Your Spring Cleaning To-Do List for Fighting Flares
Toxic relationships? Bad food choices? It’s time for these and other common inflammation triggers to hit the road.
It’s easy to fall into a rut with behaviors that work against us—we’re only human and our busy lives can make it hard to focus on healthy habits as much as we’d like to. When you have a chronic inflammatory condition—like psoriatic arthritis, ulcerative colitis, or rheumatoid arthritis—letting some not-so-stellar lifestyle behaviors take the wheel can end up working against you and your health in more ways than you think.
“Lifestyle habits contribute to a really large extent to development of flares in inflammatory diseases,” says Elizabeth Volkmann, M.D., assistant clinical professor of medicine in the division of rheumatology at the David Geffen School of Medicine at University of California-Los Angeles and director of the UCLA Scleroderma Program.
By focusing on a few key habits and doing a little spring cleaning of sorts, you can cut back on common potential triggers and reduce your risk of flares. Bonus: You’ll feel healthier and happier, too.
Dust Off Your Daily Meditation Routine
When it comes to inflammation triggers, stress gets bragging rights as the most powerful of them all. “When we experience a stressor, it causes an increase in cortisol levels, the hormone that gets activated when someone feels stressed or threatened in some way,” Dr. Volkmann explains. It’s the classic fight-or-flight response: Cortisol triggers a surge in energy to either flee or fend off whatever is threatening us. But an increase in cortisol also compromises the immune system and can cause system-wide inflammation—making people more susceptible to getting sick and having a flare of their chronic inflammatory condition, Dr. Volkmann explains.
Having chronic low-grade stress is worse than experiencing one big stressful event, Dr. Minhas says. “Accumulative day-to-day stress puts the body in a constant state of fight-or-flight, releasing more cortisol,” she explains.
Stress can also cause other lifestyle changes that are bad news for inflammation. It can lead you to sleep less (or poorly), eat unhealthy foods, skip exercise, and more. “A lot of things get shifted when we go through stress, and those can be big triggers,” Dr. Volkmann says.
You obviously can’t just wake up one day and cut all the stress out of your life. (If only.) To help train your body to handle stressful things better so that you can stay calm, Dr. Minhas recommends working on mindfulness. That doesn’t mean you need to meditate for hours each day—though meditating is an excellent way to practice mindfulness, and there are a lot of great free guided meditation apps and videos on YouTube that can help you get started. You can be more mindful by just focusing more on what you’re doing and being more present, Dr. Minhas says.
“Mindfulness is just noticing what you're doing while you’re doing it and not judging yourself,” she says. The easiest way to incorporate it: Pick any activity you do every day and try to be more focused and mindful throughout. For example, when you’re brushing your teeth in the morning, instead of stressing over the looming deadlines at work, think about how you’re holding the toothbrush, and how you’re putting it on your teeth. “Pay attention to all the sensations,” Dr. Minhas says. Honing this ability to be present and focused and do things meaningfully can help you manage and react to stressful situations better. “There really is something to this,” Dr. Minhas says.
Sweep Away Your Sugar Habit
The foods you eat can have a big impact on inflammation. While some people can pinpoint specific foods or ingredients that trigger flares, anyone with an inflammatory condition can benefit from avoiding foods known to cause inflammation.
Research shows that eating sugar promotes a low-level inflammatory response in the body. A diet high in saturated fats and trans fats is also associated with higher production of pro-inflammatory molecules in the body, which can lead to things like swollen joints, gastrointestinal (GI) issues, and skin flare-ups, depending on your chronic condition.
Avoiding high-sugar foods can also help you manage stress better, Dr. Volkmann says. “Sometimes people use sugar to give them energy to stay up late or get something done, but there’s always a high and then a low that happens. When people withdraw, they can feel lethargic and tired and be less able to deal with stressors around them,” she says.
Heavily processed foods may also contribute to inflammation. “There’s a lot of research showing food with additives and preservatives can alter gut bacteria,” Volkmann says. “When this happens and the balance of good and bad bacteria gets disrupted, it can cause inflammation in other parts of the body.” Volkmann recommends avoiding processed, packaged foods that contain a long list of ingredients beyond actual whole foods. If there are more words on an ingredients label that you don’t recognize than ones you do, odds are, it’s not great for your flares—and probably a good idea to skip it.
So, what should you eat? Deeba Minhas, M.D., a rheumatologist and clinical lecturer at Michigan Medicine in Brighton, MI, says that the so-called Mediterranean diet—based around plant-based foods plus fish and moderate amounts of dairy, poultry, and eggs—seems to be the best anti-inflammatory way of eating. In fact, a research review published in the journal Endocrine, Metabolic & Immune Disorders Drug Targets found that the Mediterranean diet may have a powerful anti-inflammatory effect and also help protect against cardiovascular disease.
Scrub Out Late Nights
“Lack of sleep can be a huge flare trigger,” Dr. Minhas says. “The body heals itself when you’re sleeping, so if you don't sleep enough, you set your body up for a flare.”
The best way to set yourself up for good sleep is to clean up your habits around sleep (coincidentally, also known as sleep hygiene), so that your body and brain are primed for sleep when it’s time to get some shuteye.
Start by establishing a nightly routine. “The body gets used to habits, so if you stick to a routine, that can help quite a bit,” Volkmann says. Set a bedtime for yourself and keep it consistent as much as possible. Establish some sort of pre-sleep ritual, like taking a relaxing warm Epsom salt bath, reading a book, or listening to peaceful music. “It’s really difficult to go from an intense job situation and come home and expect to fall asleep right away,” Volkmann says. Your pre-sleep routine should help get your mind into a more peaceful place.
Another important part of good sleep hygiene is avoiding screens before bedtime. Dr. Minhas recommends avoiding electronic devices for at least an hour before bed—the blue light that electronic screens emit can interrupt your body’s natural melatonin production, which interferes with your ability to get good sleep. It basically activates your brain and tells it it’s not nighttime anymore, Dr. Volkmann explains.
Organize Your Work-Life Compartments
Stress fuels inflammation, and for many people, work is a huge source of constant stress. During the COVID-19 pandemic, it’s become much harder to compartmentalize work and life.
“What’s happening a lot now is many people are working from home, so there’s less separation between working and home life and sometimes that line gets really blurred,” Dr. Volkmann says. It’s too easy to just stay on Zoom calls until 8 p.m. if you don’t need to commute or travel anywhere at the end of the workday. Letting work encroach on your relaxation time can put you more on edge than ever before.
Dr. Volkmann suggests setting—and sticking to—a daily cut-off time, after which you don’t take phone calls or answer emails (unless it’s a true emergency). Try scheduling something for right after work, like a 6 p.m. walk with a friend, to help make sure you stick to your guns and actually shut down your computer. She also recommends taking breaks during the day. “In a workplace setting, you'd get up and go to the break room or have lunch with a colleague and move away from the screen a little bit, but when working from home, you can just stay glued to it the whole time.” If you can, set aside 15 minutes every now and then for walk breaks—preferably outside. Just getting up and stepping away physically and mentally for a short time can make a big difference.
Tidy Up Toxic Relationships
Having supportive people in your life can be extremely helpful when you have a chronic condition. But the opposite holds true, too: Toxic relationships can be a source of stress and make it even harder to cope. “With continued exposure, these can really affect how the immune system functions,” Dr. Volkmann says.
If the people in your life are causing you to feel stressed or on-edge, it can put you in a state of chronic fight-or-flight, Dr. Volkmann explains. This can increase inflammation the same way that other stressors do.
Typically, she adds, these relationships do not have good boundaries in place that set limits on what is acceptable and not acceptable. Being able to first recognize that a relationship is unhealthy and then either set new boundaries or strengthen existing ones can help make the relationship less taxing.
The first step in setting boundaries is communicating your needs. It’s also important to set expectations for what you can and can’t bring to the relationship. Being honest and upfront will make it easier for everyone to be on the same page, avoid disappointment, and reduce another source of flare-inducing stress in your life.
- Sugar and Inflammation: StatPearls Publishing (2021.) “Chronic Inflammation.” ncbi.nlm.nih.gov/books/NBK493173/
- Food Additives and Inflammation: Nutrients. (2019.) “Impact of Food Additives on Gut Homeostasis.” ncbi.nlm.nih.gov/pmc/articles/PMC6835893
- Mediterranean Diet: Endocrine, Metabolic & Immune Disorders Drug Targets. (2016.) “The Immune Protective Effect of the Mediterranean Diet against Chronic Low-grade Inflammatory Diseases.” ncbi.nlm.nih.gov/pmc/articles/PMC4443792/
- Chronic Stress and Inflammation: Frontiers in Human Neuroscience. (2017.) “Inflammation: The Common Pathway of Stress-Related Diseases.” ncbi.nlm.nih.gov/pmc/articles/PMC5476783/