A growing number of products and routines – such as red light masks and de-puffing regimens – claim to fight the signs of inflammation. Many nutritional methods have proven to help chronic inflammation, too – such as eating a vegetable-heavy Mediterranean diet or more whole grains and omega-3-rich fish.
But cost and access issues can get in the way of these solutions. Plus, they may not address a major root cause, as increasing evidence says chronic stress can induce chronic inflammation.
To prevent and manage chronic stress, more health professionals are offering “social prescriptions”, or referrals to non-medical, community-based, de-stressing activities. Often, these activities are free or the costs are covered by another party, like an insurer or local non-profit.
Dr Alan Siegel, executive director of non-profit Social Prescribing USA and a family physician at Kaiser Permanente in Oakland, has prescribed community walks, painting classes and museum visits to his patients for over two decades. “Whether somebody walks into my office with type 2 diabetes or depression, I’ve seen how social prescriptions can help patients truly heal and adopt healthier lifestyles in the long-term.”
More than 30 countries and a dozen US states have social prescribing programs, which have led to improved health and reduced pressure on healthcare.
But even without a doctor’s note or a thick wallet, anyone can engage in these scientifically backed anti-inflammatory activities.
What is inflammation?
Inflammation – the body’s evolutionary response to infection, injury, or other threats – has been a trending topic in the health world. Some scientists have even called inflammation “the cause of all diseases”. But what actually causes inflammation, and what fights it?
In some contexts, inflammation is good. When the body faces an acute threat – say, an ear infection or a sprained ankle – it responds with acute inflammation, an immune system process marked by fever, swelling and pain in the affected area.
But in the face of chronic threats – say, from trauma or job stress – acute inflammation can also become chronic, and the immune, stress and cardiometabolic responses can become dysregulated. Research links chronic inflammation with low mood, cognitive impairment, cardiovascular risks and a range of mental health conditions including depression and dementia.
Spend time in nature
Forest-bathing – engaging in natural environments with all five senses – is a known wellbeing booster. But according to Dr Qing Li, professor of clinical medicine at Nippon Medical school in Tokyo, forest bathing can also help support healthy functioning of the Hypothalamic-Pituitary-Adrenal (HPA) axis, a key player in controlling the stress and inflammation response.
“Forest environments can promote relaxation and activate the parasympathetic nervous system, which is responsible for the ‘rest and digest’ functions,” says Dr Li. It can also reduce activity in the sympathetic nervous system, which is responsible for the “fight or flight” responses. By helping to prevent and manage stress, forest bathing can also help prevent and manage chronic inflammation.
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A series of Li’s studies show that forest bathing can reduce the stress hormones cortisol, adrenaline and noradrenaline. Other research similarly finds time in nature can reduce physiological markers of stress, like cortisol, and the perception of stress. One study found just 20 minutes of nature per day can make a difference in stress levels.
Engage with art and music
Art can also promote relief from chronic stress. In one study, healthy adults who participated in a 45-minute art-making session saw significantly lower levels of cortisol afterward.
Feelings of stress are related to a loss of control, says Dr Girija Kaimal, professor of creative arts therapies at Drexel University, who co-authored the study. Creating art helps us feel like “there’s something we have a sense of agency over” and “lets us take charge of the distress”.
The study’s participants self-reported that they found art-making relaxing, enjoyable, “freeing from constraints”, and conducive to flow and self-discovery. “Distraction is a great initial coping mechanism to help us calm down after a stressful event, but art can help us dig deeper – it helps us pay attention to what distressed us, and it’ll help the next time something similar sets us off,” says Kaimal.
It’s important to create “the kind of art that speaks to you,” says Kaimal – whether it’s writing, dancing, or drawing – and skill level doesn’t matter. “You want to get into a judgment-free zone where you can play and have fun without consequences.”
A growing body of research suggests experiencing art, not just creating it, can also promote inflammation reduction. Some research has found listening to music, for instance, can reduce blood pressure and cortisol. Researchers at the University of Florida have been documenting the health benefits of engaging with the arts, with some studies suggesting just one to three hours of related activity per week can reduce risk of depression and cognitive decline.
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Move your body
Beyond reducing stress, exercise is linked to a number of other anti-inflammatory benefits. This makes sense from an evolutionary perspective because bodily movement was often linked with fighting a predator or fighting for our lives, says Dr Michael Gleeson, emeritus professor of exercise biochemistry at Loughborough University. “The body puts its survival first,” and temporarily inhibits the inflammatory response so it can use energy more efficiently, he says.
In his co-authored research, Gleeson suggests exercise not only induces an anti-inflammatory environment in the short-term, but may also reduce visceral fat mass in the long-term. The accumulation of visceral fat can drive and worsen chronic inflammation by promoting development of insulin resistance, atherosclerosis and other diseases linked to physical inactivity.
Other research finds that exercise can significantly reduce production of pro-inflammatory proteins, such as CRP and IL-6, and increase anti-inflammatory proteins, such as IL-10.
To reap these and other benefits, the World Health Organization recommends adults spend at least 150 minutes each week on moderate aerobic activity, such as brisk walking and cycling, or 75 minutes on vigorous activity, such as running, Zumba or sports. A longitudinal study finds sports involving social interaction – such as tennis, badminton and soccer – are best at promoting health and longevity.
Support other people
Because cooperation with others has historically been essential for survival, our bodies have evolved to respond to the absence of social connections. The late neuroscientist Dr John Cacioppo compares this evolutionary response to hunger. Just as hunger signals the absence of energy and nutrients and cues the body to find food, loneliness signals the absence of social connections, and cues us to seek out or repair relationships.
That’s why multiple studies link feelings of loneliness and social isolation to a range of stress responses, including increased pro-inflammatory proteins and dysregulated cortisol function.
Conversely, studies link high levels of social support to lower cortisol, and link social activities like volunteering and giving social support to lower pro-inflammatory proteins.
Experience ‘awe’
Within all of these activities, the experience of awe – a feeling of being in the presence of something vast that transcends our current understanding of the world – can also reduce inflammation.
Dr Jennifer Stellar, a professor of psychology at University of Toronto, co-authored a study that links awe to greater positive affect and lower inflammatory proteins.
Further research is underway but Stellar suggests “that positive emotions can undo the effects of negative emotions, and negative emotions are associated with inflammation”. Another reason is that “awe makes us feel connected to others, and social connection has been documented to act as a buffer against inflammatory responses.”
So how can you encounter awe? Her co-author, Dr Dacher Keltner, a professor of psychology at University of Berkeley California and renowned awe expert, says that it can result from engagement with the “eight wonders of life”: the moral beauty of others, nature, collective movement, music, visual design, spirituality and religion, big ideas, and the cycle of life and death.
