Ways to Ease Inflammation and Depression
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Smart lifestyle choices for a happy brain and healthy mood
In last week’s post we explored the ways in which inflammation can cause depression. The science shows that we cannot blame genetics alone for depression. That’s a good thing: it means there is a lot we can do to heal our brains. Here are some evidence-based strategies to quell inflammation and support mental health:
It is no secret that smoking cigarettes is a major driver of inflammation. Not only does smoking cause inflammation in the obvious locations of the lungs and airways, but also in the mouth, the digestive system, and – you guessed it – in ways that affect the brain. Although less smoke is inhaled into the lungs with vaping than with smoking cigarettes, vape smoking is also a culprit of inflammatory damage. As a significant source of toxic chemical exposure, furthermore, smoking is the number one cause of preventable illness in humans.
Smoking is the number one cause of preventable illness in humans.
There is no shortage of studies confirming the connection between cigarette smoking and depression,,,, and a recent case-control study has revealed a significant causal relationship between smoking-related inflammation and depression. The study compared 26,894 people who had been diagnosed with major depressive disorder (MDD) at some point in their lives to 59,001 control subjects without depression. The study found that genetics actually played a negligible role in inflammation-mediated depression. Rather, the researchers found that “increased inflammation in depression is due to… eating and smoking habits.”
In another study examining the effects of smoking on the mental health of 462,690 people, there was strong evidence to suggest that smoking is a risk factor not only for depression, but also for schizophrenia.
In short: smoking can harm mental health, in significant ways.
Maintain a healthy weight
Like many of the studies summarized in our last article, a 2019 study found a significant correlation between high levels of hs-CRP (an inflammatory marker measured in the blood) and treatment-resistant depression (TRD). Upon deeper consideration of the data, the authors found that high body mass index (BMI) (aka: being overweight or obese) was strongly correlated with hs-CRP elevations. Other studies have likewise connected elevated C-reactive protein (CRP) levels and obesity, suggesting that overweight and obese individuals live in a state of low-grade, chronic, systemic inflammation.
Overweight and obese individuals live in a state of low-grade, chronic, systemic inflammation.
The habits that cause weight gain (like eating sugary foods) are the same behaviors that drive inflammation, but fat also drives inflammation in and of itself: adipose (fat) cells produce inflammatory chemicals. In other words, the more fat you have on your body, the more inflammation those fat cells will pump into your system.
This is even the case among overweight and obese young adults ages 17 to 38, which is significant, as the rate of depression is highest among those 18 to 29 years of age, and the rate of major depression (MDD) is most prevalent among those 18 to 25.
Fortunately, a systemic literature review of 76 studies (including data from a total of 6,742 patients) reports that most studies found that weight loss caused a significant drop in inflammatory markers. This was true whether the weight loss was due to eating a low-calorie diet, exercising, or undergoing weight loss surgery.
Other reviews have found that weight loss (regardless of the method) improves inflammation profiles by reducing harmful markers like CRP, TNF-alpha, IL-6 and leptin, and by enhancing the anti-inflammatory chemicals interleukin-10 and adiponectin.,
Many of the inflammation-reducing strategies explained in this article can also help with sustainable weight loss.
Reduce alcohol consumption
Numerous studies have confirmed that alcohol consumption and depression go hand-in-hand, ,,,, and the relationship is bi-directional: alcohol consumption drives depression, and depression drives drinking. While this is a documented trend in all adult age groups, alcohol consumption causes substantially greater harm in the elderly than in younger adult groups.,
Alcohol consumption increases intestinal permeability and changes the composition of the gut microbiome.
There are many mechanisms by which alcohol hurts the central nervous system and fuels depression, anxiety, and other mood troubles – and many of those mechanisms have to do with inflammation. One way this happens is at the level of the gut, where chronic alcohol consumption increases intestinal permeability (ie: cause “leaky gut”) and changes the composition of the gut microbiome (the mix of good and bad “bugs” in the gut), thus allowing harmful gut bacteria to pass through the weakened gut lining and into the circulation. The immune system recognizes that these gut-derived bacteria are now in places where they don’t belong, and responds in turn by producing pro-inflammatory cytokines (inflammation-producing chemicals). These cytokines can then reach the central nervous system and trigger neuroinflammation (inflammation in the brain and nervous system), thus driving mood imbalances, cognitive struggles (such as those seen in Alzheimer’s disease), and addictive behaviors.,,
Cut out gluten
Alcohol isn’t the only food known to degrade the gut lining: gluten, the protein found in rye, barley, wheat, and spelt, is also notorious for causing leaky gut and in turn driving neuroinflammation in many individuals.,
Although most people think of digestive trouble when they hear the word “gluten sensitivity,” many people with the condition experience little to no intestinal issues. Symptoms like brain fog, fatigue, joint pain, skin problems, and depression are common in those with both celiac disease and non-celiac gluten sensitivity (NCGS).,
In a meta-analysis pooling results from 1,139 patients, a gluten-free diet was found to significantly improve the symptoms of depression. Interestingly, even those who did not have celiac disease tended to have a worsening of their depressive symptoms after they unknowingly ate food containing gluten.
There’s another reason to take a break from wheat: gluten aside, high carbohydrate diets may exacerbate depression.
Cut back on sugar and refined carbohydrates
While it’s common for folks with depression to gravitate towards eating toast, cereal, and other processed foods high in sugar and carbohydrates, this practice may be doing more harm than good.
A number of studies have illuminated the connection between diabetes and depression.,,, In fact, depression is more than three times more prevalent in people with type 1 diabetes than in the general population, and the rate of depression almost double in those with type 2 diabetes.,
The rate of depression almost double in those with type 2 diabetes.
Although some studies on the topic have yielded contradictory results,, a highly significant correlation has been identified between sugar consumption and the annual rate of depression in several countries.
Eat more protein
A 2019 study examining markers of oxidative stress and inflammation in 2,061 participants of the Framingham Heart Study Offspring cohort found an inverse relationship between protein intake and levels of oxidation and inflammation. In other words, the overall levels of inflammation and oxidative stress were the lowest in the people who ate the most protein. Plant-based protein was protective, but animal protein (e.g.: meat) was even more significant.
Levels of inflammation and oxidative stress were the lowest in the people who ate the most protein.
This means that having a pea protein shake, a burger made from grass-fed beef, or some poached chicken breast is likely to support brain health and mood way more than a granola bar.
Although exercise produces a brief inflammatory response in the short term, both cross-sectional and longitudinal studies have shown that exercise has long-term anti-inflammatory effects. This inflammation-soothing response may in fact be part of the magic that is exercise.
Specifically, a protein known as interleukin-6 (IL-6) is produced by the muscle fibers during exercise. IL-6 in turn stimulates the circulation of anti-inflammatory cytokines and suppresses the production of the pro-inflammatory cytokine TNF-alpha. IL-6 also helps bust up fat cells, in turn helping burn fat and lose weight in a healthy way.
The type of exercise matters, however – or rather the intensity of the exercise. In a study on the subject, 61 university students were assigned to a six-week regimen of either high-intensity interval training (HIIT), moderate continuous training, or no exercise at all. While the students who didn’t exercise had a worsening of their depression, those who did continuous training not only enjoyed better mood, but also lower blood levels of pro inflammatory cytokines (TNF-α, IL-6, IL-1β, and CRP). Although those who did HIIT had a drop in their depressive symptoms, they reported higher levels of perceived stress, and had higher inflammatory cytokine levels than those who did moderate continuous training. These findings suggest that moderate intensity exercise is likely the best bet for sustainably battling depression and quelling inflammation.
Moderate intensity exercise is likely the best bet for sustainably battling depression and quelling inflammation.
Exercise not only combats depression and anxiety, but also improves physical well being, body image, stress coping strategies, quality of life, and cognitive functioning – all of which in turn reinforce mental health., Physical inactivity, on the other hand, is associated with the development of mental health disorders.
James Brown was truly onto something when he said, “Get up offa that thing, and dance ‘til you feel better.”
Practice mindfulness and meditation
Mindfulness practice has been shown to reduce stress hormone levels and fight inflammation, thereby dampening two major players in anxiety and depression., In addition to helping with mood imbalances,, meditation can also trigger the release of endorphins, the body’s homemade natural pain relievers.
Meditation doesn’t need to be complicated or difficult. It can simply entail sitting in a chair or on the floor and breathing calmly with the eyes closed or open (with a soft gaze) for ten minutes a day.
Get more sleep
Many inflammatory markers and hormones are influenced by sleep – as well as by the lack thereof. Even short-term sleep deprivation can affect markers of inflammation like CRP, IL-1β, IL-6, and IL-17 – with the increases in CRP and IL-17 lasting as long as two days after just one night of reduced sleep.,,
Sleep deprivation is associated with poor performance on cognitive tasks and decreased motor skills,, depression, feelings of burnout, increased vulnerability to infection, weight gain, and decreased ability to balance blood sugar levels.
Most adults need seven to nine hours of uninterrupted sleep in a dark room each night for optimal well being. If you have trouble falling or staying asleep, there are thankfully natural allies to help with rest. Supplements like melatonin, magnesium, and honokiol may come in handy, along with watching the sun set, and putting away smartphones, computers, and other glowing screens at least one hour before bedtime.
You can soothe your brain
Depression may have less to do with genetics or serotonin than it does with inflammation. That’s good news: it means that through some mindful choices, we can give both our physical and mental health a major upgrade. Lay down the cigarettes and booze, eat healthy, move your body, meditate, and sleep – this might just be the recipe for a healthy mind.
ReferencesClick here to see References
 Rom O, et al. Cigarette smoking and inflammation revisited. Respir Physiol Neurobiol. 2013 Jun 1;187(1):5-10.
 Smith BM, et al. Inhalation toxicology of vaping products and implications for pulmonary health. Int J Mol Sci. 2020 May 15;21(10):3495.
 Covery LS, et al. Cigarette smoking and major depression. J Addict Dis. 1998;17(1):35-46.
 Mathew AR, et al. Cigarette smoking and depression comorbidity: systematic review and proposed theoretical model. Addiction. 2017 Mar;112(3):401-12.
 Leventhal AM, Zvolensky MJ. Anxiety, depression, and cigarette smoking: a transdiagnostic vulnerability framework to understanding emotion-smoking comorbidity. Psychol Bull. 2015 Jan;141(1):176-212.
 Weinberger AH, et al. Depression and cigarette smoking behavior: a critical review of population-based studies. Am J Drug Alcohol Abuse. 2017 Jul;43(4):416-31.
 Pitharouli MC, et al. Elevated C-reactive protein in patients with depression, independent of genetic, health, and psychosocial factors: results from the UK biobank. Am J Psychiatry. June 2021;178(6):522-9.
 Wootton RE, et al. Evidence for causal effects of lifetime smoking on risk for depression and schizophrenia: a Mendelian randomisation study. Psychol Med 2020; 50:2435-43.
 Chamberlain SR, et al. Treatment-resistant depression and peripheral C-reactive protein. Br J Psychiatry. 2019;214:11-19.
 Visser M, et al. Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999; 282:2131-5.
 Vachharajani V, Granger DN. Adipose tissue: a motor for the inflammation associated with obesity. IUBMB Life. 2009 Apr; 61(4): 424-30.
 Visser M, et al. Elevated C-reactive protein levels in overweight and obese adults. JAMA 1999; 282:2131-5.
 Centers for Disease Control and Prevention (US). Symptoms of depression among adults: United States, 2019 [Internet]. Atlanta (GA): U S Department of Health and Human Services; 2020 [cited 2021 Jul 28]. Available from: https://www.cdc.gov/nchs/products/databriefs/db379.htm
 National Institute of Mental Health. Major depression [Internet]. Department of Health and Human Services; 2019 [cited 2021 Jul 28]. Available from: https://www.nimh.nih.gov/health/statistics/major-depression
 Bianchi VE. Weight loss is a critical factor to reduce inflammation. Clin Nutr ESPEN. 2018 Dec;28:21-35.
 Forsythe LK, et al. Obesity and inflammation: the effects of weight loss. Nutr Res Rev. 2008 Dec;21(2):117-33.
 You T, Nicklas BJ. Chronic inflammation: role of adipose tissue and modulation by weight loss. Curr Diabetes Rev. 2006 Feb;2(1):29-37.
 Ramsey SE, et al. Alcohol use among depressed patients: the need for assessment and intervention. Prof Psychol Res Pr. 2005;36(2):203-7.
 Cairns KE, et al. Risk and protective factors for depression that adolescents can modify: a systematic review and meta-analysis of longitudinal studies. J Affect Disord. 2014;169:61-75.
 Holahan CJ, et al. Drinking to cope and alcohol use and abuse in unipolar depression: a 10-year model. J Abnorm Psychol. 2003;112(1):159–65.
 Boschloo L, et al. Alcohol use disorders and the course of depressive and anxiety disorders. Br J Psychiatry. 2012;200(6):476-84.
 Hasin DS, Grant BF. Major depression in 6050 former drinkers: association with past alcohol dependence. Arch Gen Psychiatry. 2002:59(9):794-800.
 Beurel E, et al. The bidirectional relationship of depression and inflammation: double trouble. Neuron.
2020 Jul 22;107(2):234-56.
 Keyes KM, et al. Alcohol consumption predicts incidence of depressive episodes across 10 years among older adults in 19 countries. Int Rev Neurobiol. 2019;148:1-38.
 Lehmann SW, Fingerhood M. Substance-use disorders in later life. New Engl J Med. 2018;379:2351-60.
 Qamar N, et al. Meta-analysis of alcohol induced gut dysbiosis and the resulting behavioral impact. Behav Brain Res. 2019 Dec 30;376:112196.
 Venkataraman A, et al. Alcohol and Alzheimer’s disease – does alcohol dependence contribute to beta-amyloid deposition, neuroinflammation and neurodegeneration in Alzheimer’s disease? Alcohol Alcohol. 2017 Mar 9;52(2):151-8.
 Leclercq S, et al. The link between inflammation, bugs, the intestine and the brain in alcohol dependence. Transl Psychiatry. 2017 Feb 28;7(2):e1048.
 Lehnert M, et al. Modulation of inflammation by alcohol exposure. Mediators Inflamm. 2014;2014:283756.
 Bishehsari F, et al. Alcohol and gut-derived inflammation. Alcohol Res. 2017;38(2):163-71.
 Casella G, et al. Mood disorders and non-celiac gluten sensitivity. Minerva Gastroenterol Dietol. 2017 Mar;63(1):32-7.
 Karakula-Juchnowicz H, et al. The study evaluating the effect of probiotic supplementation on the mental status, inflammation, and intestinal barrier in major depressive disorder patients using gluten-free or gluten-containing diet (SANGUT study): a 12-week, randomized, double-blind, and placebo-controlled clinical study protocol. Nutr J. 2019 Aug 31;18(1):50.
 Losurdo G, et al. Extra-intestinal manifestations of non-celiac gluten sensitivity: an expanding paradigm. World J Gastroenterol. 2018 Apr 14;24(14):1521-30.
 Catassi C. Gluten sensitivity. Ann Nutr Metab. 2015;67 Suppl 2:16-26.
 Busby E, et al. Mood disorders and gluten: it’s not all in your mind! A systematic review with meta-analysis. Nutrients. 2018 Nov 8;10(11):1708.
 Knüppel A, et al. Sugar intake from sweet food and beverages, common mental disorder and depression: prospective findings from the Whitehall II study. Sci Rep. 2017 Jul 27;7(1):6287.
 Nagy G, et al. Clinical aspects of the link between diabetes and depression. Orv Hetil. 2011 Mar 27;152(13):498-504.
 Rustad JK, et al. The relationship of depression and diabetes: pathophysiological and treatment implications. Psychoneuroendocrinology. 2011 Oct;36(9):1276-86.
 Petrak F, Herpertz S. Treatment of depression in diabetes: an update. Curr Opin Psychiatry. 2009 Mar;22(2):211-7.
 Mansori K, et al. Association between depression with glycemic control and its complications in type 2 diabetes. Diabetes Metab Syndr. Mar-Apr 2019;13(2):1555-60.
 Lustman PJ, Clouse RE. Depression in diabetic patients: the relationship between mood and glycemic control. J Diabetes Complications. Mar-Apr 2005;19(2):113-22.
 Roy T, Lloyd CE. Epidemiology of depression and diabetes: a systematic review. J Affect Disord. 2012 Oct;142 Suppl:S8-21.
 Hu D, et al. Sugar-sweetened beverages consumption and the risk of depression: a meta-analysis of observational studies. J Affect Disord. 2019 Feb 15;245:348-55.
 Mantantzis K, et al. Sugar rush or sugar crash? A meta-analysis of carbohydrate effects on mood. Neurosci Biobehav Rev. 2019 Jun;101:45-67.
 Westover AN, Marangell LB. A cross-national relationship between sugar consumption and major depression? Depress Anxiety. 2002;16(3):118-20.
 Freeman CR, et al. Impact of sugar on the body, brain, and behavior. Front Biosci (Landmark Ed). 2018 Jun 1;23:2255-66.
 Della Corte KW, et al. Effect of dietary sugar intake on biomarkers of subclinical inflammation: a systematic review and meta-analysis of intervention studies. Nutrients. 2018 May 12;10(5):606.
 Galland L. Diet and inflammation. Nutr Clin Pract. 2010 Dec;25(6):634-40.
 Hruby A, Jacques PF. Dietary protein and changes in biomarkers of inflammation and oxidative stress in the Framingham Heart Study Offspring cohort. Curr Dev Nutr 2019;3:nzz019.
 Kasapis C, Thompson PD: The effects of physical activity on serum C-reactive protein and inflammatory markers: a systematic review. J Am Coll Cardiol 2005; 45:1563-9.
 Metsios GS, et al. Exercise and inflammation. Best Pract Res Clin Rheumatol. 2020 Apr;34(2):101504.
 Petersen AMW, et al. The anti-inflammatory effect of exercise. J Appl Physiol. 2005 Apr;98(4):1154-62.
 Paolucci EM, et al. Exercise reduces depression and inflammation but intensity matters. Biol Psychol. 2018 Mar;133:79-84.
 Knapen J, et al. Exercise therapy improves both mental and physical health in patients with major depression. Disabil Rehabil. 2015;37(16):1490-5.
 Barreto Schuch F, Stubbs B. The role of exercise in preventing and treating depression. Curr Sports Med Rep. 2019 Aug;18(8):299-304.
 Carek PJ, et al. Exercise for the treatment of depression and anxiety. Int J Psychiatry Med. 2011;41(1):15-28.
 Atezaz Saeed S, et al. Depression and anxiety disorders: benefits of exercise, yoga, and meditation. Am Fam Physician. 2019 May 15;99(10):620-7.
 Wielgosz J, et al. Mindfulness meditation and psychopathology. Annu Rev Clin Psychol. 2019 May 7;15:285-316.
 Simkin DR, Black NB. Meditation and mindfulness in clinical practice. Child Adolesc Psychiatr Clin N Am. 2014 Jul;23(3):487-534.
 Brandmeyer T, et al. The neuroscience of meditation: classification, phenomenology, correlates, and mechanisms. Prog Brain Res. 2019;244:1-29.
 Zeidan F, et al. Mindfulness meditation-based pain relief employs different neural mechanisms than placebo and sham mindfulness meditation-induced analgesia. J Neurosci. 2015 Nov 18;35(46):15307-25.
 van Leeuwen WM, et al. Sleep restriction increases the risk of developing cardiovascular diseases by augmenting proinflammatory responses through IL-17 and CRP. PLoS One. 2009;4(2):e4589.
 Meier-Ewert HK, et al. Effect of sleep loss on C-reactive protein, an inflammatory marker of cardiovascular risk. J Am Coll Cardiol. 2004 Feb 18;43(4):678-83.
 Meier-Ewert HK, et al. Absence of diurnal variation of C-reactive protein concentrations in healthy human subjects. Clin Chem. 2001 Mar;47(3):426-30.
 Walker MP, et al. Practice with sleep makes perfect: sleep-dependent motor skill learning. Neuron. 2002 Jul 3;35(1):205-11.
 Pilcher JJ, Walters AS. How sleep deprivation affects psychological variables related to college students’ cognitive performance. J Am Coll Health. 1997 Nov;46(3):121-6.
 Cohen S, et al. Sleep habits and susceptibility to the common cold. Arch Intern Med. 2009 Jan 12;169(1):62-7.
 Patel SR, et al. Association between reduced sleep and weight gain in women. Am J Epidemiol. 2006 Nov 15;164(10):947-54.
 Donga E, et al. A single night of partial sleep deprivation induces insulin resistance in multiple metabolic pathways in healthy subjects. J Clin Endocrinol Metab. 2010 Jun;95(6):2963-8.
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Dr. Erica Zelfand
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