A new test identifies your inflammation age - which could provide early health warnings
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WHEN asked how old we are, most of us give our chronological age. But scientists from Stanford University and the Buck Institute of Research on Ageing in the US believe it does not accurately reflect our true age. They have developed a blood test that measures our inflammatory age (iAge) and say this ‘biological clock’ is a more significant indicator of ageing than our traditional method of using calendar years.
“Our chronological age shouldn’t matter to us so much,” says Dr Nazish Sayed, assistant professor of vascular surgery at Stanford and a member of the research team that developed the blood test. “What should matter is how well we age. Our goal should be a healthier old age, one in which we prevent some of the ill health that is all too commonly associated with it.”
Sayed and his team say their blood test can help with this. According to their research, published in the journal Nature Ageing, it measures chronic inflammation in the body.
So, what is chronic inflammation? According to Dr Luke O’Neill, a professor in biochemistry at Trinity College Dublin and author of Keep Calm and Trust the Science, inflammation is a normal bodily process. “It happens in response to injury or infection,” he says. “Its job is to restore everything back to normal and to repair any damage.”
This type of inflammation is often accompanied by fever, swelling, or pain and typically resolves itself in a matter of days.
“However, inflammation can go out of control and become chronic,” says O’Neill. “In that situation, it starts to damage our own tissues, giving rise to a whole host of diseases.”
That’s precisely why Sayed and his team believe that measuring our chronic inflammation levels can help us stay healthier for longer as we age. “Chronic inflammation is characterised by being low-grade and persistent, and ultimately it leads to collateral damage to tissues and organs,” says Sayed.
“It has been associated with heart disease, cancer, and neurodegenerative diseases. Thus, we hypothesise that by testing for and then working to lower iAge, we can minimise the diseases that are associated with chronic inflammation.”
As we age, the level of chronic inflammation in our body tends to increase. This is exacerbated by smoking, obesity, poor diet, pollution, and stress. It’s a gradual process and most of us are unaware of it until we start to develop symptoms.
“It might be that someone doesn’t realise they have heart disease until they show symptoms such as high blood pressure,” says Sayed. “Had they been tested for chronic inflammation, this might have been detected sooner.”
In his study, Sayed and his team analysed blood samples from more than 1,000 people for levels of 50 cytokines, immune system proteins known to be involved in inflammation. They then combined the blood test results with details about the person’s age and health, allowing them to determine a person’s iAge — their biological age based on their body’s level of inflammation.
In many cases, their case studies’ iAge was older than their chronological age. There were people aged 45 who had an iAge of 65, which meant their levels of inflammation had caused so much damage that their bodies were 20 years old than they should be.
However, this wasn’t always the case. In another study, Sayed and his team took blood samples from 37 people from one particular area of Italy. Half of the participants were aged between 50 and 79 and in normal health for their age, while the other half were aged 100 and older and in particularly good health. The younger group had an iAge that was higher than their chronological age while the older group had an average iAge that was 40 years younger than their actual age. This tallies with Sayed’s claim that iAge is a better marker of health than your birth date.
“iAge doesn’t necessarily have to increase over time,” says Sayed. “It’s basically an indicator that reflects the status of inflammatory markers in humans.”
His research showed that these inflammatory markers could also be used to predict who is most at risk of becoming frail as they age, or developing a heart condition called left ventricular hypertrophy, which raises the risk of heart failure.
Sayed’s team hope that their research will change the way doctors diagnose inflammation-related conditions. “Our test isn’t commercially available yet, but we hope it could be used to screen for these inflammatory markers as part of annual check-ups,” he says. “This could allow for early detection of a variety of chronic conditions including heart disease and maybe even type 2 diabetes and dementia.”
Those with a high iAge could then be forewarned of possible future health issues and take preventative measures. For example, they could start exercising more, change their diets, or begin taking medication.
Paula Mee, dietitian, food consultant, and author, believes that what we eat has a role in controlling the levels of inflammation in our bodies.
“There is no one food that is going to keep your system in balance,” she says. “Instead, it’s about how we combine foods over a period of time. Our diet in Ireland and the western world is often high in sugar and poor fats, and that combination is thought to be pro-inflammatory.”
The typical Mediterranean and Japanese diets are at the other end of the spectrum. “They are high in fruits and vegetables, fish which contain omega 3 fats, nuts, berries, seeds, seaweed, legumes, herbs, spices, and olive oil,” says Mee. “The synergistic effect of the good fats and antioxidants in these foods appears to reduce inflammation and contribute to other positive health effects such as improving blood pressure.”
She also points out that these diets tend to be low in processed foods. “It’s about what you don’t eat as much as it is about what you do eat,” she says. “Processed foods can contain free radicals which cause oxidation in the body, damage tissue, and lead to inflammation. In countries where people tend to live longer, healthier lives, they don’t eat excess sugar, much-processed meat, or many refined carbs. There’s a lot we don’t yet understand about how the mechanisms involved in our bodies breaking down food impacts our health, but one thing we do know is that too much processed food has a detrimental effect.”
While O’Neill is interested in Sayed’s team’s research, he is cautious about overstating its implications. “Testing for inflammation is important for some chronic diseases because it allows doctors to assess how serious the inflammation is or it may help with diagnosis,” he says. “However, I’m not sure how useful it would be the absence of any symptoms.”
He would like to see more evidence of the difference it could make to medicine. “Are the changes they are measuring causally linked to disease status,” he asks. “We know that inflammation increases as we age — ‘inflammaging’ is the term that is used — but there’s always a danger that correlation doesn’t equal causation. In other words, there may be a correlation between the changes and certain diseases, but that doesn’t mean that what is being measured is actually causing the disease.”
He points out that there are already ways of gauging inflammation levels in the body. C-reactive protein is a marker of inflammation that a simple blood test can already detect. “It’s the best measure there is at the moment,” says O’Neill. “It’s easy to measure and very reliable.”
O’Neill also cautions about focusing on one aspect of the body’s immune response at the expense of others. “There’s always concern that if you target inflammation, you’ll impair the body’s response to infection as inflammation and immunity are so entwined,” he says.
Nevertheless, he is looking forward to seeing further research in this area. “The key question for me is how useful this information will be,” he says. “Will it reveal new therapeutic targets to decrease someone’s iAge? Will it forestall or prevent disease?”
Sayed and his team hope so. “Our immediate plan is to extend our studies beyond the cardiovascular system towards neurodegenerative diseases such as Alzheimer’s,” he says. “Another avenue we are exploring is screening for compounds that can counteract the inflammatory markers in individuals who do have a higher iAge.”
In the meantime, both he and O’Neill agree on the basics. “We believe that having good healthy habits, including eating a balanced diet and exercising, can keep our iAge lower,” says Sayed.
“Maintaining a healthy lifestyle, which includes adequate sleep as well as exercise and a balanced diet, may limit inflammation as we age,” says O’Neill. “Perhaps these are the best things we can do currently.”
Mee thinks so, too, although she warns against believing we can entirely stop the body’s ageing process, inflammation, and disease. “Diet and exercise are important,” she says. “But most diseases are multifactorial. We can’t control everything in our bodies. We will all age. We can only do our best to do so healthily.”
Inflammation has become a buzzword in medicine. But what exactly does it mean and what can we do to control it?
1. According to Professor Luke O’Neill, inflammation is part of the immune system’s natural response to injury or infection. Your body sends inflammatory cells to attack the bacteria or heal the damaged tissue. This raises the blood flow to the area of injury or infection, which can cause redness, fever, swelling, and pain. Called acute inflammation, it usually lasts for a matter of days.
2. Chronic inflammation is when your body continues sending these inflammatory cells even when there is no injury or infection. Over time, this can cause damage to tissues and organs in the body.
3: Chronic inflammation is involved many serious health conditions, including Alzheimer’s disease, heart disease, rheumatoid arthritis, and type 2 diabetes.
4. Some lifestyle factors can contribute to inflammation in the body. You’re more likely to develop chronic inflammation if you drink alcohol in excess, are obese, if you smoke, or if you experience chronic stress.
5. Exercise is also thought to be a factor. Inflammation can result from repeated, intense exercise or not exercising enough.
6. Certain vitamins (A, C, and D in particular) and zinc can play a role in reducing inflammation. Spices such as turmeric, ginger, and garlic can also have anti-inflammatory properties.
7. Doctors may prescribe anti-inflammatory medication such as ibuprofen or steroids.
8: Dietitian Paula Mee believes that following an anti-inflammatory diet such as the Mediterranean diet can help too. This involves eating more foods such as oily fish, leafy greens, olive oil, and tomatoes while cutting back on foods that may increase inflammation, such as fried food, meats cured with nitrates, highly-refined oils, and trans fats, and refined carbohydrates such as sugar, pastries, and white bread.
9. Other steps you can take to control your inflammation levels include maintaining a healthy weight, quitting smoking, exercising regularly, limiting your alcohol intake, and managing your stress with tools such as meditation.
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