Inflammation has been quite a buzz word the past few years (or really, decades). Many athletes don’t understand the full story and yes, benefits of inflammation. In fact, inflammation is one of the body's most important protective mechanisms. It helps the immune system identify threats, eliminate damaged or infected cells and initiate tissue repair. Without inflammation, the body could not effectively respond to injury or infection.

In reality, the problem isn't inflammation itself. The problem occurs when the inflammatory response doesn't resolve. Remember that word, resolve, as it is an important one that you will read over and over in this article.

When inflammation remains elevated for weeks, months or even years, it can create a chronic state of immune activation that affects virtually every major system in the body. Yes, you read that correctly. 

The immune system is of significant importance here as it is responsible for protecting the body from pathogens, damaged cells, toxins and other potential threats. When the immune system detects a threat, it initiates a coordinated response that includes the release of inflammatory signaling molecules such as cytokines.

This process is highly useful in the short term.

Here’s what the acute immune response looks like:

1) Threat, 2) immune activation, 3) inflammation, 4) threat removed, 5) inflammation resolves

For example, when muscle tissue is damaged during exercise, the immune system responds to the damaged tissue. Immune cells help clear cellular debris and initiate the repair process. This inflammatory response is part of how the body adapts to exercise.

This is what most people don’t understand. The goal is not to eliminate inflammation.

Rather, the goal is to activate inflammation when necessary and then resolve it efficiently. There’s that word again!

That’s the acute inflammation story but what happens with chronic systemic inflammation? The type when inflammatory signaling remains elevated or is repeatedly activated without sufficient resolution?

The process can look something like this:

1) Persistent stimulus, 2) immune activation, 3) chronic inflammation, 4) tissue stress, 5) additional immune activation

A variety of factors can contribute to this state, including excess visceral adipose tissue, metabolic dysfunction, poor sleep, psychological stress, persistent infections, excessive training, inadequate recovery, environmental exposures, intestinal dysfunction and autoimmune processes.

Chronic inflammation doesn't necessarily mean that the immune system is simply "too strong."

Instead, it may indicate that the immune system is continuously receiving signals that a threat still exists.

Time to revisit that word again - resolution. 

One of the most important concepts in understanding chronic inflammation is resolution.

A healthy inflammatory response has a beginning, middle and end. The immune system is activated, the threat or damage is addressed, and then inflammatory signaling decreases as the body returns toward homeostasis.

Resolution involves coordinated biological processes that include changes in immune-cell activity, clearance of damaged cells, restoration of tissue function and production of specialized pro-resolving mediators (read more about this in THIS article).

When these processes don't occur effectively, inflammation can persist.

Looking at this more closely, it becomes more apparent that the goal isn’t to necessarily to stop or suppress inflammation but rather, to restore the body’s ability to appropriately activate and resolve it.

How Chronic Inflammation Can Affect the Immune System

Persistent inflammatory signaling can alter immune function over time.

Initially, chronic inflammation may involve continued activation of innate immune cells such as macrophages and neutrophils. Cytokines including IL-1β, IL-6, and TNF-α, can remain elevated or become repeatedly activated.

Over time, this chronic inflammatory environment can contribute to several problems such as tissue damage, metabolic dysfunction, impaired tissue repair and immune deregulation.

In other words, chronic inflammation may represent an immune system that is constantly stimulated but poorly regulated.

Stay tuned to next week’s part 2 of this topic to understand why all of this matters for athletes.

In the meantime, be sure to check out our great Team of Sports Dietitians and our Optimal Performance Nutrition Program. It is a 6-week program that helps you periodize your nutrition, nutrient timing and supplements to optimize health and performance.