Fix your pain with your diet

Inflammation is all the rage lately. And rightfully so. Research has shown that chronic inflammation is at the core of most, if not all, of the chronic diseases that affect Americans. But what about chronic pain? Could chronic joint pain, back pain, or muscle pain be caused by chronic inflammation? And can it be alleviated by changing your diet? The answer is yes.

What is Inflammation?

First, we must understand what inflammation is. Inflammation is the term given to describe the biological response that occurs as a result of tissue damage. Bacterial infections, trauma, chemical exposures and dying tissue may all start the inflammatory cascade. In human physiology there are two kinds of inflammation. First, there is the acute form. In this form of inflammation the body responds to an injury by creating an environment that is conducive to healing and tissue repair. The body does this by sending fluids and blood to the area. That’s why the injury swells, turns red and becomes warm to the touch. This is a necessary step after an injury. Acute inflammation is a good thing for the body.

The second type of inflammation, called chronic inflammation, is not a good thing for the body. Chronic inflammation is a lower grade inflammatory response, but it is persistent. Unlike acute inflammation, which resolves, chronic inflammation is a continuous phenomenon that persists silently for years on end. The chronicity of the response is precisely what makes it so problematic. It increases the risk of heart disease, cancer, Alzheimer’s disease, diabetes and many other conditions.

Chronic Inflammation and Pain

How does chronic inflammation affect your pain level? First, it’s important to remember the most widely used pain relievers in the world like ibuprofen, acetaminophen, and aspirin work by reducing inflammation, not by working directly on nerves. This should illustrate the importance of inflammation in producing pain in the human body. However, there are ways to reduce inflammation without resorting to medications, which have serious side-effect profiles, even when taken as directed. The diet is the key.

Dietary-induced chronic inflammation produces an assortment of inflammatory chemicals capable of sensitizing the pain pathways. Moreover, if this sensitization of the pain pathways persists, adaptive responses by the brain cause the sensation of the pain to become exaggerated or inappropriate. The key to fixing this is to reduce the chronic inflammation.

The Pro-Inflammatory Diet

In this country, most people eat a “pro-inflammatory” diet.  That is, they consume food that consistently feeds the inflammatory cascade in the body, leading to chronic inflammation.  As previously pointed out, chronic inflammation leads to tissue destruction and many disease states.  In order to fully understand why our diets lead to this state, we must understand the basics of fatty acids.

Fatty acids are individual molecules that make up triglycerides in our body.  Triglycerides are the storage form of fat that humans use for energy.  In human physiology there are three important fatty acids.  There are omega-3 (n-3), omega-6 (n-6) and omega-9 (n-9) fatty acids.  Omega-3 and omega-6 fatty acids are essential in the human diet.  This means that we must consume them in our diet in order to survive.  Omega-9 fatty acids are classified as non-essential because we are able to synthesize them from other unsaturated fats in our body.  It is the balance of these fatty acids that is critical for controlling and reducing inflammation in human physiology.

First, we must examine the role of fatty acids in our body when speaking about inflammation.  Fatty acids work to produce a variety of chemicals in the body called eicosanoids.  These chemicals are at the heart of the inflammatory cascade.  Some eicosanoids are beneficial while others can contribute to inflammation.  The harmful eicosanoids that contribute to the inflammatory cascade are related to an omega-6 fatty acid called arachidonic acid.  If arachidonic acid is incorporated into a specific eicosanoid then it becomes pro-inflammatory.  If it is not incorporated it becomes anti-inflammatory.  It is arachidonic acid that will fuel the inflammatory cascade, eventually resulting in the production of chemicals capable of sensitizing the pain pathways.

So, we must take a closer look at this specific fatty acid called arachidonic acid.  Arachidonic acid is found preformed in animal products, especially meat.  In addition, it is easily converted in the body from the fatty acids found in grains and vegetable oils like corn, safflower and sunflower oil.  Also, animals fed a steady diet of grain are exceptionally high in arachidonic acid.

Obviously, what we eat will determine our fatty acid profile and potentially contribute to chronic inflammation and pain.  One might think, based on the information given above, that becoming a vegetarian would significantly reduce one’s overall inflammatory load.  And it does make sense especially if we take into account that arachidonic acid is preformed in meat.  It has been shown, however, that the opposite is true.

The average American diet has unfortunately shifted to promote excessive production, storage and utilization of arachidonic acid.  This leads to the over-production of pro-inflammatory eicosanoids.  Research has shown that man evolved with a ratio of omega-6 fatty acids to omega-3 fatty acids of about 1:1.  Today, the average ratio in the diet is anywhere from 10:1 to 20-25:1.  This is disadvantageous because we know that omega-3 fatty acids are anti-inflammatory and have a wealth of other health benefits.  Plainly put, our diets have shifted to favor inflammation.

As mentioned earlier, it would seem that vegetarian diets would be most beneficial in creating an anti-inflammatory state because animal products are high in preformed arachidonic acid.  This hypothesis, however, has not held up in clinical studies.  It has been shown that vegetarians, in fact, have a higher plasma level of arachidonic acid and an essentially equal level of arachidonic acid found in red blood cells when compared to meat eaters.  The study also showed that vegetarians have lower levels of the protective and anti-inflammatory omega-3 fatty acids, specifically EPA and DHA. This suggests that  vegetarian diets shift people closer to an inflammatory state than they probably desire.

A diet high in fruits, vegetables and healthy proteins and fats it ideal for stopping and preventing chronic inflammation.  This type of diet will invariably be low glycemic.  The glycemic index refers to the effect on blood sugar that a particular food will have.  A food that has a low glycemic index (GI) will raise blood sugar much more slowly than a food with a high GI.  Foods with a low GI are much more beneficial for controlling inflammation because low glycemic foods cause a much smaller response from the hormone insulin.  Insulin is the hormone that’s required for most of the cells in our body to use and store sugar for energy.  Insulin, which is secreted from the pancreas, actually stimulates an enzyme that converts omega-6s into the dreaded arachidonic acid.  So a diet that is high glycemic will cause one’s body to over secrete insulin and further drive the inflammatory cascade.

So a diet high in fruits, vegetables, protein and healthy fat will lead to lower inflammation and greater pain control, but are there are other things you can add into your diet to help? As it turns out, there are. Certain spices have powerful anti-inflammatory effects. Turmeric, ginger, garlic and black pepper all have the potential to reduce inflammation when consumed in the diet. There are many other spices that have anti-inflammatory properties so go ahead, spice up your food! Your body may thank you for it.

Chiropractic saves 40% on care for low back pain.

Image via Wikipedia

My blogs generally focus on nutrition and other topics that relate to health.  That is the main focus of my practice.  But as a chiropractor by training I still see some patients that want just that – chiropractic.  I enjoy those patients because I feel as if it gets me back to my roots, so to speak.

Recently I came across a study that was just too good not to share with all of you.  It was about low back pain, its costs to patients and insurance carriers, and how starting your care with a chiropractor can save an astonishing 40%!  This is big news in this day and age with health care costs skyrocketing.  The medical profession and insurance companies should take notice and stop putting so many road blocks in the way of getting quality chiropractic care for people.

The new study showed that people who initiated care for low back pain with chiropractors saved an average of 40% over people who initiated care with a medical doctor.

The study collected data from 85,000 Blue Cross Blue Shield beneficiaries.  It concluded that insurance companies that restrict access the chiropractic will likely end up paying more for care.  This is precisely what insurance companies should be trying not to do.

The study was published in the December 2010 issue of the Journal of Manipulative and Physiological Therapeutics. It looked at Blue Cross Blue Shield of Tennessee over a two year span.  The people in the study had open access to medical doctors and doctors of chiropractic through self-referral.  There were no limits applied to the number of MD or DC visits and no differences in co-pays.

The study showed that people who started their care with a chiropractor instead of a medical doctor saved their insurance company almost 40%.  They calculated that would save BCBS of Tennessee $2.3 million annually.

I’m not one to listen to the insurance companies crying poor.  This story isn’t about saving insurance companies more money.  The point is that chiropractic has been shown to be more effective than conservative medical care and this study shows that it is also more cost effective.  Considering 85% of people will experience back pain in their life time and in a time when health care costs are on the national stage, this story should be front and center.

So next time you have back pain, make sure you see a chiropractor first.  Not only is it more effective, it will save you money!

3 Medical Myths Debunked

Health care can be a confusing field.  There is so much information out there, much of it conflicting, that leaves consumers confused about their health.  Well, today I am here to sort some of them out for you.  Below are some common medical myths that people believe but are not necessarily true.

1. High Cholesterol Means a High Heart Attack Risk

This is perhaps the biggest one I see in practice.  Everyone thinks that having high cholesterol means they are at risk for having a heart attack.  They also think that having low cholesterol is protecting them from heart disease and heart attacks.  Neither is true!  As a matter of fact, 50% of the people who have heart attacks annually have high cholesterol and 50% have low cholesterol. To most people this is an astounding stat, but it’s true.  What has been shown in the research is that your total cholesterol is not actually a predictor of heart disease.  Looking at the break down of the HDL (the good) versus LDL (the bad) cholesterol is helpful but still is not the entire story.  What you should be looking at is the size of your cholesterol.  How do you do that?  It’s simple really.  It’s just a blood test.  It is how the lab analyzes your cholesterol that’s different.  Without getting to technical, small, dense particles of LDL cholesterol are bad because they can make their way into the lining of your blood vessels most easily.  Light, fluffy, large pieces of LDL are not problematic because they cannot readily get into the walls of your vessels and cause the atherosclerotic plaques that are so dangerous.  These are tests that several of the largest laboratories are performing now and give us better information about cardiovascular health.  I have begun measuring cholesterol in this fashion on all my high risk cardiovascular patients and the results have helped us tailor nutritional programs that will be most effective for them.

2. Bed Rest of Back Pain

I recently had someone visit my office on a Monday for an acute case of back pain.  She was in quite a bit of distress and discomfort.  So much so that she had been to the emergency room over the weekend.  There she was given test and test and finally told that her back pain was not life threatening and to go home, take some pain killers and get bed rest for 5 days.  The advice of bed rest is still being given out by many physicians around the country for back pain despite the evidence that overwhelmingly concludes that this only makes back pain worse. In fact, the research shows that if you do go with bed rest you are much more likely to develop a chronic back problem.  If you have an episode of back pain do not stay in bed.  Your best bet is to stay as active as possible.  Your goal should be to continue your normal activities, within reason, but modify these activities to fit your current limitations.  Now, if your normal activities include vigorous exercise you may want to hold off on that until your back is feeling better, but you should try to walk if you can.  Rest if you need to, but keeping the joints and muscles of the back active even when they are hurt is the best way for them to heal appropriately.  You should also see a chiropractor.  Chiropractors are trained extensively on the back and know how to provide nonsurgical relief for back pain.

3. Eating Fat Makes You Fat

This is a biggie.  People come into my office for a lot of reasons.  However, regardless of their initial reason I always ask about their diet.  Inevitably someone will tell me they eat a healthy diet because they eat low fat.  People assume that low fat is the best way to keep fat from accumulating around their midsection (and everywhere else!).  This simply is not true.  It seems intuitive that eating fat would make you fat just like saving money makes you rich.  However, things in the human body are hardly ever that linear.  The way the human body stores fat is by secreting a hormone called insulin.  Insulin is secreted when a person consumes carbohydrates (bread, pasta, sugar) and to some degree protein.  Insulin signals the body’s cells to take in the energy in the blood, in the form of sugar, and store it as fat or use it.  Notice that I did not say that fat causes insulin release?  That’s because it doesn’t!  If fat does not cause the body to secrete the hormone necessary for fat storage then how can fat make you fat?  It can’t!  This myth comes from the fact that fat is higher in calorie than other foods but somewhere along the line people made the leap that eating fat caused fat to accumulate in the body.  When fat is consumed it is actually slowly converted to sugar and burned, not stored.

There are many more to choose from, but these are some of the most common that I see in my office.  If you’d like to know more, let me know in the comments section and I’ll post about your questions.

Related Articles

• Dr. Joseph Mercola: The Cholesterol Myth That Is Harming Your Health (huffingtonpost.com)
• The Cholesterol Con (lewrockwell.com)