Synopsis: Low-level systemic inflammation is being tied to many disorders including heart disease, and now research has even tied inflammation to intermittent explosive disorder, a syndrome of repeated rage. Experts discuss these findings and how inflammation can be combatted through diet and supplementation.

Host: Nancy Benson. Guests: Dr. Melina Jampolis, nutrition specialist physician and author, The Calendar Diet; Dr. Emil Coccaro, Professor and Chairman of Psychiatry and Behavioral Neuroscience, University of Chicago.

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Nancy Benson: Whenever you cut your finger or have a sore throat, your body responds with inflammation. The blood vessels dilate and infection-fighting cells flood the area. It results in heat, redness, swelling and pain. All of those responses are uncomfortable, but without inflammation, we’d be in trouble.

Dr. Melina Jampolis: You need some inflammation in your body. If we didn’t have it, you’d be exposed to a cold and we’d all be in the hospital. But you don’t need that much. When you have too much over time, that’s when you get into the negative health consequences.

Benson: That’s Dr. Melina Jampolis, author of The Calendar Diet and one of only a few hundred board-certified nutrition specialist physicians in the United States.

Jampolis: What we’re really talking about is silent inflammation, so it’s not necessarily something that you see or feel; it’s more of a low-grade inflammation throughout the body. And what we’ve learned in the last decade or two is that that seems to be at the core of many diseases like Alzheimer’s, diabetes, heart disease, even cancer, in addition to obviously a genetic component and an environmental insult. But inflammation is really a key part of the evolution of many of these diseases.

Benson: With heart disease, for example, we used to think that cholesterol was the biggest factor in creating life-threatening arterial blockages. Now we know that runaway inflammation is often to blame, leading to a buildup of infection-fighting cells that blocks the arteries. And now there’s yet one more major problem that’s been linked to inflammation–a syndrome of repeated violent rage called “Intermittent Explosive Disorder” or IED.

Dr. Emil Coccaro: These are people who blow up when they’re frustrated by something or there’s some kind of threat.

Benson: Dr. Emil Coccaro is professor and chairman of psychiatry and behavioral neuroscience at the University of Chicago. He says people with IED have quick triggers and no brakes on their tempers. They frequently lash out or throw things in a rage in response to a relatively mild provocation.

Coccaro: The average person doesn’t blow up very often because he has a very high threshold at which point to blow up. But people with IED have a much lower threshold so they do it more frequently and it gets them into trouble.

Benson: Coccaro’s study in the journal JAMA Psychiatry shows that people with IED have much higher levels of inflammation in their bodies, as shown by two chemical markers. The more of those chemicals in the body, the more violent and more frequent the rage. That would make explosive anger more than a character flaw– it’s a medical condition that can lead to other mental issues.

Coccaro: The average age of onset for somebody with IED would be somewhere in the teen years and the average age of onset for, let’s say, depression or bipolar or those other kind of disorders is likely to be later in time. So the IED can come first and it might be a gateway disorder to these other disorders. You can obviously see how if you’re making a mess of your own personal life and/or work life how you could get depressed later down the road or you could get anxious. But the aggressive behavior does tend to precede those other mental issues.

Benson: If high levels of inflammation are behind explosive rage, it’s no wonder anger management courses often don’t cure it. But it may be more than just inflammatory chemicals at work. Coccaro says a brand new study finds a double dose of physical issues in people with IED.

Coccaro: It looks like people with anger problems not only have chronic low levels of inflammation but also chronic low levels of oxidative stress. Which would explain some of the medical problems these folks all get later down the road, such as problems with arthritis, problems with heart disease, stroke, and those other kinds of things.

Benson: But none of that means that inflammation is necessarily the cause of the rage, or that we even know which one comes first. But Coccaro says we have some pretty good clues.

Coccaro: In animal studies though, when they’ve infused levels of let’s say IL2 or IL6 into the brains of let’s say cats, they can induce defensive rage which would certainly suggest that elevated forms of those markers could be causative. We’re not really gonna know yet.

Benson: Does that mean that a healthy dose of anti-inflammatory drugs could help curb explosive rage? Research on humans is just beginning, so we can’t say yet that an aspirin a day keeps anger away. But Jampolis says there are plenty of other reasons–and other ways–to limit runaway inflammation in the body.

Jampolis: That’s one of the most exciting things is we can really control this to some extent. It’s not just taking all those bad foods out, it’s also the foods that you put in that help fight inflammation on the cellular and molecular level.

Benson: Jampolis says that scientists are paying close attention to the ratio of omega-6 and omega-3 fatty acids in the diet as a source of inflammation. Omega-3’s are good. Omega-6’s are bad.

Jampolis: There are omega-6 fatty acids that actually are pro-inflammatory. Where do they come from in our diet? They come from a lot of the vegetable oils that we’re consuming that are substantive — the corn oil, the soybean oil, the sunflower. So those are rich in omega-6. We’re consuming a lot more of those and those trigger a pro-inflammatory reaction by the body. And omega-3 fatty acids, for example, on the other hand trigger an anti-inflammatory reaction.

Benson: The best natural source of omega-3’s is fish. Thousands of years ago, fish were more a part of the diet, so Jampolis says most cavemen probably consumed about a two-to-one ratio of omega-6’s to omega 3’s. Today, almost no one achieves that. Even the Mediterranean diet that’s famous for health promotion has a ratio of about three-to-one. And the standard American diet? Jampolis says it’s more like 20-to one. That’s why she recommends something extra.

Jampolis: When it comes to supplementation, purity and potency are a very important part of the equation. The average supplement that you can get inexpensive really only has about 30% purity so the rest of it is different fats and the fish oil, saturated fat, it may even have some impurity. So the company that I’m working with now, Omax3 has a 91% pure fish oil product. This wasn’t possible; to have this pure of a supplement was impossible 10 years ago because we didn’t have the technology to distill these omega-3 fatty acids. So this is really a newer category, but I think in this one particular instance purity is not a marketing hype and you get what you pay for to some extent. But if you’re taking 1,000 mg of fish oil and you’re only getting 300 mg of EPA and DHA, that’s gonna have health implications. You’re not going to have the benefits that you would from a more pure supplement.

Benson: Jampolis says it’s likely that inflammation will get more and more attention in the future. Tests for inflammation markers like c-reactive protein may become more common. And if people score highly, they could be prescribed a regimen to reduce it the same way people now take drugs for high cholesterol.

You can find out more about Dr. Melina Jampolis at You can learn more about all our guests through our website,

Our production director is Sean Waldron.

I’m Nancy Benson.


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