Chronic inflammation: Proper testing and how to keep it low

Chronic inflammation is at the heart of the chronic diseases aging. You are more than likely going to suffer and/or succumb to one of these diseases, which include:

  • Cardiovascular disease
  • Cancer
  • Rheumatoid arthritis
  • Type 2 diabetes
  • Autoimmune diseases
  • Non-alcoholic fatty liver disease
  • Neurodegenerative diseases (Alzheimer’s disease, Parkinson’s disease)

So, obviously, if there is anything you can do to limit unnecessary chronic systemic inflammation, it’s a good thing. But how do you do this, and how do you know it’s working?

In today’s blog we’ll talk about an interesting new test that measures your background level of chronic inflammation. I recently took this test, so we’ll also discuss my results and how I maintain my levels.

Glycolysated acetyls(GlycA) as a measure of chronic inflammation

The old tried and true way of measuring the levels of chronic, systemic inflammation in your body is a high sensitivity C-reactive protein(hs-CRP) test. While hs-CRP is a useful measure of systemic inflammation, it’s not a very stable one. In other words, you can take the test and it can vary greatly from measurement to measurement.

For example, if you are coming down with a cold or just getting over one, hs-CRP can vary by more than 30%. GlycA, on the other hand, remains pretty stable(~4% variability). As a result, repeated measures of hs-CRP are needed to assess chronic inflammatory status while a single GlycA measure will suffice.

But how exactly does GlycA measure inflammation?

Acute phase proteins are proteins that are called into action when inflammatory cytokines increase. GlycA essentially measures the amount of acute phase proteins and their activation state. Since it is a composite measure of acute phase proteins, it’s more stable than a single measure such as hs-CRP.

GlycA as a measure of chronic inflammation

You can check out more on GlycA and how it is independent from and additive to hs-CRP as a measure of chronic inflammation, as well as the inflammatory diseases it associates with in this review.

Interestingly, GlycA may uniquely pick up the inflammatory signal arising from metabolites originating in the gut.

What my GlycA test told me about my levels of chronic inflammation

I was first exposed to GlycA as a measure of systemic inflammation from the PREDICT trials. The PREDICT trials are a group of trials looking at the individual response to different foods in different people.

It wasn’t until recently while listening to a Healthy Rebellion Podcast with William Cromwell that I found out I could access this test. Dr. Cromwell created a test called Precision Health Reports, which measure cardiometabolic risk using lipoprotein insulin resistance score, lipoprotein breakdowns, and GlycA.

I’m deeply concerned about both cardiovascular disease and type 2 diabetes, so I ordered the test to see where I stand. We’ll cover the whole test in a video shortly. For today, we’ll focus on GlycA.

My results for GlycA were quite remarkable:

On the surface, it’s a pretty good result. But when you dig into the literature and look at where most people stand, it’s actually beyond excellent.

The MESA(Multi-ethnic Study of Atherosclerosis) is a multi-ethnic study of atherosclerosis(Funny how that works). It involved over 6600 men and women aged 45-85 and found my value would fall just under the 2.5th percentile.

The PREVEND(Prevention of Renal and Vascular End‐Stage Disease) found a similar distribution with 4524 people with an age range of 28-75 years old. The cutoff for the 2.5th percentile in PREVEND is 288 umol/L, with 245umol/L representing the 0th percentile.

What this effectively means is that if I were in a room with 100 people who had a GlycA measurement, fewer than 2.5 of them would have a lower score than mine. Let’s assume that’s 2, since my level is below that line and I’d hate to meet a half a person.

In other words, I have extraordinarily low levels of chronic inflammation.

What keeps my chronic inflammation low?

Currently, my self-care routine is pretty locked in. If I were to venture a guess as to the biggest drivers, I’d say things I’m certain are driving my inflammation low are:

  • Locked in circadian rhythms (There’s a bi-directional relationship between circadian rhythms and inflammation)
  • Rock solid sleep via excellent sleep hygiene
  • High fiber (~50g/day), high polyphenol omnivorous diet & decent amounts of plant protein(Likely increases butyrate production)
  • Focus on gut health
  • High levels of physical activity, excellent exercise routine
  • Maintaining healthy weight
  • Smoked salmon 2x/week

Other factors that may play a minor role and/or I’m unsure because the data is iffy:

  • Chamomile tea consumption (Contains a CD38 inhibitor, may promote better sleep)
  • Daily blueberry & raspberry intake
  • Fermented food consumption(Goat milk kefir and fermented soybean paste daily, rotating others)
  • High spermidine foods(Edamame, Fermented soy, wheat germ)
  • Lots of time in nature

While I do have a pretty locked down routine, I don’t deprive myself of fun things. I enjoy ice cream, chips & salsa, and we eat out a couple of times a week.

In the past, I’ve done Paleo and Keto and felt pretty good. But I really don’t enjoy restricting things from my diet unnecessarily, and eating cheesesteak and pizza on the reg doesn’t seem to cause major issues from an inflammatory perspective. At least for me.

Why I decided to take the Precision Health Report test

I decided to take this test for a few reasons. First, because my father recently passed from heart failure at 72 and all of the males on his side of the family had early heart attacks in their 40s. My maternal Grandmother also had an early heart attack.

Second, I’ve been down the restrictive diet rabbit-hole, but have currently ventured away from it. I don’t like needlessly complicating my life and I don’t like having needless restrictions on what I eat. I also like drinking beer on the weekends, and clearly it’s not having a negative impact right now. I’ve done that whole “I keep my Omega 6 intake low, carbs cause diabetes, don’t eat any processed foods, no beer, etc. etc.

But digging deeper into the literature, it became clear to me that most of that stuff was bogus, And most of the people pushing those narratives are either parroting someone else, or are that someone else simply abstract surfing on pubmed.

As a result, I came to the conclusion that I need to see how my routine is treating me by testing this stuff. It’s excellent to see that what I’m doing has chronic inflammation on lockdown. I enjoy what I do and am thankful that I’m not needlessly restricting foods or taking boatloads of supplements to subsidize a poor diet.

Test, don’t guess!

Conclusion

Chronic inflammation is one of the most important things to minimize if you want to live a long, healthy life. A new composite measure of chronic inflammation known as GlycA provides additional information beyond tradituional markers such as hs-CRP, while also being more stable.

Focusing on developing a healthy lifestyle is a critical aspect of maintaining low levels of chronic, systemic inflammation as you age. As far as I can tell, mine is pretty much keyed in right now. And the best part is I don’t have to micromanage my diet in any way or ostracize myself when at a party or social event.

I highly recommend you check out the Precision Health Report cardiometabolic screening to assess your cardiometabolic health get a good baseline of inflammation, insulin resistance, and cardiovascular disease risk. While your at it, check out Robb Wolf’s Healthy Rebellion Radio. It’s a great source for being exposed to things like this.

Stay tuned next week for a follow up video covering my insulin resistance score and cardiovascular disease risk.

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