Inflammaging: The Inflammation + Aging Connection

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Chronic inflammation is the central culprit behind all kinds of chronic illness. Inflammation is also behind many of the symptoms and diseases we associate with aging, which is why the term “inflammaging” was coined. (1) 

Research has shown that chronic, low-grade inflammation becomes more common as we get older, and is typically at the root of age-related diseases. (2) 

Inflammation is not just a result of aging and age-related illness, it’s a cause. And it’s not inevitable. Like all knowledge, this understanding provides us with an opportunity. 

By taking action at any time in our lives to prevent or reduce chronic inflammation, we can give our bodies the chance to live healthier for longer. 

So why does inflammation tend to increase as we get older? What are the mechanisms behind inflammaging? What causes it? How can you assess where you’re at now? 

I’m going to answer all of these questions, plus share tons of effective tools and strategies you can use to lower inflammation and live better. Let’s get into it. 

How Inflammaging Affects The Body

Inflammaging affects the body much in the same way that inflammation in general affects the body. As I write about in The Inflammation Spectrum, inflammation happens on a continuum, and can be increasingly problematic over time if it’s not resolved. 

What we see with inflammaging is actually the accumulation of many years (often decades) of low level inflammation that eventually causes destruction, deterioration, and dysfunction throughout the body. 

Inflammation is marked by a high level of circulating proinflammatory cells and molecules including tumor necrosis factor (TNF), interleukins (ILs), nuclear factor-kappa B (NF-kB), prostaglandins, cytokines, and free radicals, and ongoing activation of immune cells. We may also see a decreased ability to fight inflammation (e.g. lower levels of antioxidants like glutathione that combat oxidative stress). 

All of these things, when chronic, can affect the whole body, which is why many people find themselves with various, seemingly unrelated symptoms and conditions. 

Here are some of the ways in which inflammaging and long term inflammation can affect the entire body: 

  • Inflammation disrupts metabolic function, which over time can lead to conditions including metabolic syndrome, type 2 diabetes, cardiovascular disease, high blood pressure, obesity, and atherosclerosis. (3) 
  • Chronic inflammation in the organs, including the liver and lungs, can lead to organ damage and disease. 
  • Ongoing inflammation disrupts the gut microbiome and can damage the gut lining, leading to dysbiosis, leaky gut, and other gastrointestinal problems. 
  • Persistent inflammation in the brain has been shown to cause or contribute to disrupted mood, depression, and anxiety, as well as cognitive dysfunction, brain fog, memory loss, and cognitive decline. Inflammation is behind age-related neurocognitive disorders like Alzheimer’s and dementia. 
  • Inflammation disrupts immune system function and contributes to the development of autoimmune conditions including rheumatoid arthritis and inflammatory bowel disease (IBD). (4) 
  • Chronic inflammation disrupts hormonal balance, which can trigger insulin resistance, imbalances in sex hormones, and thyroid conditions. (5) 
  • Ongoing inflammation can impact the skin, leading to the loss of collagen and other important proteins and molecules that keep the skin healthy, and contributing to wrinkles, loss of elasticity, and other skin concerns associated with aging. 

    • Inflammaging and Cellular Senescence 

    One key feature of aging and age-related disease is increased cellular senescence. Cellular senescence occurs when cells within the body stop dividing the way they should. These cells stay alive, accumulate, and can damage otherwise healthy cells. 

    Senescent cells (those that have stopped dividing but haven’t died off) have been shown to release inflammatory molecules – and inflammation has also been shown to trigger or contribute to cellular senescence. This can create a vicious cycle, with inflammation triggering cellular damage and damaged cells triggering inflammation. (6) 

    Potential Root Causes

    There are several possible root causes of inflammation and inflammaging. (7) In most cases, chronic inflammation is brought on by a combination of different causative factors, rather than just one thing. The more of these causes we can understand, the better chance we have of combating the problem and improving our healthy longevity. 

  • Imbalances in the gut microbiome (gut dysbiosis) (2) 
  • Cellular senescence (6)
  • Mitochondrial dysfunction (8) 
  • Exposure to toxins and pathogens
  • An inflammatory diet (especially a diet high in sugar, processed foods, and alcohol) (9)
  • Autoimmune disease
  • Lack of exercise
  • Chronic use of certain medications including NSAIDs (like Ibuprofen/Advil) (10)
  • Hormonal imbalances
  • An impaired sleep cycle or circadian rhythm 
  • Chronic stress 
  • Ongoing parasitic, bacterial, viral, or fungal infections
  • Smoking

    • It’s also worth noting that many of these potential root causes are related to one another, and they often exist in a bidirectional, cyclical relationship with inflammation – for example, gut dysbiosis can trigger inflammation, and inflammation can trigger gut dysbiosis. That’s why taking a holistic, whole body, whole person view is so important when it comes to reducing inflammation at its various sources. 

    To better understand how much inflammation is impacting your health and what you can do about it, pick up a copy of my book The Inflammation Spectrum. I’ll teach you to recognize how inflammation is manifesting in your body and then walk you through an elimination diet so you can develop a dietary plan that works for you.

    How To Reduce Inflammaging

    We have more power over inflammation, aging, and our overall health than we’ve long been led to believe. There are so many things you can do to reduce inflammaging and feel your best at any age. 

    Here are some of my favorite evidence-based tips for reducing inflammaging.

    Reduce Inflammaging Through Diet 

  • Cut out inflammatory foods. Reduce your intake of sugar, processed foods, fried foods, refined carbohydrates, gluten, dairy, and alcohol, all of which are massive contributors to chronic inflammation. 
  • Eat a variety of nutrient-dense foods. When it comes to fruits and vegetables, eat as many different kinds as possible in order to take in all of their unique anti-inflammatory and health-promoting benefits. Make sure to eat plenty of healthy fats, antioxidant-rich foods, and gut-friendly fiber. 
  • Uncover your individual triggers with an elimination diet. If you’re already eating a pretty healthy diet, the next step is to figure out if there are any surprising foods that you might be sensitive to. Any food can trigger inflammation if you have a sensitivity to it. Try an elimination diet (where you eliminate several possibly inflammatory foods and then reintroduce them one at a time and monitor your symptoms) to help identify any of your unique triggers. 
  • Eat oceanic superfoods. Sea moss, blue spirulina, sea vegetables, and marine collagen are a few examples of powerful oceanic superfoods that can help to improve gut health, reduce inflammation, and support brain and cellular health. 
  • Try intermittent fasting. The discovery that limiting food intake could prolong the lifespan of mice and rats was actually one of the first findings that launched anti-aging research almost a century ago. (6) But fasting doesn’t have to feel restrictive – it’s not necessarily about how much (or how little) you eat but about the timing. Various different patterns of intermittent fasting have been found to reduce inflammation and improve metabolism. Fasting also helps to activate sirtuins, sometimes referred to as the “longevity genes”. 
  • Boost Nrf-2 through food. Nrf-2 is a protein that helps to decrease inflammation and enhance antioxidant and detox pathways. (11) You can activate Nrf-2 with the help of certain antioxidant-rich foods and drinks, including green tea, apples, turmeric, grapes, broccoli, garlic, and rosemary. 
  • Eat to decrease NF-kB. NF-kB is an inflammatory factor that plays a significant role in chronic inflammation. (12) Foods including turmeric (which contains the active ingredient curcumin), blueberries, thyme, oregano, and grapes can help to decrease NF-kB. 

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    Reduce Inflammaging Through Lifestyle Habits, Practices, and Rituals

    • Practice regular physical activity. It’s arguably consistency that matters most when it comes to exercise and fitness. A super high impact workout that you only have the energy to do once a month is probably going to be less effective than a low impact activity that you do every day or several times a week (also: too much high intensity exercise can actually trigger inflammation by putting excess stress on the body). Start with what works for you, whether it’s walking, running, swimming, yoga, weight training, pilates, dance, or something else.
    • Prioritize social connection. Spending time in meaningful social connection, whether it’s with friends, family, or your local community, is good for your body, mind, and soul, and can help to reduce inflammation. (13)
    • Try red light therapy. Red light therapy can reduce inflammation, boost collagen production, improve skin health, and reduce the inflammatory effects of aging. Learn more about it here
    • Practice mindfulness, emotional expression, and self-compassion. Self-compassion has been shown to be protective against the chronic inflammatory effects of stress. (14) Similarly, meditation, mindfulness, and emotional expression can help to reduce inflammation and keep your mind and body healthier as you get older. Even 5 minutes of meditation every day can make a big difference.
    • Detox regularly. In addition to avoiding toxin exposure, following a regular detox practice can help to keep inflammatory toxins and pathogens from building up and causing harm over time.
    • Try cold plunging or contrast therapy. The benefits of cold therapy (this can be through cold showers, cold plunging, ice baths, or cryotherapy) are numerous, and one important one is lowering inflammation. Contrast therapy (switching between hot and cold, such as going from the sauna to a cold plunge) is also a great approach.
    • Refine your sleep routine. Getting regular, good quality sleep is one of the most important things you can do to reduce inflammation and support healthy aging. I think just about everyone can stand to improve their sleep quality. Here are a few tips to optimize your routine.


    Ready to learn more about how to master autoimmunity and reduce inflammation with functional medicine? Check out my course here.

    Reduce Inflammaging With Supplements

    Targeted dietary supplements can help to support an anti-inflammatory diet and lifestyle. Here are a few of the most effective options:

    Getting Tested

    There’s no single test for inflammaging, but there are several tests that can help to identify chronic inflammation as well as other relevant signs of aging. In my functional medicine telehealth practice, we look at these labs holistically alongside an individual’s health history and symptoms to help us get a whole picture of what’s going on.

    Here are some of the labs we run to look at signs of inflammation and aging:

    • C-reactive protein. C-reactive protein (CRP) is a key inflammatory biomarker we look at. Elevated levels of CRP indicate inflammation, and CRP can contribute to accelerated aging, telomere damage, and other health concerns. (15)
    • Homocysteine. Elevated homocysteine is linked to inflammation, cognitive decline, autoimmunity, and destruction of the blood-brain-barrier. (16, 17)
    • Hgb A1C. This test looks at your recent blood sugar levels, and can help to predict future concerns like insulin resistance, diabetes, and Alzheimer’s disease.
    • Telomere length. While not a direct marker of inflammation, the length of telomeres (the structures at the end of your chromosomes that help to keep cells healthy and function) can help to indicate the speed at which your body is aging (often as a result of inflammation).

    Other labs we may run include small dense LDL particles, vitamin D, gut microbiome tests, tests for leaky gut or SIBO, ferritin, and methylation gene testing.

    READ NEXT: What Exactly Does Inflammation Feel Like? | Dr. Will Cole 

    Combating Inflammation With Functional Medicine

    I’m glad that in the larger conversation these days, we seem to be talking not just about living longer but about living healthier for longer. One of the best ways we can do this is by combating chronic inflammation – and the earlier we get started, the better. At our functional medicine telehealth clinic, we can help you understand what hidden factors may be contributing to inflammation for you, and how to fix it.

    As one of the first functional medicine telehealth clinics in the world, we provide webcam health consultations for people around the globe.

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    1. Franceschi, C., & Campisi, J. (2014). Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 69(Suppl_1), S4-S9.
    2. Franceschi, C., Garagnani, P., Parini, P., Giuliani, C., & Santoro, A. (2018). Inflammaging: a new immune–metabolic viewpoint for age-related diseases. Nature Reviews Endocrinology, 14(10), 576-590.
    3. Lee, Y. S., & Olefsky, J. (2021). Chronic tissue inflammation and metabolic disease. Genes & development, 35(5-6), 307-328.
    4. Duan, L., Rao, X., & Sigdel, K. R. (2019). Regulation of inflammation in autoimmune disease. Journal of immunology research, 2019.
    5. Straub, R. H. (2014). Interaction of the endocrine system with inflammation: a function of energy and volume regulation. Arthritis research & therapy, 16, 1-15.
    6. Li, X., Li, C., Zhang, W., Wang, Y., Qian, P., & Huang, H. (2023). Inflammation and aging: signaling pathways and intervention therapies. Signal Transduction and Targeted Therapy, 8(1), 239.
    7. Singh, A., Schurman, S. H., Bektas, A., Kaileh, M., Roy, R., Wilson, D. M., ... & Ferrucci, L. (2024). Aging and Inflammation. Cold Spring Harbor Perspectives in Medicine, 14(6), a041197.
    8. Seegren, P. V., Harper, L. R., Downs, T. K., Zhao, X. Y., Viswanathan, S. B., Stremska, M. E., ... & Desai, B. N. (2023). Reduced mitochondrial calcium uptake in macrophages is a major driver of inflammaging. Nature Aging, 3(7), 796-812.
    9. Pitsavos, C., Panagiotakos, D. B., Tzima, N., Lentzas, Y., Chrysohoou, C., Das, U. N., & Stefanadis, C. (2007). Diet, exercise, and C-reactive protein levels in people with abdominal obesity: the ATTICA epidemiological study. Angiology, 58(2), 225-233.
    10. Marcum, Z. A., & Hanlon, J. T. (2010). Recognizing the risks of chronic nonsteroidal anti-inflammatory drug use in older adults. The annals of long-term care: the official journal of the American Medical Directors Association, 18(9), 24.
    11. Rahman, I., Biswas, S. K., & Kirkham, P. A. (2006). Regulation of inflammation and redox signaling by dietary polyphenols. Biochemical pharmacology, 72(11), 1439-1452.
    12. Tak, P. P., & Firestein, G. S. (2001). NF-κB: a key role in inflammatory diseases. The Journal of clinical investigation, 107(1), 7-11.
    13. Leschak, C. J., & Eisenberger, N. I. (2019). Two distinct immune pathways linking social relationships with health: inflammatory and antiviral processes. Psychosomatic medicine, 81(8), 711-719.
    14. Breines, J. G., Thoma, M. V., Gianferante, D., Hanlin, L., Chen, X., & Rohleder, N. (2014). Self-compassion as a predictor of interleukin-6 response to acute psychosocial stress. Brain, behavior, and immunity, 37, 109-114.
    15. Solorio, S., Murillo-Ortíz, B., Hernández-González, M., Guillén-Contreras, J., Arenas-Aranda, D., Solorzano-Zepeda, F. J., ... & Malacara-Hernández, J. M. (2011). Association between telomere length and C-reactive protein and the development of coronary collateral circulation in patients with coronary artery disease. Angiology, 62(6), 467-472.
    16. Tucker, K. L., Qiao, N., Scott, T., Rosenberg, I., & Spiro III, A. (2005). High homocysteine and low B vitamins predict cognitive decline in aging men: the Veterans Affairs Normative Aging Study. The American journal of clinical nutrition, 82(3), 627-635.
    17. Kamath, A. F., Chauhan, A. K., Kisucka, J., Dole, V. S., Loscalzo, J., Handy, D. E., & Wagner, D. D. (2006). Elevated levels of homocysteine compromise blood-brain barrier integrity in mice. Blood, 107(2), 591-593.

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    BY DR. WILL COLE

    Evidence-based reviewed article

    Dr. Will Cole, DNM, IFMCP, DC is a leading functional medicine expert who consults people around the globe, starting one of the first functional medicine telehealth centers in the world. Named one of the top 50 functional and integrative doctors in the nation, Dr. Will Cole provides a functional medicine approach for thyroid issues, autoimmune conditions, hormonal imbalances, digestive disorders, and brain problems. He is also the host of the popular The Art of Being Well podcast and the New York Times bestselling author of Intuitive Fasting, Ketotarian, Gut Feelings, and The Inflammation Spectrum.

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