East Jefferson General Hospital

Optimum Performance: Inflammation more than just aching joints

With NFL training camps now in full swing, those aches and pains the NFL players experience from daily participation in the collision sport of pro football will soon start to mount up. The common denominator these gridiron gladiators face during the NFL season, as well as, their respective careers is inflammation.

Inflammation is a normal physiological reaction to a bodily insult, and it is necessary for our survival. The Oxford Dictionary defines inflammation as a localized physical condition in which part of the body becomes reddened, swollen, hot, and often painful, especially as a reaction to injury or infection. When inflammation gets out of control, it can have a negative effect on our immune system, such as the case with certain forms of arthritis.

The symptoms of chronic systemic low grade inflammation, which, according to an article in July 2013 issue of the Journal of Nutritional Biochemistry, "is at the basis of many, if not all, typically Western diseases centered on the Metabolic Syndrome. Problems such as being excessively overweight (abdominal obesity), having impaired glucose (blood sugar) metabolism, elevated blood pressure, and an imbalance in your cholesterol profile -- all combine to form a metabolic syndrome profile -- which in my experience, is not uncommon to be found in NFL offensive and defensive linemen. Many of these players are obese with pre- hypertensive blood pressures (> 120/75), some with pre-diabetic blood sugar levels (>110mg/dl), and in some cases a poor balance between the so-called good (HDL) and bad (LDL) cholesterols –- leading to high- risk low- grade inflammation.

In the long run, these big men will survive the inflammation from the bumps and bruises but potentially succumb to the hidden forms of inflammation in their arteries long after their careers are over without addressing this dangerous issue. Just look at the situation of former Saint Norman Hand, who passed away at the age of 37 from just such an occurrence after he retired. So, inflammation of the chronic low grade type which can effect one's vascular system may predispose certain individuals over time to diseases such as type 2 diabetes, cardiovascular disease, certain cancers (breast, colorectal, pancreas), neurodegenerative diseases (Alzheimer's disease), pregnancy complications, fertility problems, and other diseases.

Let's help out our big guys down in the NFL trenches with some background on how lifestyle and nutritional imbalances from our typical Western diet may be to blame for placing them at risk beyond the regular collisions that go on each week in the NFL.

Environmental factors, which may cause chronic low- grade inflammation, include inactivity, a high fat (saturated / trans fat) diet, excessive alcohol consumption, a low fiber intake, high sodium (salt) consumption, and excessive sugar intake. The anti- inflammatory lifestyle includes being physically fit, consuming a Mediterranean style diet with emphasis on fiber, nuts, fish and fish oil, mono-unsaturated fats such as found in olive oil, lean meats, fruits and vegetables, teas (green), and alcohol (red wine) in moderation.

I could build a strong case that if NFL players followed a Mediterranean style eating plan, they might not require as many anti-inflammatory injections and medications to get through the season in one piece resulting from the associated pain and discomfort from the collisions they face in practice and games.

The Carolina Panthers have thus far eliminated much of their full contact in training camp opting for form tackling. Defensive players are yelled at if they make full contact with an offensive player causing him to hit the ground. As was stated by a Panther player, there is enough full contact in the four pre-season games coming up.

The New York Times reported in an August 1st cover story, New Rules at N.F.L.’s

Camps: No tackling. It’s just practice saying, “ it’s as if a bunch of touch football gamehave broken out.”

The same journal I referenced earlier in this article stated,” inflammation may be useful when controlled, but deadly when it is not. For example, head trauma may kill hundreds of thousands of neurons, but the secondary inflammatory response to the head trauma may kill millions of neurons or the patient.”

From a dietary standpoint, inflammation can be accelerated with an imbalance between the Omega 6 fatty acids - from certain vegetable oils, saturated and trans fats, too much red meat versus not enough Omega 3 fatty acids found in such foods as fish, fish oil, and flax seeds to name a few. “ Eating fish once weekly was associated with a 15% lower risk of CVD (cardiovascular disease) compared with consumption of less than once per month, while each 20 gram/day increase in fish consumption was related to a 7% lower risk of CVD mortality.”

In a 2009 study of active NFL players receiving fish oil supplements versus non users, “ the group given the omega 3’s showed an increase in the good cholesterol HDL and a decrease in the smaller, more dangerous forms of the cholesterol: LDL.”

A diet low in magnesium – found in foods like spinach, almonds, and cashews- “ scores high on the University of North Carolina’s “ dietary inflammation index.” You can add chronic stress, passive smoking, and environmental pollution, insufficient physical activity, and insufficient sleep to the list of pro-inflammatory stimuli.

The moral of this story is that inflammation is here to stay. But, exposure to low grade long term kind, whether or not you are an NFL player, is something you want to address with a sound Mediterranean eating plan and sensible exercise. Why not start right now.

Mackie Shilstone, a regular contributor to NOLA.com | The Times-Picayune, has been involved in the wellness sports performance industry for nearly 40 years. He is currently the fitness coach for Serena Williams and has trained numerous other professional athletes and consulted a litany of professional sports franchises. He's the Executive Director of the Fitness Principle with Mackie Shilstone at East Jefferson General Hospital. Contact him at mackieshilstone.com.