Some of my patients start their day with stimulants (caffeine) and end with relaxants (the foods they’re addicted to or glass of wine or beer every night). All of these things have a cumulative effect on chronic inflammatory conditions. But how much of an effect? Let’s look at how three major players affect inflammation: sugar, caffeine, and alcohol. This low-grade inflammation contributes to the development of numerous age-related chronic conditions1 including nonalcoholic fatty liver disease (NAFLD), type 2 diabetes, and cardiovascular disease that may lead to a heart attack. Sugar also contributes to obesity, characterized by a chronic low-grade inflammation2 in fatty tissues as well as systemically. With obese people, we see an increased immune response within fat tissue that researchers call metabolic inflammation2. Sugar, especially added sugar in processed food, can also result in insulin resistance3. In this condition, your pancreas works on overdrive, secreting ever higher amounts of insulin because your cells have become resistant to “hearing” this hormone signal. Insulin resistance can lead to metabolic syndrome, a major cause of heart and vascular disease, and diabetes—all major causes of health problems that can destroy your quality of life. Insulin resistance also perpetuates the vicious cycle of inflammation. Chronic inflammation, in turn, fuels insulin resistance4. Once it gets kicked off by excess sugar and processed carbs in the diet, it’s hard to shut off. More problematic are the so-called healthy sugars in foods like agave-sweetened cookies, almond and other nut milks, and even fruit. Large amounts of fructose3, even from healthy foods like fruit, can create or exacerbate insulin resistance and inflammation. Insulin resistance doesn’t exist in a vacuum; it also leads to other imbalances that fuel the inflammatory fires. Take leptin, a very important hormone that regulates your feeling of fullness. The more leptin in circulation, the less hungry you should be. However, the brains of people who are obese do not respond to the leptin signal. Their levels are high, but these levels are not sensed by their brain to signal that they are full and they should stop eating. That leads to another problem—leptin resistance—leaving you hungry when you’ve already had all the food you need for fuel. Too much sugar leads to insulin resistance, which leads to leptin resistance, resulting in weight gain—all of which increase inflammation. All carbohydrates convert to sugar in your body. Some convert more quickly than others. If you eat a food containing gluten (such as pasta) and you have a sensitivity to that food, that will only add more fuel to your inflammatory levels. Want to dial down inflammation? Start with sugar, in all its many forms. I see this in my own practice: Some patients do fine on three or four cups of black coffee in the morning, while others get jittery on even a few cups of green tea. Everyone responds to caffeine differently. Knowing your body means tuning in to the signals it gives you. If you feel jittery after two cups of coffee, then dial back down to one cup once daily. It all depends on whether you are a slow metabolizer or fast metabolizer. For myself, I’m a slow metabolizer, so one cup of coffee will leave me feeling jittery for hours. As a result, I decided to give up coffee altogether and instead drink tea for caffeine because of its more measured, tempered effect. Now don’t get me wrong, I did love the taste of coffee, but I value an internal sense of calm more than the accelerated fuel coffee can offer. Caffeine can also be dehydrating, so I encourage patients to stay ahead of their hydration. Drink at least 64 fluid ounces of clean, filtered water daily, or even more depending on your caffeine habit. However, large amounts of alcohol can create intestinal inflammation8 through multiple pathways. A vicious cycle ensues as the inflammatory response exacerbates alcohol-induced organ damage, affecting your gut but also other organs, like the liver. Some people also enjoy a glass of dry red wine as their dessert. For others, a glass becomes two, and before they know it, they’re devouring a second piece of pie. In other words, know how alcohol makes you behave, as it disinhibits your brain control centers and will lead you to overindulge in the other contributors to inflammation. Like caffeine, alcohol can be dehydrating. Be especially mindful to drink sufficient water when you’re drinking. Certain situations like drinking while flying can be even more dehydrating, potentially exacerbating inflammation. A cutting-edge nutrition deep dive taught by 20+ top health & wellness experts