Stress and Inflammation: The surprising link between marital distress, leaky gut and chronic inflammation

Since I wrote a book on the anti-inflammatory diet, The Anti-Inflammatory Family Cookbook: A Kid-Friendly, Pediatrician-Approved Way to Transform your Family’s Health, I often get two questions: What is inflammation. And where does it start? I’m going to break that down here.

First, for context, inflammation is linked to every chronic physical and mental health conditions that we know of. Here’s a short list:

·      Depression & Anxiety

·      Attention Deficit Hyperactivity Disorder (ADHD)

·      Irritable Bowel Disease (IBS)

·      Inflammatory Bowel Diseases (IBD)

·      Heart disease and high blood pressure

·      Diabetes

·      Allergies (to foods, pollen, cats, anything)

·      Chronic skin conditions like eczema and psoriasis

·      Chronic UTIs or yeast infections

·      Arthritis and Joint Pain

·      Alzheimer’s disease

·      ….and a lot more

Notice, please, that inflammation does not distinguish between mental and physical health.

Acute inflammation is fast and fiery.

First, inflammation is not inherently bad! On the contrary. It is simply part of the body’s healing mechanisms and immune response, and without it, we wouldn’t make it very far in this world. For example, say you scrape your knee like this poor fellow…

Your body will immediately respond with an inflammatory process. Just around the knee, you’ll observe the characteristic 4 signs of inflammation—redness, swelling, pain, and heat. Underneath your skin, your body is initiating a cascade of events that will help protect the body and heal the wound.

I short, when there is injury, inflammation is our bodies’ way of healing it. The immune cells get called out to do 2 important tasks here:

1. Protect: They attack any bacteria or debris that enters the wound, and

2. Repair: They help to initiate repair of damaged skin and tissue.

This short-term inflammation is fast and fiery. It comes to the rescue when needed, helps resolve the injury, and cools down until the next time it’s needed.

Chronic inflammation smolders and has no end.

Acute inflammation is your immune system being productive; chronic inflammation is your immune system gone awry.

While acute inflammation is linear and has an end point, chronic inflammation is cyclical, and involves a feedback loop with no end. Immune cells are called out to fix the problem, but because there is no clear end to the injury, inflammation proliferates uncontrollably. This process ends up damaging more tissue, which then provokes more inflammation. And so on.

In our modern world, it’s hard to pin down the exact origin of chronic inflammation. In some cases, it is triggered by an acute event that doesn’t resolve, like an infection that lingers or salmonella poisoning from eating bad food. But usually, it arises from a variety of things that stress our bodies. Like: unhealthy foods, overwork, isolation, lack of sleep, environmental pollutants, trauma, discrimination and oppression, and feelings of overwhelm or anxiety. These are all quite different, but your body perceives them similarly, as threats. And, simply put, inflammation is our immune response to threats.

How does stress turn into inflammation?

Just like chronic inflammation impacts our physical and mental health equally, the cause of inflammation may be physical or emotional. So, how does emotional stress lead to a physical condition? It can be hard to make this leap conceptually, so let’s track it through one example, taken from a 2018 study on the link between marital distress, depression and leaky gut [1].

Keep in mind that, while I’m choosing this one example, you can substitute “marital distress” for anything that is regularly stressful for you, including other primary relationships, work, racism, and of course, Covid-related anxieties. All stressors similarly trigger an increase in the stress hormones cortisol and adrenaline, and can bring you down a similar cascade of events.

Here’s an illustration of what happens:

Put into words:

• Marital distress (or any stress) —>

• Elevates levels of adrenaline and cortisol —>

• Which creates changes in the composition of our microbiome (for example it can increases the amount of bacteria 10,000 fold and make harmful bacteria more potent) —

• Plus it loosens right junctions between out gut cells, creating a “leaky gut,” which is associated with IBS and other chronic health conditions—>

• Bacteria sneak through openings between gut cells. They move from intestines into our blood, where they don’t belong! —>  

• Body registers bacteria in the blood. Signals danger! —>

• Triggers immune response, e.g. pro-inflammatory signals like LBP (LPS-binding protein) —>

• This wakes up more pro-inflammatory chemicals in a pro-inflammatory cascade, where one triggers another with no “shut-off” valve —>

• The inflammation further damages gut tissue, leading to even more leaky gut damage and —>

• Over time, chronic, low-grade inflammation sets in all over the body....which leads to lots of negative health consequences.

So, what can you do to prevent or reverse chronic inflammation? I’ll save the details for future blog posts, but here’s a quick sneak peak:

1. Physical activity: When you exercise, you productively use up any excess cortisol and adrenaline that other stressors may have triggered. If these hormones don’t hang around in the body, they can’t cause as much trouble. Like teenagers: they need something to do. Plus, there are a hundred other reasons why physical activity keeps us well.

2. Mind-body techniques, such as meditation, breathwork, biofeedback, and techniques to ensure healthy heart-rate variability: The core mechanism of these evidence-based modalities is that they reduce stress, which means less stress hormones in the body.

3. Eat Plants: As I explain in my book, plant-foods (veggies, fruits, nuts, seeds, legumes and especially herbs and spices) are the most concentrated sources of anti-inflammatory chemicals that we have at our disposal. These phytochemicals directly talk to our bodies’ inflammatory chemicals. They turn down pro-inflammatory signals and they turn up anti-inflammatory signals. Plants therefore help “tip the scale” back towards an anti-inflammatory state, even when other stressors are present.

To see the study referenced here, click this link: Marital distress, depression, and a leaky gut: Translocation of bacterial endotoxin as a pathway to inflammation (Kiecolt-Glaser, J. K. et al, 2018)

And to learn how inflammation impacts children, check out Harvard University’s Center for the Developing Child: What Is Inflammation? And Why Does it Matter for Child Development?