Weekly Wellness Spotlight

In this week’s wellness spotlight, Dr. Stuart Richer shares an article written by Scott Nygren for the Pain Management Newsletter of The Captain James Lovell Federal Health Care Center in Chicago. This is an excellent example of nutritional awareness becoming more mainstream in healthcare. 

What Does Nutrition Have to do with Inflammation and Pain?

Inflammation is a response to injury or to a possible assault to the body’s “ecosystem”. When this response occurs, it may manifest in many systems (cellular, molecular, neural and vascular). If there is a continual assault to any one or multiple areas, the result can cause pain and chronic disease. On a cellular level, inflammation inhibits the body’s ability to operate the way it’s supposed to, resulting in cellular damage, oxidative stress and impaired healing. Many studies have found inflammation is linked to almost every disease: cardiovascular, diabetes, kidney, Alzheimer’s, autoimmune, cancer, depression, metabolic syndrome, IBS/IBD, Parkinson’s, arthritis and many more.

Conditions with pain that may be affected by nutrition include: complex regional pain syndrome, rheumatoid arthritis, gout, fibromyalgia, migraines, neuropathy, inflammatory bowel disease. Research uses many different inflammatory markers to study the effect of nutrition on the body. Some of these markers are C-Reactive Protein, Interleukin (IL-6, IL-4, IL-10, IL-18, IL-15), Tumor Necrosis Factor (TNF), Erythrocyte Sedimentation Rate (ESR), Fibrinogen, Nuclear Factor Kappa-B, Pro-Inflammatory Eicosanoids and Cytokines.

At the University of North Carolina, researchers created a Dietary Inflammatory Index (DII) to be able to evaluate the inflammatory potential of diet (negatively or positively) by reviewing 1,943 research articles and 11 data sets globally. The researchers concluded that there are correlations/consistencies between foods and life-styles that result in inflammation positively or negatively.

Diet components that are found to increase inflammation include:

  • Cooking method
  • Excessive animal proteins (saturated fats)
  • Low fiber intake or foods low in fiber
  • Excessive added sugar intake
  • Artificial sweeteners
  • Processed meats

Diet components that are found to decrease inflammation – known as the “anti-inflammatory diet”:

  • High fiber
  • Fruits (in moderation)
  • Vegetables
  • Seafood (omega-3 fatty acids) in moderation
  • Whole grains
  • Monounsaturated fats (olive oil, peanut, avocado, almond)
  • Herbs and spices

Other areas that may increase inflammation are foods that someone may have a sensitivity to such as with dairy, gluten, eggs, GMO foods, pesticides, herbicides, and various chemicals on foods.

Nutrition is just one part of the overall care for the chronic pain patient. Additional areas also influence inflammation: obesity, medications, lack of sleep, gut microbiome, stress (physical / emotional), activity level.

Developing a healthier life-style is a gradual process. Assisting patients to start on the path of making changes in their diet can affect their pain as well as their overall quality of life.

If you have a patient who lives with chronic daily pain, then ask them about their diet and recommend dietary changes as part of your pain treatment plan. Refer to FHCC nutritional services for education on anti-inflammatory diet and setting SMART goals to start making these dietary changes.

References:

References:

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Duan Y, Zeng L, Zheng C, Song B, Li F, Kong X, Xu K., Inflammatory Links Between High Fat Diets and Diseases. Front Immunol. 2018 Nov 13;9:2649.

Hajihashemi P, Haghighatdoost F. Effects of Whole-Grain Consumption on Selected Biomarkers of Systematic Inflammation: A Systematic Review and Meta-analysis of Randomized Controlled Trials. J Am Coll Nutr. 2018 Sep 5:1-11.

Hosseinpour-Niazi S, Mirmiran P, Fallah-Ghohroudi A, Azizi F. Non-soya legume-based therapeutic lifestyle change diet reduces inflammatory status in diabetic patients: a randomized cross-over clinical trial. Br J Nutr. 2015 Jul;114(2):213-9.

Jafarirad S, Ayoobi N, Karandish M, Jalali MT, Haghighizadeh MH, Jahanshahi A. Dark Chocolate Effect on Serum Adiponectin, Biochemical and Inflammatory Parameters in Diabetic Patients: A Randomized Clinical Trial. Int J Prev Med. 2018 Oct 12;9:86.

Maiorino MI, Bellastella G, Petrizzo M, Scappaticcio L, Giugliano D, Esposito K. Mediterranean diet cools down the inflammatory milieu in type 2 diabetes: the MÉDITA randomized controlled trial. Endocrine. 2016 Dec;54(3):634-641.

Wen L, Duffy, A. Factors Influencing the Gut Microbiota, Inflammation, and Type 2 Diabetes. J Nutr. 2017 Jul; 147(7): 1468S–1475S.