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What Is Chronic Inflammation (Inflammaging), and How Can You Measure It?

Updated: 9 minutes ago



What is Chronic Inflammation?

Chronic inflammation, often referred to as inflammaging, is a persistent, low-grade activation of the immune system in the absence of acute infection or injury.


Unlike acute inflammation, which is protective and resolves quickly, chronic inflammation is:

  • Systemic

  • Sustained

  • Often asymptomatic

  • Biologically disruptive over time


The term “inflammaging” was introduced  by Franceschi et al. to describe the chronic immune activation that accompanies aging and contributes to age-related disease [1].


Chronic inflammation has been implicated in cardiovascular disease, type 2 diabetes, neurodegeneration, cancer, frailty, and overall mortality [2]. This type of inflammation has been identified as a central hallmark of aging [3], and a contributing factor in cardiovascular disease, type 2 diabetes, neurodegeneration, frailty, and all-cause mortality. 

Importantly, studies of long-lived populations show that individuals who age successfully tend to have lower levels of inflammatory biomarkers compared to age-matched peers [4].


So the practical question becomes: how do you quantify chronic inflammation before disease develops?



Biomarkers for Chronic Inflammation


There is no single blood test that defines chronic inflammation. Instead, clinicians and researchers assess several biomarkers that together provide insight into ongoing immune activity.


1. C-Reactive Protein (CRP) and High-Sensitivity C-Reactive Protein (hs-CRP)


C-reactive protein (CRP) is a protein produced by the liver in response to inflammatory signaling by the immune system. Standard CRP tests detect larger elevations typical of infection or acute inflammation, while high-sensitivity CRP (hs-CRP) measures much lower levels of circulating CRP that reflect low-grade, chronic inflammation [5].


An hs-CRP test can detect subtle increases in CRP that are associated with risk for cardiovascular disease even in people without symptoms, and it is widely used as a non-specific marker of systemic inflammation and cardiometabolic risk. Multiple large prospective studies have shown that higher hs-CRP levels are correlated with future cardiovascular events such as heart attack and stroke, independent of traditional risk factors like cholesterol and blood pressure [6].


Because hs-CRP testing is relatively inexpensive and standardized across clinical labs, it is commonly included in preventive health assessments when evaluating inflammation, cardiometabolic risk, or responses to lifestyle changes.


2. Interleukin-6 (IL-6)


Interleukin-6, or IL-6, is a small signaling protein made by immune cells when the body senses stress, infection, or tissue damage. Think of IL-6 as one of the early “alarm signals” in the inflammatory process. When IL-6 rises, it tells the liver to produce C-reactive protein (CRP) and helps coordinate the broader immune response. IL-6 rises earlier in the inflammatory process, so it can reflect active immune signaling, while CRP represents a later response to that signal [7].


Higher IL-6 levels have been linked to:


  • Frailty

  • Reduced physical function

  • Increased risk of disability

  • Higher mortality risk in older adults


In a large longitudinal study of older adults, Ferrucci and colleagues found that individuals with higher baseline IL-6 levels were more likely to develop disability and had a greater risk of death over follow-up, independent of other risk factors [8].


Because IL-6 reflects active immune signaling, it is often used in aging research as a core marker of “inflammaging,” the chronic low-grade inflammation associated with biological aging.

For those tracking longevity biomarkers, IL-6 can be useful when measured alongside hs-CRP. While CRP can shift quickly with short-term stress or illness, IL-6 may provide additional context about whether inflammatory signaling is persistently elevated.


3. Tumor Necrosis Factor Alpha (TNF-α)


Tumor necrosis factor alpha, or TNF-α, is another inflammatory signaling protein produced by immune cells when the body detects stress, infection, or tissue damage.Like IL-6, TNF-α helps coordinate the inflammatory response. In short-term bursts this is protective. But when TNF-α remains chronically elevated, it contributes to persistent low-grade inflammation [9].


Higher TNF-α levels have been linked to:

  • Insulin resistance

  • Metabolic syndrome

  • Cardiovascular disease

  • Muscle loss and frailty with aging


The connection between TNF-α and metabolic dysfunction was first highlighted in early research showing that TNF-α interferes with insulin signaling, helping explain why chronic inflammation and insulin resistance often occur together [10]. 


In aging research, persistently elevated TNF-α is considered part of the broader inflammatory environment associated with inflammaging. While it is less commonly measured in routine primary care than CRP, it is frequently used in research settings to better understand chronic immune activation and metabolic stress.


For those tracking inflammatory health more deeply, TNF-α can add context alongside IL-6 and CRP, especially when evaluating long-term metabolic and immune balance.


4. IgG Glycosylation and Glycans

An emerging and increasingly validated way to track chronic inflammation and immune aging involves glycans, specific sugar structures attached to proteins [11]. One of the best-studied examples is IgG glycosylation, the glycan pattern attached to Immunoglobulin G (IgG), a major antibody in human blood.


These IgG glycan patterns influence how inflammatory IgG behaves. Certain glycan structures are associated with a more pro-inflammatory immune response, while others are linked to a more regulated, anti-inflammatory profile. With aging and metabolic stress, IgG glycosylation patterns tend to shift toward configurations associated with higher inflammatory activity [12].


Research suggests these glycan patterns::


  • Correlate with biological age

  • Change in response to lifestyle interventions

  • Are associated with cardiometabolic risk and longevity outcomes


Unlike markers such as CRP, which can fluctuate over days in response to infection or stress, IgG glycosylation reflects longer-term immune system patterning [13]. For this reason, glycan-based biological age testing has gained attention in longevity-focused settings.


Tests such as GlycanAge assess IgG glycosylation patterns associated with systemic inflammation and immune aging.


Because glycan profiles tend to shift gradually over months rather than hours or days, they can:


  • Capture cumulative inflammatory load

  • Reflect sustained lifestyle improvements

  • Provide a measurable readout of immune aging trends


If you are actively working on reducing inflammation through exercise, dietary change, weight loss, alcohol reduction, or metabolic improvement, glycan-based testing may provide a complementary longitudinal signal alongside CRP and other shorter-term inflammatory biomarkers.



Risk Factors for Chronic Inflammation



Chronic low-grade inflammation is strongly associated with certain modifiable lifestyle and metabolic factors that influence immune signaling and cardiometabolic health.


Alcohol


Chronic alcohol intake alters immune function, increases gut permeability, and promotes systemic inflammatory signaling. Sustained higher consumption is associated with elevated inflammatory biomarkers and immune dysregulation [14].


Ultra-Processed Foods


Higher intake of ultra-processed foods is associated with increased inflammatory burden, cardiometabolic disease risk, and higher all-cause mortality. These foods are typically high in refined carbohydrates, additives, and energy density, and low in fiber and micronutrients, factors linked to metabolic stress and inflammatory signaling [15, 16].


Added Sugar


High intake of added sugars, particularly from sugar-sweetened beverages and refined products, is associated with increased inflammatory markers and oxidative stress [17].

It is important to note that these associations primarily apply to added and refined sugars. In contrast, naturally occurring sugars in whole fruits and vegetables are not consistently linked to increased inflammation and are often associated with lower inflammatory markers, likely due to their fiber, polyphenols, and micronutrient content [18].


Sedentary Lifestyle


Physical inactivity is associated with higher CRP, IL-6, and other inflammatory biomarkers [19]. 

Sedentary behavior contributes to insulin resistance and increased visceral fat, both of which are linked to chronic immune activation [20].


Obesity and Visceral Fat


Adipose tissue, particularly visceral fat, is metabolically active and releases pro-inflammatory cytokines such as IL-6 and TNF-α, contributing to chronic low-grade inflammation. Greater visceral fat accumulation is associated with higher circulating inflammatory biomarkers and increased cardiometabolic risk [21, 22].



Other Contributors to Chronic Inflammation


Smoking


Cigarette smoking is strongly associated with elevated inflammatory biomarkers, oxidative stress, and immune dysregulation. Smoking increases CRP, IL-6, and other inflammatory mediators and contributes to chronic systemic inflammation across multiple organ systems [23–25].


Chronic Psychological Stress


Chronic psychological stress activates the hypothalamic–pituitary–adrenal (HPA) axis and sympathetic nervous system, which can alter immune regulation and promote inflammatory signaling over time. Persistent stress exposure has been associated with elevated inflammatory markers and impaired immune resilience [26].



Insufficient or Poor-Quality Sleep

Sleep disruption and short sleep duration are associated with increased inflammatory cytokines and altered immune function. Chronic sleep deprivation may contribute to low-grade systemic inflammation and cardiometabolic risk [27].




How to Reduce Chronic Inflammation



1. Exercise


Regular aerobic and resistance training are associated with reductions in inflammatory biomarkers, including CRP and IL-6 [28]. Even moderate, consistent physical activity has been linked to lower systemic inflammation over time [29].


Exercise also influences other drivers of inflammation. Regular physical activity is associated with improved sleep quality and duration [30], and structured exercise programs have been shown to reduce perceived stress and improve stress resilience [31].


Because poor sleep and chronic psychological stress are independently linked to elevated inflammatory signaling, exercise may reduce inflammatory burden both directly and indirectly through its effects on metabolic health, recovery, and stress regulation.


2. Anti-Inflammatory Diet Patterns


The Mediterranean dietary pattern is associated with lower inflammatory markers and reduced cardiometabolic risk.


Key components commonly associated with anti-inflammatory effects include:

  • Extra virgin olive oil

  • Fatty fish rich in omega-3 fatty acids

  • Vegetables and polyphenol-rich plant foods

  • Nuts and legumes


These foods provide fiber, antioxidants, and bioactive compounds linked to improved metabolic and inflammatory profiles [32].


3. Eliminate or Reduce Pro-Inflammatory Exposures


If any of the following apply to you, reducing or correcting them may meaningfully lower long-term inflammatory burden. These factors tend to sustain immune activation over time, even in otherwise health-conscious individuals.


Smoking


Cigarette smoking is strongly associated with elevated CRP, IL-6, TNF-α, and systemic oxidative stress. If you smoke, cessation is associated with a more favorable inflammatory profile over time, including reductions in hs-CRP, with effects becoming more evident after sustained abstinence rather than immediately [33].


Alcohol Use


Alcohol affects gut permeability, liver metabolism, and cytokine production, all of which can elevate inflammatory biomarkers. If your alcohol intake is frequent or above current public health guidance, reducing it may improve inflammatory and metabolic markers. Studies in heavy drinkers show that several inflammatory cytokines decline during weeks of sustained abstinence, suggesting that inflammatory signaling may normalize as alcohol exposure decreases [34].


Most public health guidelines recommend limiting intake to no more than one standard drink per day for women and two for men [35]. However, recent analyses have questioned earlier findings suggesting cardiometabolic benefits from moderate drinking, and the World Health Organization states that no level of alcohol consumption can be considered completely safe for health [36].


Sleep Consistency and Duration


Sleep plays a central role in immune regulation. Short sleep duration and sleep disruption are associated with increased inflammatory cytokines and elevated CRP [37]. If you regularly sleep less than 7 hours or experience fragmented sleep, improving sleep duration and consistency may reduce inflammatory burden over time [38].


Reduce Psychological Stress


Chronic psychological stress can keep the body in a prolonged “fight-or-flight” state, which is associated with elevated inflammatory biomarkers and disrupted immune regulation.

Reducing ongoing stress has been linked to improvements in inflammatory markers such as C-reactive protein (CRP). Meta-analyses of stress-reduction programs, including mindfulness-based approaches and related behavioral interventions, have reported measurable reductions in inflammatory biomarkers in several studies [39,40].


If you experience persistent psychological stress without adequate recovery, improving stress regulation may help lower inflammatory signaling over time.


4. Evidence-Supported Supplements


Some supplements have demonstrated reductions in inflammatory biomarkers in clinical studies, particularly in individuals with elevated baseline inflammation. Always consult a healthcare professional before beginning supplementation.


Omega-3 Fatty Acids

Omega-3 fatty acids, commonly found in fatty fish and fish oil supplements, have been associated with reductions in inflammatory markers such as CRP and inflammatory cytokines in several analyses [41,42].


Curcumin

Curcumin, a polyphenol derived from turmeric, has been studied for its anti-inflammatory effects and may reduce inflammatory biomarkers in certain populations [43,44].


Vitamin D (If Deficient)

Vitamin D deficiency has been associated with increased inflammatory activity. Correcting deficiency may help improve inflammatory profiles in some individuals [45].

Supplement effects vary based on baseline status, dose, and duration. Testing vitamin D levels before supplementation is generally recommended.



5. Routine Testing and Tracking


Chronic inflammation is often silent. Measuring key biomarkers periodically can help you establish a baseline, detect early changes, and track how lifestyle changes affect your biology over time.


Many inflammation-related biomarkers are now accessible through routine lab testing, either through a primary care physician or through direct-to-consumer laboratory services.


A practical monitoring approach may include:


  • hs-CRP to assess systemic inflammatory activity

  • IL-6 for deeper insight into inflammatory signaling

  • IgG glycosylation (glycan profiling) to assess longer-term immune aging dynamics


Because different markers reflect inflammation on different timescales, tracking them together can provide a more complete picture than relying on a single measurement.

For example, hs-CRP may change relatively quickly in response to illness or lifestyle adjustments, while glycan-based biomarkers tend to reflect longer-term immune system trends.


If you are actively working to reduce chronic inflammation through improvements in diet, exercise, sleep, alcohol intake, or stress management, repeating these tests periodically can help confirm whether those changes are translating into measurable biological improvements.



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