I had my question answered by Infragistics, but offer the solution in case others come across it as well.
The solution was simply to cast the cells as WorksheetCell instead of using var in the foreach loop, so:
foreach (WorksheetCell cell in region)
{
cell.CellFormat.Fill = CellFill.CreateSolidFill(System.Drawing.Color.Gray);
cell.CellFormat.Font.ColorInfo = new WorkbookColorInfo(System.Drawing.Color.White);
}
I'm not entirely sure why that fixes it, so I plan on digging into that at some point and may update this answer with that info when I have it.