Category Archives: Medical

Books, Health, Medical, Research, Science

Book Review: A Silent Fire

THE FLAMES WITHIN

Intro: A fascinating primer explores the crucial role of inflammation in our bodies and how it can go awry. What you need to know about inflammation in the body

INFLAMMATION is a crucial tool of the body’s immune system. As the first line of defence against injury or invaders, it traps bacteria and viruses, heals wounds and signals to other cells for help. It results in symptoms such as pain and swelling. Once a threat is remedied, inflammation, along with its ensuing discomfort, disappears – or at least it should.

In her debut book A Silent Fire: The story of inflammation, diet and disease, gastroenterologist Shilpa Ravella explains how inflammatory responses can turn against us. Crucially, she shows how chronic inflammation plays a role in many common conditions such as heart disease and cancer, and why Western diets are at least partially to blame.

This primer sees Ravella start with some fascinating history, travelling all the way back to the 1st century, when Aulus Cornelius Celsus first described four of the five main signs of inflammation: pain, heat, redness and swelling. The fifth, a loss of function, was identified in the mid-1800s.

Ravella spends a lot of time examining the work of Victorian scientists, such as Élie Metchnikoff, who won a Nobel Prize in 1908 for discovering immune cells called phagocytes that engulf pathogens and particles. Eventually, she moves on to modern-day researchers like Charles Serhan, who helped identify molecules known as resolvins that turn off inflammation.

This lays a proper foundation for the book’s second section, which connects these discoveries to inflammation’s possible role in disease. Low levels of inflammation have been found in people with conditions such as cancer. While inflammation is a normal response to injury and disease, persistent inflammation is now being viewed as a potential cause of illness.

Ravella further speculates that inflammation can contribute to conditions like depression and Alzheimer’s disease, though as a responsible medical professional, she provides important caveats and stresses the need for more research.

The most damning evidence links inflammation to autoimmune conditions – which occur when the body damages its own cells – such as rheumatoid arthritis. Characterised by long-lasting, low levels of inflammation, these conditions increase susceptibility to other problems like bone loss, heart disease and kidney disease.

The book wraps up by detailing how factors like diet and exercise can contribute to inflammation as well as help dampen it. For many, this won’t be new, but what may be illuminating is Ravella’s explanation of lifestyle significance.

For instance, she devotes a whole chapter to the gut microbiome, describing how processed foods and animal products, like red meat and dairy, disrupt microbial composition, setting off a chain of events that leads to increased inflammation. She then explains why fruits, vegetables and whole grains can help undo these effects.

A Silent Fire is no quick read: it is packed with information, combining medical history, innovative research and first-hand clinical experiences. At times, it feels over-ambitious, as Ravella crams in as much as possible rather than clearly connecting the various topics. It can also be difficult to keep track of all the different microbes, scientists and immune cells involved, especially if you lack a scientific or medical background.

But Ravella’s writing style keeps even the most dense page engaging. She breathes life into biological function, at one point describing types of white blood cells as “sophisticated warriors” that “voraciously gobble up” particles. Ultimately, the book is perfect for those looking to delve deeper into the history and intricate workings of immunology, diet and disease.

– A Silent Fire is published by Bodley Head

– Rheumatoid arthritis, as shown in this X-ray, is a chronic inflammatory condition
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Health, Medical, Science

Are we all really getting more stressed?

STRESS

Intro: Modern life’s pressures can feel like they are increasing, but science reveals that it’s the nature of the stress we suffer today, rather than the amount, that has changed

BEFORE the 1940s, the only people who talked about “stress” were engineers describing whether the struts of a bridge would hold up. Today, “stress” is a vague catchall term for all of the many challenges you might face in your life: you may have stress at home, be stressed out by work, and the anxiety you feel around hospitals or before exams can be “stressful”. If you believe the headlines, the world is the most stressed out it’s ever been – and we are fretting our way throughout life.

Pick up any stress-management book or tap into a healthy-living website and you will encounter the classic stress story that we all undergo, the “fight-or-flight” survival response and its accompanying deluge of hormones when stressed. However, the body is far more sophisticated than we give it credit for. No two “stresses” are the same: being punched in the gut triggers a different biological response to the turmoil of a feud with a neighbour or the worry over a delayed pay cheque. Each demand (or “stressor”) placed on you has its own survival response.

Different kinds of stressors cause the body’s defensive systems to react in different ways: for example, a brief stress response triggers helpful infection-fighting chemicals, whereas longer term trauma can cause virus-attacking white blood cells to stop multiplying. Your responses also vary with age, past experiences, general health, and any past or existing medical conditions. You will undergo the most drastic fight-or-flight responses if you’re threatened or physically injured.

“Stress” has become such a fuzzy term, it’s no wonder we think there’s more of it in the world. While it can be a useful way to understand our responses to mental and physical challenges, labelling every negative experience as “stress” risks impoverishing our experience of the richness of what it is to be human.

How can I deal with constant stress?

RECURRENT, relentless demands and uncertainties really can harm your health. The body’s fight-or-flight response is a primal sledgehammer reaction that was a lifesaver for fending off predators, but is now utterly out of proportion for cracking the small nuts of modern life’s trials. With your emergency systems primed for a catastrophe your body’s internal chemistry is stretched to its limits. When fight-or-flight and stress hormones surge repeatedly over many days and weeks, it can cause damage to your internal organs, and brain.

Coping strategies are often the go-to technique for dealing with repeated or long-term stress, and many of these are critical for quelling an overactive fight-or-flight response, offering you essential time to relax and reflect. They might include making to-do lists, exercise, yoga, meditation, breathing exercises, or even just “me time”. These techniques are, however, all just an ice pack for soothing the fever and are rarely the cure. The best solution to never-ending pressures is to uproot the source and reframe how you think about the underlying problem.

If relentless pressure is putting your body on high-alert then you won’t be able to see beyond the immediate crisis. By seeking advice from a trusted friend or family member, fresh perspectives and solutions often appear. There is also measureable evidence that working through problems with a professional health worker will let you unpick destructive thoughts and habits, as well as make practical steps to alleviate near-constant stress.

Can stress ever be good for me?

If you have ever felt the motivational push of stress, you’ll know it can have its benefits. There’s a fine balance, however, to be kept between “good” and “bad” stress.

THE natural “stress” hormones your body produces, and their effects on the body, are vital in providing you with the energy, strength, and single-mindedness to overcome physical and mental challenges. If your body can’t produce enough cortisol to sustain you, then you’ll be weak and fatigued. Without cortisol, your blood pressure and blood sugar will drop, you will be thirsty, and a sudden injury, infection, or bout of strenuous exercise could even lead to sudden death.

Not only is a stress response key to keeping your alive, but moderate pressure in daily life can do you good: regular pulses of adrenaline and cortisol when you’re excited, motivated, or exercising improve concentration and provide small boosts in your mind.

Constant and extreme demands will always be harmful, and if you’re always feeling ill when away from the stressor, then that stress is doing you no good at all.

Balanced demands

When life is manageable, the stress response is invigorating and sustaining. But when your demands seem to exceed your capacity, the stress response is ever-present and damaging.  

. Science Book

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Medical, Research, Science

Flu jab offers hope in fight against dementia

FLU VACCINE

Intro: Having vaccine for six years in a row cuts risk of developing incurable illness by 14%

HAVING the flu vaccine every winter could significantly reduce the risk of dementia, a study suggests.

The jab lowered the chances of developing the incurable condition by 14 per cent.

But the analysis by scientists says it seems to work only when patients have had it for at least six years in a row.

Researchers believe the vaccines – given to tens of millions in the UK last winter – gradually strengthen the ageing immune system to the point where it can prevent the underlying damage in the brain that causes dementia.

Britain faces an epidemic of Alzheimer’s disease and dementia because of an ageing population.

Alzheimer’s Scotland estimates that by 2031, there will be between 102,000 and 114,000 people in the country with dementia.

There has been no major breakthrough in treatment for decades – but now scientists believe vaccines such as the flu jab could play an important part in decreasing the surge in patients.

Researchers from Saint Louis University School of Medicine in the US tracked nearly 70,000 individuals aged 60 or over. They monitored how many had an annual flu vaccine and whether they subsequently developed dementia.

The findings, first published in the journal Vaccine, showed little difference between those who had received no jab and those immunised annually for the previous four or five years. But once they got to six years or more, the risk dropped by an average of 14 per cent. Scientists said there is no suggestion that catching flu causes dementia. Instead, the benefit comes from having a vaccine later in life.

Animal studies suggest vaccinations such as the one for flu increase the activity of immune system cells in the central nervous system that are responsible for repairing damage that can lead to dementia.

The study says: “Flu vaccines could be a cheap, low-risk intervention against dementia.”

A spokesperson for Alzheimer’s Research UK called the results intriguing, adding: “Understanding why this is the case is an important avenue for further research.”

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