A Silent Fire

August 15, 2022
“Hidden inflammation, which once lived in the margins of medical literature, is far from benign, and uncovering it... has been a process as slow and sinuous as the disease itself,” writes gastroenterologist Ravella in her impassioned if disjointed debut. She defines inflammation as “our natural protection from harm in the context of immunity,” and writes that while the typical American diet—replete with processed foods—fosters an aberrant immune system, eating whole foods (those “closest to their natural state”) reduces systemic inflammation and helps fight disease and aging. “The immune system responds poorly to... substances in animal foods,” she writes, and the most crucial “anti-inflammatory nutrient” is fiber. Ravella begins her comprehensive history of diet and inflammation in 1845, with a vivid profile of doctor Rudolf Virchow, whose work in hospitals “laid the foundation for our modern understanding of inflammation.” She also outlines the work of surgeon John Harvey Kellogg, “one of the first physicians to tell patients that food played an important role in health.” But as the book progresses, Ravella’s writing gets more textbook-like, riddled with academic jargon and scientific terms. Though Ravella attempts to break up the science with personal anecdotes from her clinical practice, they feel too superficial to stick. This one doesn’t quite come together.

September 1, 2022
A chronicle of the history of inflammation and suggestions for remedies for chronic inflammation. In her debut book, gastroenterologist Ravella takes a deep dive into the scientific and medical history of inflammation. Rather than focusing on specific organs or systems, the author looks at the body as a whole, exploring how scientists and physicians came to understand inflammation as both a cause and consequence of disease. She traces the strengths and weaknesses of the immune system; discusses how and why it might turn against the body by creating autoimmune disorders; and explains the role of "invisible" inflammation in afflictions such as heart disease, cancer, and Alzheimer's disease. Ravella makes a compelling case for the role of diet in reducing chronic inflammation, and she offers a host of recommendations for alleviating it: Eat a plant-based diet with few processed foods; experiment with fermented foods; don't overeat; get plenty of rest; and exercise. Regarding the latter, she issues a warning: "Exercising too much, or in the wrong way, injures and inflames. Long, intense periods of exercise, particularly for those unaccustomed to such rigor, can increase the risk of chronic, hidden inflammation." Though the author's suggestions are straightforward and largely unsurprising, she provides a full justification for each of them from the point of view of a medical doctor as well as a researcher. Examples of cases from her medical practice serve as cautionary tales for those who fail to take the effects of inflammation seriously. While the amount of medical detail included can be daunting, Ravella's prose is clear, nuanced, and restrained. Readers fascinated by the science behind her assertions will be satisfied, while those more interested in the takeaways can access them easily. A full set of endnotes provides possibilities for further reading, and Ravella's ability to connect the concrete and the abstract makes this a worthwhile study of a complex process. A thoughtful and well-informed discussion of a misunderstood subject.

COPYRIGHT(2022) Kirkus Reviews, ALL RIGHTS RESERVED.