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Q: I hear so much about the dangers of chronic inflammation. What dietary changes can I make to reduce the risks?

A: Diet plays an important role in chronic inflammation, most likely due to the ingredients in the foods and beverages we ingest and the bacteria that populate our intestines, known as our microbiome.

These intestinal bacteria release chemicals that may spur or suppress inflammation. Some foods encourage the growth of bacteria that stimulate inflammation, while others promote the growth of bacteria that help suppress it.

Here are some of the foods and beverages with beneficial ingredients that have been linked to less inflammation:

• Fruits and vegetables. Most fruits and brightly colored vegetables naturally contain high levels of antioxidants and polyphenols — potentially protective compounds found in plants.
• Nuts and seeds. Studies have found that consuming nuts and seeds is associated with reduced markers of inflammation and a lower risk of cardiovascular disease and diabetes.
• Beverages. The polyphenols in coffee and the flavanols in cocoa are thought to have anti-inflammatory properties. Green tea is also rich in both polyphenols and antioxidants.

Studies have shown that polyphenols have multiple anti-inflammatory properties. A review published in the British Journal of Nutrition summarized a number of studies supporting the notion that dietary polyphenols may lower inflammation in the body and improve the function of cells that line blood vessels.

Foods high in polyphenols include onions, turmeric, red grapes, green tea, cherries and plums, as well as dark green leafy vegetables such as spinach, kale and collard greens.

In addition, olive oil, flaxseed oil and fatty fish such as salmon, sardines and mackerel offer healthy doses of omega-3 fatty acids, which have long been shown to reduce inflammation.

Foods that fuel inflammation

The foods that contribute to inflammation are the same ones generally considered bad for other aspects of health. These include sugary sodas and refined carbohydrates (like white bread and pasta), as well as processed meats.

Such unhealthy foods are also likely to contribute to weight gain, which is itself a risk factor for inflammation.

In addition, certain components or ingredients in processed foods, like the emulsifiers added to ice cream, may have effects on inflammation.

How to reduce inflammation

To practice anti-inflammatory eating, it’s best to focus on an overall healthy diet rather than singling out individual “good” and “bad” foods.

In general, a healthy diet means one that emphasizes fruits, vegetables, nuts, whole grains, fish and healthy oils, and limits food loaded with simple sugars (like soda and candy), beverages that contain high-fructose corn syrup (like juice drinks and sports drinks), and refined carbohydrates.

Q: I get a lot of earwax buildup. Why do some people have this problem? Can I prevent it?

A: If the wax in your ear isn’t causing any discomfort or problem hearing, you don’t have to do anything about it.

Earwax (cerumen) is made in the ear canal. It serves four main purposes:

• It moistens the skin to prevent dryness and itching.
• It helps protect the canal and eardrum from damage.
• It helps stop bacteria from multiplying, so it helps prevent infections.
• It keeps the ear clean. The oily substance made by the cells lining the ear canal mixes with the dead skin and debris inside. The mixture then slowly moves out of the ear.

The consistency of earwax ranges from liquid to rock-hard. It depends on the makeup of the wax. It also depends on how long the wax has been in the canal.

The higher the proportion of dead skin cells and hair, and the longer the mixture has been in the ear canal, the harder the wax.

The ear should remove wax naturally. However, some reasons for excessive buildup include:

• An especially narrow or curvy ear canal.
• A skin condition, such as eczema, that is affecting the canal.
• Excessive hair growth in the canal.
• Trying to clean your ears with a Q-tip. This can push the wax farther back into the ear canal, where it builds up and hardens.
• Wearing a hearing aid or earplugs.

You only need to remove earwax if it causes problems with hearing, ringing in the ear or an earache.

To unblock the wax, you can try using an over-the-counter ear cleaning treatment to flush it out. Do not try this if you have a history of ear drum perforation or have had ear surgery. If you aren’t successful in clearing the earwax, make an appointment with your doctor.

Never try to dig out earwax with something like a Q-tip, paper clip or hairpin. That could push it farther into the canal or injure your eardrum.

Another procedure to avoid is ear candling. That’s when you stick a lighted hollow candle into the ear, ostensibly to suck out the wax. This doesn’t work, and it could do serious harm.

Preventing earwax blockage is difficult. People with frequent blockages may use mineral oil drops or another earwax softener once a week to help keep wax from hardening and building up.

But earwax is there for a purpose. It doesn’t normally need to be removed.

Your best bet is simply to clean your outer ear with a washcloth. And leave wax removal to your ear’s self-cleaning mechanism.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, see health.harvard.edu.

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