Five 'Shuns!)