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"The Link Between Inflammation and Chronic Illness" by Dr. Janet Volpe

In the United States, chronic illness is on the rise. From 1994 to 2006, the rate of chronic conditions in U.S. children more than doubled, increasing from 12.8% to 26.6% according to a study published in the Journal of the American Medical Association in 2010.

Chronic illness is debilitating, reducing quality of life including decreased time that children would be engaged in activities such as attending school or simply having fun playing. Chronic illness often requires children to take daily medication, or utilize specific health services, or even require them to need special equipment. Chronic illness is expensive, according to data from the Centers for Disease Control, chronic medical conditions accounted for 75% of total U.S. health care spending in the private and public insurance sectors, reaching $1.5 trillion in 2005 (CDC Chronic disease overview page, 4/6/2007).

Why are chronic illnesses on the rise? Though it is true that our ability to diagnose chronic conditions may be improving because of better tools and assessment skills over the past few decades, it also well documented that our society’s ecology has also shifted during this time. We are exposed to more toxic stressors, the Standard American Diet (high in sugar and processed foods) lacks essential nutrients and necessary fiber, we aren’t getting enough exercise or sleep, and we are spending too much time on our electronic devices.


What Causes Chronic Illness?

Chronic illness is a result of chronic inflammation. Chronic inflammation is a biochemical reaction that develops when the body out of balance.

Inflammation itself is not a bad thing. In fact, the temporary form of inflammation is necessary for the survival of humans. It is a vital biological response to an acute stressor such as a burn, a cut on skin, a head cold or a stomach virus, to name a few examples.

There are two types of inflammation: acute and chronic.

Acute, or temporary, inflammation has a beginning, middle and end. It begins when the body realizes it has been exposed to a stressor. The part of the body that becomes activated when exposure to a stressor has occurred is called the immune system. The immune system is responsible for getting rid of the stressor, and releasing and activating specific chemicals to promote healing and minimize tissue damage. Acute inflammation ends when the effect of the stressor is gone.

Chronic inflammation develops when the release of these chemicals do not come to their normal ending. Either the stressor does not go away or these chemicals continue to perceive the body is under attack. Ongoing release and activation of these inflammatory chemicals can then cause direct damage to tissues in the body.

How to Treat Chronic Illness

As a pediatrician, my main goals in evaluating patients with ongoing health conditions are to identify factors that may be causing chronic inflammation that is contributing to their condition, and to work with them and their families to modify these factors so they are in a better position to achieve balance at the cellular level.

There are eight major factors contributing to chronic illness in children. They are:

  • Diet

  • Substandard Gastrointestinal Functioning (“Leaky Gut”)

  • Infections

  • Toxins

  • Stress – Physical and Psychological

  • Genetics

  • Physical Inactivity

  • Poor Sleep Hygiene


Any one of the above factors alone has the ability to disrupt the complexity of keeping a human in balance, resulting in chronic inflammation and therefore chronic illness. Imbalance of the human body can occur when there is either deficiency of a needed substance (dietary nutrient, clean air, being nurtured), and/or an excess of a toxin (lead, pesticide, abuse/neglect). Let’s look at each of these factors in more detail.


An imbalanced diet with lack of appropriate micronutrients, including vitamins and antioxidants (chemicals in the body that can prevent or slow down cell damage), can trigger inflammation because micronutrients are necessary co-factors or helpers that allow the body to perform vital functions at the cellular level to stay in balance.

Certain foods can trigger inflammation because the body might be genetically programmed to respond as if being attacked when that food is consumed. Foods with high sugar content may provoke a hormonal response that disrupts normal cellular metabolism. A food also might contain a pesticide or other chemical residue that can cause harm at the cellular level after a person ingests it. Additionally, residues or toxins from our environment that are not only eaten but incorporated into our bodies from our skin (personal care products) or lungs (breathing pollution), also have the ability to potentially trigger a chronic immune response.

Leaky Gut

Toxins may directly damage the gut by causing the cells that line the intestines to physically separate from each other resulting in a more permeable or “leaky gut”. This small but significant separation can then allow toxins including pesticides, partially digested proteins and bacteria, to enter into the blood stream. The immune system may them as foreign invaders and if so, can mount an immune response that creates further inflammation. That inflammation might occur right at the gastrointestinal tract or the inflammation may occur elsewhere such as joints or the skin because the bloodstream may carry these “foreign” particles to other parts of the body.


Chronic underlying infections such as intestinal parasites or certain types of viruses can continue to stimulate the immune response in an overactive manner and result in chronic inflammation.


Both physical and psychological stress can cause the body to produce and release increased amounts of specific hormones that can cause abnormalities to immune system functioning. Recent studies have shown increased stress hormones directly contributing to leaky gut.


Genetics dictates not only obvious traits such as our height and hair color, but it also makes us distinct from one another at the cellular level in terms of our biochemistry. This explains not only why one person may react negatively to a certain food otherwise tolerated by most people, but also why a toxin might build up in an individual, where most others could easily clear it from their body.

Physical Inactivity and Poor Sleep Hygiene

While genetics may not be easily modifiable, the other factors contributing to chronic illness, including level of physical activity and sleep quality, are based on lifestyle and environmental influences, and often have the ability to be changed. And with changes comes the potential for balance.


  1. Journal of the American Medical Association 2010; 303(7), 623-630

  2. Centers for Disease Control, Chronic Disease Overview, April 6, 2007

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