Anti-inflammatory Medications

Anti-inflammatory Medications

If inflammation plays a key role in the aging process, what about taking over-the-counter anti-inflammatory drugs like aspirin?

Aspirin

Aspirin has been shown to extend the lifespan of mice and other model organisms. It has existed in tablet form for over 100 years, and it is probably the most widely used drug in the world. But we have been using its active anti-inflammatory ingredient, salicylic acid, for thousands of years, in its natural form (as an extract from willow bark), to relieve pain and fever. One reason it remains so popular, even though there are now better anti-inflammatory painkillers, is that millions of people take it daily as a blood thinner to reduce their risk of heart attack.

The benefit of taking aspirin daily must be weighed against the danger of complications from internal bleeding. In my video see.nf/aspirin I go through all the numbers. In short, daily aspirin use is generally not recommended for people who have no known history of heart problems or stroke, especially not for older people, since the risk of bleeding complications rises massively in those over 70. How can we benefit from the anti-inflammatory effects without the bleeding risk?

Aspirin actually consists of two active components. Technically, it is acetylsalicylic acid. Within minutes after we take it, enzymes in the intestine split it into an acetyl group and salicylic acid. The acetyl group is the part that disables our platelets and thins the blood. If we could take salicylic acid directly, we would fight inflammation without the bleeding risk. And we can accomplish that through diet.

Vitamin S

In my chapter in How Not to Die about how to avoid an iatrogenic (doctor-caused) death, in discussing aspirin I note that willow is not the only plant that contains precursors of salicylic acid. We find others in the plant kingdom in many fruits and vegetables. In fact, the blood levels of people who eat plant-based match those of some people taking low-dose aspirin, but the former likely have a substantially lower risk of stomach ulcers, thanks to the gut-protective nutrients that are packaged along with the salicylic acid in plants.

In whole, organically grown, unpeeled plants, these aspirin phytonutrients are especially concentrated. Among the best are beets, peas, avocados, dates, nuts, cocoa, lentils, and buckwheat, but the highest concentrations are found in herbs and spices. Dried basil, chili powder, coriander, dried oregano, paprika, and turmeric are rich in the ingredient, but the largest amount per serving is found in cumin. A teaspoon of ground cumin can contain more salicylic acid than a “baby aspirin.”

The more heavily spiced, the better. According to calculations, a hot vegetable vindaloo contains four times as many salicylic-acid-like components as a milder vegetable dish in Madras style. In rural India, one in four vegetarians tested had blood levels that were above the lower segment of people taking aspirin daily. That could explain why India, with its traditionally spice-rich diet, is among the countries with the lowest colon cancer rates worldwide—the cancer that appears to be most sensitive to the effects of aspirin.

The benefit of salicylic acid is another reason you should try to choose mostly organic fruits and vegetables. Since a plant uses the compound as a defensive hormone, its concentration can be increased when it is nibbled by insects. Plants treated with pesticides are nibbled on less, and presumably for that reason they produce less salicylic acid. In one study, for example, it was found that a soup made from organic vegetables contained almost six times as much salicylic acid as a soup made from conventional, non-organically grown ingredients.

With so many facts arguing in favor of aspirin, some in public health believe salicylic acid should be classified as a vital “vitamin S” to counter widespread “salicylic acid deficiency.” Whether it is the salicylic acid or a combination of other phytonutrients that accounts for the benefits of whole plant foods, the solution is the same: Eat more of them.

Food for thought

You can think of getting old as an inflammatory disease. If you measure inflammatory markers such as CRP or IL-6, their values can be used to predict physical and cognitive performance as well as the remaining lifespan of older people. In one study that followed thousands of people over time, of those with age-related diseases and a CRP level above 10 milligrams per liter, only one third were still alive five years later, whereas among the participants with a CRP of at most 3 milligrams per liter, only one third died over the same period.

Fortunately, severe inflammation can be soothed by dietary change. Those who eat little pro-inflammatory food in middle age will probably age more successfully, meaning: independent living without serious chronic diseases, without depressive symptoms, without function-limiting pain, and with the feeling of being generally healthy—socially, physically, mentally. The associated extension of health span and lifespan suggests that anti-inflammatory could be synonymous with anti-aging.

To help slow this path of aging, you should daily:

mTOR

It sounds like science fiction: Bacteria in a vial with soil from a mysterious island create a compound that extends life. Scientists named it rapamycin—after the origin of the bacterium, the mystical Easter Island, which the locals call Rapa Nui and which is famous for its stone figures. Rapamycin inhibits the enzyme mTOR (mechanistic target of rapamycin, “target molecule for rapamycin”). mTOR has since been described as a “determining factor for life expectancy and aging.”

Full speed into old age

So what does the enzyme actually do? mTOR is the biggest growth driver in animals, and when it is activated, cells grow in size and number.

When we are young, mTOR keeps us alive and promotes our development, but when we get older, it acts like a cinder block on our ankle, pulling us down.

mTOR is, so to speak, the engine in a “runaway car with no brakes.” In this comparison, aging is a speeding car that barrels into the 30-mph zone of adult life and wreaks havoc because it can’t brake. Living beings have no brakes because they never needed them. In the wild, animals often do not grow old. Most die before they are adults, and in the past the same was true for humans. In the 17th century, for example, in London most people died before their 16th birthday.

With mortality so early, living beings have to grow as quickly as possible to reproduce before they are killed by external forces. Perhaps in that case the best evolutionary strategy is to drive at top speed. But once we have crossed the finish line, won the race, and passed on our genes, we keep clattering along at an unsustainable speed anyway, in part because of this enzyme. In childhood, mTOR is a growth engine, but in adulthood it can be viewed as a driver of aging. Nature chooses the brightest light, which then in turn casts the darkest shadow.