Notes on "The Park Avenue Diet Show: Inflammation: an Introduction"; November 21, 2010

The inflammatory response is the body's way of protecting us when infections or injuries threaten our health. The biochemistry is extremely complex, involving many different chemical mediators (prostaglandins, leukotrienes, thromboxanes) secreted by many different types of cells (granulocytes, macrophages, leukocytes).

In medical school we were taught the classic signs of inflammation along with their Latin names (which are redness/rubor, swelling/tumor, heat/calor, and pain/dolor). Of course, these are the signs of inflammation that you can see; a good example would be a skin infection like an infected cuticle.

But inflammation has a dark side. It may also be a destructive process on a microscopic level and might be so small that someone might feel entirely well yet may be perilously ill.

Remember our program called "Oil and Water" a few months ago? If not, you might want to listen again on my website http://www.parkavenuediet.com/. Here's a quick recap, but try to listen again to the entire program.

Cholesterol floats through your bloodstream isolated from water-soluble molecules. Being fat-soluble, cholesterol cannot dissolve and therefore is in somewhat of a state of suspension, like grease stains on a shirt or the fatty component of lamb stew, chicken soup, or spaghetti with meat sauce. Ever leave beef stew leftovers in a plastic container overnight in your refrigerator? In the morning you'll find an orange-yellowish wax that has floated to the top. Oil and water don't mix.

So when you're overeating and your triglyceride levels and LDL start overflowing, some of those fat droplets wind up in the walls of the larger arteries. And you know that oil and water don't mix. These fat droplets are very irritating to the surrounding tissues, and your body decides to try to get rid of them, or at least wall them off and neutralize their effect. This happens by the process of inflammation; those chemical mediators we mentioned are called into action and white blood cells swarm into the area.

But this process is totally counterproductive. The arterial wall, a most delicate organ, is now a battleground between oil and water.

The extent to which damage occurs depends on many factors: which arteries are affected (brain/heart/kidneys); if the individual decides to avoid further damage by making lifestyle changes (such as you will read in The Park Avenue Diet); and if the individual is wise enough to use the benevolent force of good nutrition to help save the day.

We've been discussing inflammation, which as you know is part of the human body's normal response to injury or infection. But when it occurs in an inappropriate way, such as when the arterial wall becomes a battleground between cholesterol droplets and white blood cells, the result is tissue destruction, circulatory impairment, and other self-inflicted wounds.

The abnormal inflammation in the walls of the heart's arteries is thus a form of "friendly fire." Instead of bullets, white blood cells release powerful chemical mediators that are forms of arachionic acid and its precursor, linoleic acid.

An enzyme called cyclo-oxygenase turns the arachionic acid into one of several possible potentially dangerous chemicals. These are named; prostaglandins, thromboxane, and leukotriene. Thromboxane A2 is a good - or rather a bad-example . This chemical mediator causes platelets, those sticky little cells that are part of the clotting system, to become even more sticky and start to clump together while circulation throughout the body.

You can see them at work, and even feel them, if you are a male medical student at Maimonides Medical Center shaving in the morning too quickly. Those teeny red "shaving-nicks" are in part made up of platelets. But Thromboxane A2, one of the prostaglandins made from arachidonic acid, turns this usually appropriate function into something altogether different.

In people with high levels of Thromboxane A2 (and by the way, this is a chemical that becomes excreted due to stress), platelets start to stick to those irritating cholesterol droplets inside the arterial wall. The more platelets that stick to the cholesterol droplet, the narrower the artery becomes. Then , the entire irritated area literally explodes-just like a pimple on the surface of your skin. Except this pimple is inside a coronary artery. And after it explodes, more platelets become stuck to the lesion.

I'm sure you have heard the medical term for this horrible cascade of biochemical events. It's called a coronary thrombosis. And you've heard about the illness that is the immediate and sometimes fatal result. It's called a heart attack. The end result of a heart attack might have severe pathological, psychological, and social repercussions. But it all began due to abnormal biochemistry...biochemistry that activated the body's inflammatory response in an inappropriate, painful, and sometimes tragic way.

And now for some really good news: there's a way to manipulate these chemical mediators in an extremely beneficial way. Nature has provided beneficial molecules called Eicosanoids that have the ability to offset the dangerous accumulation of thromboxanes, leukotrienes, and malevolent prostaglandins.

Eicosanoids are made from omega-3 or omega-6 essential fatty acids. And the more omega-3 oils one has circulationg through the body, the more healthy the overall picture. Omega-3 oils reduce the inflammatory effects of arachionic acid and its products.

Let's review this: Arachionic acid promotes inflammation. Omega 3 and 6 oils are much less inflammatory, or inactive, or even anti-inflammatory.

Tune in next week when we will continue with our discussion on inflammation.