Inflammaging: The Chronic Inflammation Behind Aging

TL;DR: Inflammaging is the low-grade, chronic inflammation that gradually builds as we age, and it is increasingly understood as a root driver of the diseases that end most lives: heart disease, type 2 diabetes, Alzheimer's, cancer, and frailty. It is not the sharp, useful inflammation of a healing cut; it is a persistent background hum that damages tissues over years. It comes from aging cells, visceral fat, gut changes, poor sleep, chronic stress, and an ultra-processed diet. You can measure it with a simple blood test (hs-CRP), and the levers that lower it are the same ones that drive healthspan overall. At Fishtown Medicine we measure your inflammation and treat what is driving it, rather than chasing an anti-inflammatory supplement.

If you have heard that inflammation is behind most chronic disease and wanted to understand what that means and what to do, this page is a grounded guide. Inflammaging is one of the more useful lenses in longevity medicine, because it connects heart disease, diabetes, and cognitive decline to a shared process you can measure and move. Here is what it is, what drives it, and how to lower it.

What is inflammaging?

Inflammaging is a term for the chronic, low-grade, sterile inflammation that rises with age. Inflammation itself is a healthy, necessary response: when you cut your hand or fight an infection, the immune system floods the area, does its job, and stands down. Inflammaging is different. It is a persistent, low-level activation of the immune system with no injury to heal, running in the background year after year and slowly damaging tissues.

The concept has strong scientific footing. Researchers first described inflammaging around the year 2000, and it is now recognized as one of the hallmarks of aging, a core process that both marks and drives getting older.¹⁵ Large reviews have tied this chronic inflammation to a wide range of age-related diseases, positioning it as a common thread that connects conditions once thought separate.² In other words, the same underlying fire shows up in the arteries, the pancreas, and the brain.

What drives chronic inflammation as we age?

Inflammaging has several sources, and most of them are things you can influence:

• Aging and senescent cells. As cells age, some enter a state called senescence, where they stop dividing but refuse to die and instead pump out inflammatory signals. These accumulate over time and stoke background inflammation. Clearing them with compounds called senolytics, such as fisetin, is an active area of longevity research, though the human evidence is still early.
• Visceral fat. The fat around your organs is not inert storage; it is metabolically active tissue that releases inflammatory molecules, which is a major reason excess visceral fat drives so much disease.
• Gut changes. Age-related changes in the gut lining and microbiome can let inflammatory triggers cross into the bloodstream, adding to the load.
• Lifestyle drivers. Poor sleep, chronic stress, physical inactivity, smoking, heavy alcohol use, and an ultra-processed diet all raise inflammation, while their opposites lower it.
• Chronic conditions and infections. Gum disease, ongoing infections, and other chronic conditions keep the immune system low-level activated.

The useful part of this list is how much of it is modifiable. Senescent cells and the passage of time you cannot change, but visceral fat, diet, sleep, activity, alcohol, and dental health are all within reach, which is why lifestyle has such a large effect on how inflamed a person is.

How does chronic inflammation cause disease?

Chronic inflammation causes disease by damaging tissues and accelerating the specific processes behind each major age-related condition. In the arteries, inflammation is central to atherosclerosis: it helps drive the buildup and, critically, the rupture of plaque that causes heart attacks and strokes. Trials that lowered inflammation directly, without changing cholesterol, reduced cardiovascular events, which is strong evidence that inflammation is a cause rather than just a bystander.³

The same pattern repeats across the body. Chronic inflammation worsens insulin resistance and pushes toward type 2 diabetes, contributes to the neuroinflammation involved in Alzheimer's and cognitive decline, creates conditions that favor cancer, and drives the muscle loss and frailty of later life.⁴ This is why inflammaging is such a powerful lens: rather than treating each disease as a separate problem, it points to a shared driver that, when lowered, benefits many systems at once.

How do you measure and lower chronic inflammation?

The practical way to measure chronic inflammation is a blood test called hs-CRP (high-sensitivity C-reactive protein), which reflects your background inflammatory level and independently predicts cardiovascular risk. It is inexpensive, widely available, and a reasonable marker to track over time. Research markers like IL-6 add detail but are less commonly used in everyday care.

Lowering inflammation is mostly a matter of the same levers that drive healthspan, and no supplement matches their effect:

• Move your body. Regular exercise, both aerobic and resistance training, lowers inflammatory markers, partly by building muscle and cutting visceral fat.
• Lose visceral fat. Because organ fat is a major inflammation source, reducing it is one of the highest-yield changes.
• Eat whole foods. A diet rich in fiber, vegetables, omega-3 fats, and polyphenols lowers inflammation, while ultra-processed food raises it.
• Protect sleep and manage stress, both of which strongly influence inflammatory signaling.
• Address the specifics: treat gum disease, moderate alcohol, and stop smoking.

The honest note on supplements is that a whole-food, active, well-rested life does far more than any anti-inflammatory pill, and the marketing around "anti-inflammatory" products tends to outrun the evidence. The foundation is lifestyle; targeted tools come after.

How Fishtown Medicine approaches chronic inflammation in Philadelphia

We treat inflammation as a root process to measure and lower, rather than a vague buzzword. That starts with putting a number on it, usually hs-CRP, read alongside the markers that travel with it: fasting insulin, lipids including ApoB, and body composition. A high inflammatory level rarely stands alone, so we look for what is feeding it, most often visceral fat, an ultra-processed diet, poor sleep, or a specific issue like gum disease, and we treat the driver.

From there the plan is built on the levers that move it, exercise, visceral fat loss, whole foods, and sleep, with follow-up to confirm the number is coming down. When a persistent high inflammation level points to something that needs specialist evaluation, we refer to highly qualified specialists who are in network for you, and for complex cases we compare notes across a network of specialists. Whether you are in Fishtown or Rittenhouse, or across the bridge in Cherry Hill or Moorestown, the aim is to cool the background fire that drives so much of aging.

Guidance from the Clinic

"I think of chronic inflammation as a slow fire that most people cannot feel. It does not hurt, so it is easy to ignore, but it is doing damage to the arteries, the brain, and the metabolism the whole time. What I find hopeful is that it is so responsive to the basics. When someone loses visceral fat, sleeps better, moves more, and cleans up their diet, I watch their inflammation markers fall, and that falling number means risk is coming down. You do not need an exotic supplement to lower it. You need the boring things done consistently."

Related at Fishtown Medicine

• High CRP: What an Elevated Inflammation Marker Means - the test that measures inflammaging
• Fatty Liver (MASLD) - one downstream result of the same inflammation
• Ultra-Processed Food - a major dietary driver of chronic inflammation
• Muscle Is the Organ of Longevity - training lowers inflammation and builds reserve
• The Advanced Tests Your Doctor Isn't Ordering - where hs-CRP fits the fuller panel

Scientific References

1. Franceschi C, Bonafè M, Valensin S, et al. "Inflamm-aging: An evolutionary perspective on immunosenescence." Annals of the New York Academy of Sciences. 2000;908:244-254.
2. Furman D, Campisi J, Verdin E, et al. "Chronic inflammation in the etiology of disease across the life span." Nature Medicine. 2019;25(12):1822-1832.
3. Ridker PM, Everett BM, Thuren T, et al. "Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease." New England Journal of Medicine. 2017;377(12):1119-1131.
4. Ferrucci L, Fabbri E. "Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty." Nature Reviews Cardiology. 2018;15(9):505-522.
5. López-Otín C, Blasco MA, Partridge L, Serrano M, Kroemer G. "Hallmarks of Aging: An Expanding Universe." Cell. 2023;186(2):243-278.