UA center studied how to fight inflammation before it was a medical buzzword

In a recent piece for the Atlantic, Dr. Jason Liebowitz, a physician and professor at Columbia University, sounds the alarm about what he sees as a troubling trend.

“Popular culture,” he writes, “has latched on to the concept of inflammation and made it a catch-all term for something amiss in the body — a bête noire for wellness gurus, health influencers, and the Make American Healthy Again movement.”

Liebowitz goes on to write about his experience treating patients who come in with misguided perceptions about inflammation — why they have it and how to treat it.

The current obsession with inflammation may seem new, but at the University of Arizona’s Andrew Weil Medical Center for Integrative Medicine, it’s an issue they’ve been studying for a long time.

The Weil Center, in fact, has a lot to do with the general public’s awareness of inflammation in the first place. Weil’s doctors advocate specific forms of diet and lifestyle to counter the negative impacts of inflammation, and their work is sometimes used as a scientific basis for the less reliable information that internet wellness culture spins into social media fodder.

Dr. Stephen Dahmer is a physician at Weil, and he says it’s important to understand what inflammation actually is. There’s good inflammation — it’s how the body reacts, for example, if you accidentally slice your finger while you’re cutting an apple.

But there’s also bad inflammation, where the body turns on itself and inflames internal organs and joints, leading to autoimmune diseases like IBS and rheumatoid arthritis.

As Dahmer recently told The Show, those conditions can be debilitating, and he understands the hunger for answers about how to treat them.

Full conversation

DR. STEPHEN DAHMER: Well, I think we always are looking for some form to better our health, and I think it’s long been held in many cultures that inflammation is a root cause of many diseases that we face. And we’ve been seeing also a lot of literature and science that support the importance of microbiome, an altered microbiome and the inflammation that can ensue from that and how that might impact the body’s overall health and trigger disease.

So I think, like many things, it’s a perfect storm of a culprit to point to that makes intuitive sense. And science even has supported it in ways to showcase how there might be a way that this can contribute to disease.

SAM DINGMAN: And am I right to make a possible association there between — just since you brought up the microbiome — we have also in recent years, and particularly in the last couple of years with the rise to prominence of figures in the so-called MAHA movement, we’ve seen an increase in scrutiny on things like artificial dyes in foods, these sorts of things.

Is the idea that because of the increased scrutiny of things like that that is leading some folks to wonder whether there is a correlation between those things and an increase in inflammation in the body?

DAHMER: Yeah, I think this concern for inflammation being a driving force for many illnesses and symptoms and disease processes long predated that. But I think that has it been a perfect storm where that’s really added to the discussion of inflammation, where it rises to the point of articles and things that become mainstream.

DINGMAN: So a lot of the work that you and others do at Weil is around lifestyle and in particular diet.

DAHMER: Absolutely. Since the time of Hippocrates, where it was more anecdotal and would observe these clear connections between right nutrition and better health, and wrong nutrition and worse health, we’ve seen a whole slew of science that supports the connection between nutrition and our overall health, specifically chronic disease.

And if we want to hone in on the area of inflammation, one, I would just say that it’s difficult. It’s difficult for our gold standard — a randomized, double blind, placebo-controlled trial — to do that with a dietary intervention.

University of Arizona

This is not a single-drug intervention. So it becomes much harder to do that work. And oftentimes the support or even the funding for it is not as prominent. Yet the studies exist. One that was a randomized, controlled, single-blinded crossover study in rheumatoid arthritis found positive effects of anti-inflammatory diet. That’s where we’re really looking at omega 3 fatty acids, fiber, probiotics and how that impacted in a positive way disease activity scores in rheumatoid arthritis patients.

It’s not binary. It’s not that you can utilize a DMARD or the latest of pharmaceutical interventions for an autoimmune disease, or you can approach a dietary and lifestyle modification for your disease. The two go best hand in hand.

And it’s truly our belief that that combination of integrative medicine, right, the lifestyle intervention with the latest in pharmaceutical therapies is what will afford best outcomes for our patients.

DINGMAN: And I know that you guys also advocate for things like yoga, meditation, tai chi in concert with dietary adjustments.

There are folks who follow wellness influencers online who are concerned that it is in fact some of the medicines that have created these conditions of chronic inflammation that they feel like they’re struggling with.

What is your reaction to that, since a moment ago you were talking about the fact that it is through the combination of some of the things that you recommend at Weil and pharmaceutical interventions that these treatments can be really effective?

DAHMER: Yeah, I think that’s a wonderful question. And I think that when you’re a physician on the front lines for 20 years, as I’ve been — I came from clinic this morning, Sam — is health and personal health is very nuanced. And across the board. Do I believe in an FDA process that approves these medications that have anti-inflammatory effects on those that suffer from autoimmune disease? Absolutely.

They have a tremendous role in helping patients with quality of life better manage their disease. Do they actually trigger inflammation? You can find different ways to unravel that, right. If you are on a strong, extremely strong anti-inflammatory like prednisone and you remove that prednisone, is there a rebound effect where inflammation might occur when you pull that drug away?

I believe that there is. Does that mean that the drug actually caused inflammation? No, I wouldn’t say that. But this is the challenge, right, in really meeting people where they’re at and addressing their concerns specifically and head on as it relates to their body and their disease.

DINGMAN: Are you concerned at all that there is somewhat of a culture of distrust amongst some in this wellness movement towards the medical establishment, which I imagine you would consider yourself to be a part of, and that because of that culture of distrust, people are going more towards influencers and folks of that nature and not getting good information?

Whereas you’re saying that there may in fact be some truth to some of the things that they’re finding online. But a person in your position, if I’m hearing you correctly, is in the best position to help somebody truly identify what’s happening.

DAHMER: Yeah. And I think that, you know, you’re hitting the nail on the head, Sam, is the why behind the why. And that’s something that we really try to explore within integrative medicine. I would absolutely agree we’re seeing increasing distrust of the medical system. I feel it as a physician on the front lines.

And why is that? Oftentimes, you know, in integrative medicine we like to, rather than ask a patient what’s the matter, what matters most? And their quality of life, their stress. It’s that patient perspective I think sometimes we’re missing in modern medicine. And rather than meeting a patient where they’re at and establishing rapport, we throw the baby out with the bathwater.

And anything but the pharmaceutical intervention is on the wrong side of right, which the patient is going to take issue with and will walk away with increased distrust of the system. And I think sometimes we have to be frank of the limits of what we know, but phrase it in a way that can establish rapport that helps a patient to understand.

We don’t know all the nuances of inflammation, nor exactly why you got this disease, but these are our approaches to best improve your life.