Inflammation is the human body’s natural response to protect itself against injury, infection, and illness. Trauma, exposure to foods (poor diet), microbes, and/or toxins, can commonly cause inflammation. Chronic inflammation can happen due to continued exposure to a trigger, such as when an injury hasn’t healed yet or when a person has unknown food intolerances, and due to immune system dysfunction. According to healthcare professionals, most chronic health issues are associated with chronic inflammation. Avoiding exposure to triggers and regulating inflammatory mediators released by the immune system with nutrition and physical activity can ultimately help reduce inflammation. In part 2 of the following series of articles, we will discuss eicosanoids as inflammatory mediators.

What are Inflammatory Mediators?

An inflammatory mediator is a messenger that acts on blood vessels and/or cells to promote an inflammatory response. Several well-known locally acting inflammatory mediators can include:

• Endothelins (endothelium) – vasoconstrictors
• Nitric oxide: endothelium, leukocytes, CNS
• Angiotensin II: systemic circulation
• Platelet-activating factor: mast cells and basophils, neutrophils, platelets, endothelium
• Eicosanoids (prostanoids, leukotrienes): leukocytes and most other cells

Eicosanoids: Intercellular Messengers

Eicosanoids are “locally-acting” inflammatory mediators or intercellular messengers produced by oxidation of 20-carbon long-chain PUFAs or polyunsaturated fatty acids. The essential fatty acids used to produce these signaling molecules are stored in membrane-bound phospholipids which are mainly affected by diet. Eicosanoids are short-lived inflammatory mediators that are synthesized as needed. Eicosanoids help regulate inflammatory reactions, such as redness, swelling, heat, and pain. These also help regulate smooth muscle tone (vascular, uterine, bronchial, GI) and vascular rheology. Moreover, these messengers can affect hormone secretion, nerve transmission, and mood. Several research studies have also found that these can potentially help lower triglyceride levels.

Eicosanoids are produced by two major types of enzymes: prostanoids and leukotrienes: Prostanoids are generated by COX, including prostaglandins, prostacyclins, and thromboxanes, while leukotrienes are generated by LOX, another type of enzyme. The specific production of these is determined by the number of predominant enzymes in different cells. Eicosanoids are synthesized as needed by diet from omega-3s in flax, walnut, chia, canola, fish, wild game, and enriched eggs as well as omega-6s in borage, black currant, sunflower, safflower, peanut, red meat, dairy products, and shellfish. An individual’s arachidonic acid (AA), an omega-6 fatty acid, to eicosapentaenoic acid (EPA), an omega-3 fatty acid, ratio is an important marker for inflammatory mediators, including eicosanoids.

AA (Omega-6)/EPA (Omega-3) Ratio

Healthcare professionals can measure AA (omega-6)/EPA (omega-3) ratio by plasma or whole blood. The total percentage of EPA and DHA is determined in red blood cell (RBC) fatty acids by serum or plasma although it is less accurate. The AA/EPA ratio can also be used as a biomarker for congenital heart disease (CHD) mortality. An omega-3 index of less than or equal to eight percent has been associated with the greatest cardioprotection while less than or equal to four percent has the least. Furthermore, the AA/EPA ratio can also be used as a biomarker for eicosanoid balance and cellular inflammation. An ideal AA/EPA ratio of less than 3 percent is ideal, while a ratio of 3 to 6 has a moderate risk, 7 to 15 has an elevated risk, and 15 has a high risk of potential inflammation.

Non-Classic Anti-Inflammatory Eicosanoids

A variety of different types of eicosanoids, known as non-classic anti-inflammatory eicosanoids, can come from omega-3s and omega-6s. Several well-known eicosanoids can include:

• Lipoxins: derived from AA
• Resolvins: derived from EPA and DHA: (production enhanced by aspirin)
• Protectins: derived from DHA
• Epoxyeicosatrienoic acids = EETs: derived from EPA & AA via CYP450 epoxygenase
• Isoprostanes: biomarker of oxidative stress (nonenzymatic peroxidation of EFAs)
• Endocannabinoids (e.g. anandamide): derived from AA

Finally, according to several research studies, essential fatty acids (EFAs) can also help improve a variety of health issues, including but not limited to the following:

• Allergy / asthma / eczema
• Autoimmune diseases, such as rheumatoid arthritis, systemic lupus erythematosus, and psoriasis
• Cardiovascular diseases, such as hypertriglyceridemia, hypertension
• Chronic kidney disease
• Neurodegenerative diseases, such as Alzheimer disease
• Mood disorders, such as depression and schizophrenia
• Dysmenorrhea
• Cancer cachexia

Inflammation helps protect the human body against injury, illness, and infection. Because most health issues are believed to be associated with chronic inflammation, regulating the inflammatory response is fundamental to promote overall health and wellness. Diet and exercise can ultimately help regulate inflammatory mediators, such as eicosanoids, which can cause inflammation. Eicosanoids are “locally-acting” inflammatory mediators or intercellular messengers. Eicosanoids help regulate inflammatory reactions, such as redness, swelling, heat, and pain. Moreover, these messengers can affect hormone secretion, nerve transmission, and mood. Furthermore, a balanced AA (omega-6)/EPA (omega-3) ratio can help promote the balanced release of eicosanoids. – Dr. Alex Jimenez D.C., C.C.S.T. Insight

---

Protein Power Smoothie

Serving: 1
Cook time: 5 minutes

• 1 scoop protein powder
• 1 tablespoon ground flaxseed
• 1/2 banana
• 1 kiwi, peeled
• 1/2 teaspoon cinnamon
• Pinch of cardamom
• Non-dairy milk or water, enough to achieve desired consistency

Blend all ingredients in a high-powered blender until completely smooth. Best served immediately.

---

Cucumber is 96.5% Water

Because they’re so naturally high in water, cucumber is also very low in calories. It only has 14 calories per 100g (3.5oz). That means you can nibble on it all day without worrying about your waistline.

---

Inflammation is the human body’s natural response to protect itself against injury, infection, and illness. Trauma, exposure to foods (poor diet), microbes, and/or toxins, can commonly cause inflammation. Chronic inflammation can happen due to continued exposure to a trigger, such as when an injury hasn’t healed yet or when a person has unknown food intolerances, and due to immune system dysfunction. According to healthcare professionals, most chronic health issues are associated with chronic inflammation. Avoiding exposure to triggers and regulating inflammatory mediators released by the immune system with nutrition and physical activity can ultimately help reduce inflammation. In part 2 of the following series of articles, we discussed eicosanoids as inflammatory mediators.

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas*& New Mexico* 

Curated by Dr. Alex Jimenez D.C., C.C.S.T.

References:

1. Wendell SG, Baffi C, Holguin F. Fatty acids, inflammation, and asthma. J Allergy Clin Immunol. 2014 May;133(5):1255-64. doi: 10.1016/j.jaci.2013.12.1087.
2. Balbás GM, Regaña MS, Millet PU. Study on the use of omega-3 fatty acids as a therapeutic supplement in treatment of psoriasis. Clinical, Cosmetic and Investigational Dermatology. 2011;4:73-77. doi:10.2147/CCID.S17220.
3. Jacobson TA, Glickstein SB, Rowe JD, Soni PN. Effects of eicosapentaenoic acid and docosahexaenoic acid on low-density lipoprotein cholesterol and other lipids: a review. J Clin Lipidol. 2012 Jan-Feb;6(1):5-18. doi 10.1016/j.jacl.2011.10.018.
4. Hu J, Liu Z, Zhang H. Omega-3 fatty acid supplementation as an adjunctive therapy in the treatment of chronic kidney disease: a meta-analysis. Clinics. 2017;72(1):58-64. doi:10.6061/clinics/2017(01)10.Neurodegenerative disease
5. Chiu CC, Su KP, Cheng TC, Liu HC, Chang CJ, Dewey ME, Stewart R, Huang SY. The effects of omega-3 fatty acids monotherapy in Alzheimer’s disease and mild cognitive impairment: a preliminary randomized double-blind placebo-controlled study. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Aug 1;32(6):1538-44. doi: 10.1016/j.pnpbp.2008.05.015.
6. Hegarty B, Parker G. Fish oil as a management component for mood disorders – an evolving signal. Curr Opin Psychiatry. 2013 Jan;26(1):33-40. doi: 10.1097/YCO.0b013e32835ab4a7.
7. Rahbar N, Asgharzadeh N, Ghorbani R. Effect of omega-3 fatty acids on intensity of primary dysmenorrhea. Int J Gynaecol Obstet. 2012 Apr;117(1):45-7. doi: 10.1016/j.ijgo.2011.11.019.
8. Giacosa A, Rondanelli M. Fish oil and treatment of cancer cachexia. Genes & Nutrition. 2008;3(1):25-28. doi:10.1007/s12263- 008-0078-1.
9. Dowden, Angela. “Coffee Is a Fruit and Other Unbelievably True Food Facts.” MSN Lifestyle, 4 June 2020, www.msn.com/en-us/foodanddrink/did-you-know/coffee-is-a-fruit-and-other-unbelievably-true-food-facts/ss-BB152Q5q?li=BBnb7Kz&ocid=mailsignout#image=24.