A Silent Fire: The Story of Inflammation, Diet, and Disease

by Shilpa Ravella

Overview

“Fascinating.…[Ravella’s writing] breathes life into biological functions.” —Grace Wade, New Scientist

A riveting investigation of inflammation—the hidden force at the heart of modern disease—and how we can prevent, treat, or even reverse it.

Inflammation is the body’s ancestral response to its greatest threats, the first line of defense it deploys against injury and foreign pathogens. But as the threats we face have evolved, new science is uncovering how inflammation may also turn against us, simmering underneath the surface of leading killers from heart disease and cancer to depression, aging, and mysterious autoimmune conditions.

In A Silent Fire, gastroenterologist Shilpa Ravella investigates hidden inflammation’s emerging role as a common root of modern disease—and how we can control it. We meet the visionary nineteenth-century pathologist who laid the foundation for our modern understanding of inflammation, the eccentric Russian zoologist who discovered one of the cells central to our immune system, and the dedicated researchers advancing the frontiers of medical and nutritional science today. With fascinating case studies, Ravella reveals how we can reform our relationships with food and our microbiomes to benefit our own health and the planet’s.

Synthesizing medical history, cutting-edge research, and innovative clinical practice, Ravella unveils inflammation as one potential basis for a unifying theory of disease. A paradigm-shifting understanding of one of the most mysterious, buzzed-about topics in medicine and nutrition, A Silent Fire shows us how to live not only long but well.

Product Details

ISBN-13:	9781324074328
Publisher:	Norton, W. W. & Company, Inc.
Publication date:	01/02/2024
Pages:	352
Sales rank:	85,155
Product dimensions:	5.40(w) x 8.20(h) x 0.90(d)

About the Author

Shilpa Ravella is a transplant gastroenterologist with expertise in nutrition and an assistant professor of medicine at Columbia University Medical Center. Her writing has appeared in the Atlantic, New York magazine, Slate, Wall Street Journal, and Discover, among other publications.

Table of Contents

Introduction 1

Chapter 1 Metamorphosis 11

Chapter 2 Horror Autotoxicus 34

Chapter 3 A Sense of Strangling 47

Chapter 4 Open Wounds 73

Chapter 5 Anatomical Intimacies 85

Chapter 6 Gray Matter 99

Chapter 7 Resolution 115

Chapter 8 Quiet Conversations 130

Chapter 9 Fat Wars 150

Chapter 10 Sweet, Salty, Deadly 168

Chapter 11 Feeding Germs 178

Chapter 12 Farm Country 191

Chapter 13 Mangiafoglia 204

Chapter 14 Shaping Sustenance 222

Chapter 15 Dirty Cures 240

Chapter 16 Easter Island 253

Chapter 17 Human Chimeras 263

Acknowledgments 285

Notes 287

Index 329

Editorial Reviews

"Compelling, thoughtful and rigorously researched."

Times - Rhys Blakely

"Controlling inflammation is the key to good health, and this beautifully written and researched book is the best way to understand it."

Tim Spector

"Shilpa Ravella’s deeply researched, far-ranging book shows us how inflammation links the pathologies of modern life. Even better, it lets us in on a practicing gastroenterologist’s insights on the role of diet and what we can do to stop or even reverse the effects of ‘inflammaging.’ This necessary book has the power to change the way we think and eat."

Amit Majmudar

"A fascinating, case-oriented story of inflammation, diet and disease."

Nature - Andrew Robinson

"As gripping as a mystery story and as useful as a self-help book."

Bee Wilson

"Ravella’s fascinating, poetic, exploration of the body, food, and history will sweep you up sentence by sentence. A book that could not only reshape readers’ understanding of their own systems and choices but possibly medicine itself."

Lauren Sandler

"A spellbinding tale taking us from the early Greek physicians to the COVID-19 pandemic.… The insights Shilpa Ravella reveals point to a pathway that can enhance both our personal well-being today and that of the planet we pass on to our grandchildren."

Walter C. Willett

2022-08-17
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.

Kirkus Reviews

08/15/2022

“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. (Oct.)

Publishers Weekly

"Inflammation is a double-edged sword that heals and destroys; it has already saved your life, but most likely will contribute to ending it.… Shilpa Ravella takes us on a grand tour of the medical science and the personal cases that have advanced our understanding of the whys and ways of this fundamental process."

Martin J. Blaser

"A must-read for anyone interested in cutting-edge medicine. It is no exaggeration to say that low-level inflammation may be an insidious factor contributing to numerous diseases of aging, and Shilpa Ravella, a gastroenterologist with a writer’s gift for translating complex science into clean, beautiful prose, is the perfect person to tell this gripping tale."

Kathleen McAuliffe

"Critical to our health is understanding how to stave off inflammatory diseases.… Shilpa Ravella makes this complex topic accessible and engaging, winding together a wonderful historical perspective with cutting-edge science."

Justin Sonnenburg