Chronic Pain and Nutrition

Many people suffer with chronic pain and try the most obvious route, medication, to reduce discomfort.  Medications can cause many side effects, such as: constipation, drowsiness, nausea, GI discomfort and brain fog. There are many other alternatives to medication, such as: physical therapy, acupuncture, magnetic therapy, yoga and herbal medicine to name a few. What most people do not consider is, the foods we eat can both help or inflame chronic pain.  I will discuss some foods and supplements that you can add/remove to help with chronic pain and support your overall well being.

• Deep sea fatty fish such as salmon, herring, sardines and halibut have omega 3 fatty acid. Omega 3 fatty acid has been shown to reduce inflammation. In a study published in Osteoarthritis Cartilage, Reduction of inflammation was shown with the usage of Omega 3 fatty acid. Other sources of Omega 3 include: walnuts, canola, hemp, flax and grape seed oil. If you are unable to consume foods high in Omega 3, you might consider a supplement containing 1200mg of Omega 3 (eicosapentaenoic acid decosahexanoic acid).
• Antioxidant rich foods: Foods rich in resveratrol- a natural phenol, and a phytoalexin found in plants.  Good sources of resveratrol include: purple grapes, blueberries, raspberries and peanuts. Some early studies have shown that resveratrol has the potential to reduce inflammation and atherogenic status (can reduce risk of atherosclerosis), as well as having neuroprotective properties.
• Soy containing foods have been shown to reduce neuropathic pain and chronic inflammation. In a study published in the European Journal Of Pharmacology, it was shown that soy was able to reduce oxidative stress and nerve pain associated with diabetes. It is not recommended to take soy supplements, so try and get soy from foods such as edamame, tofu, tempeh, and sietan.
• Green tea contains polyphenols that have been shown to reduce inflammation. In a study published in the Journal of Immunology, it was shown that green tea enhanced the resolution of pulmonary inflammation. Green tea is loaded with catechins that are a powerful antioxidant. Green tea does contain small amounts of caffeine, so I recommend drinking it in the morning and reducing or stopping consumption by noon.
• Tumeric has been shown to be a powerful anti inflammatory agent. There have been numerous studies showing the positive effects of this powerhouse spice.  If you do not like the taste, supplementation dosage is: 400-600mg 3x/day.
• Bromelain, an enzyme found in pineapple that has been shown to reduce pain and swelling.  A supplement called Phlogenzym has been shown to help with the pain and swelling associated with arthritis. So throw some pineapple n your fruit salad in the morning!
• Supplements-There are a number of supplements that have been showing promise in reducing chronic inflammation and pain. GLA (gamma-linoleic acid) is an Omega 6 fatty acid. It is most commonly found in plant oils such as evening primrose oil and borage oil. Not all Omega 6 oils are created equal and some can promote inflammation (Linoleic acid and arachidonic acid). The Omega 6 found in GLA has been shown to reduce symptoms of diabetic neuropathy, Rheumatoid arthritis,  PMS, menopause and osteoarthritis. 5-hydroxytrytophan, a precursor to tryptophan, an amino acid that converts into 5-HTP which then converts to serotonin (a neurotransmitter related to mood), has been shown to reduce chronic pain, especially fibromyalgia. 5-HTP is not found in foods, so supplementation is used: 50mg 1-3x/day.  But tryptophan is found in foods, and that can help boost serotonin levels. Foods rich in serotonin include: turkey, chicken, milk, potatoes, pumpkin, sunflower seeds, turnip and collard greens, and seaweed. Certain vitamin and minerals can be therapeutic for pain reduction. Vitamin B6, B12 and B2, selenium, zinc, copper and magnesium to name  a few!

These are just a few of the foods and supplements that can naturally help reduce the signs and symptoms of chronic pain. There are a few foods that can cause inflammation in the body for some people. These can include: dairy, fried foods, red meat, eggs, wheat, corn, nuts and chocolate.  This does not affect everyone.  I always recommend keeping a food journal and eliminating one food group at a time for 2 weeks at a stretch.  If you find eliminating certain foods reduce your pain and inflammation, you have found a source of your inflammation! Always speak to your physician before taking supplements as they can interfere with medications you are currently taking. There are always different ways to support yourself and food/nutrition should always be the first route to assist with any pain/disease state that you have. It can be difficult to do this on your own so getting support from a registered dietitian can help reduce painful inflammation and chronic pain. Citrus Salmon with Garlicky Greens Katherine Cobbs,  Cooking Light MAY 2004      

Ingredients

  2 teaspoons grated orange rind 1/2 cup fresh orange juice (about 1 orange) 1/4 cup low-sodium soy sauce 4 (6-ounce) salmon fillets (about 1 inch thick) Cooking spray 2 teaspoons vegetable oil 1 teaspoon bottled minced garlic 1/2 teaspoon salt 2 (10-ounce) packages fresh spinach (about 20 cups) 1 tablespoon seasoned rice vinegar 2 tablespoons green onions, thinly sliced (optional)    

Preparation

Combine first 3 ingredients in a zip-top plastic bag; add salmon. Seal bag; marinate in refrigerator 30 minutes. Preheat oven to 500°. Remove fillets from bag, and discard marinade. Place the fillets, skin sides down, in a shallow roasting pan coated with cooking spray; cook at 500° for 13 minutes or until fish flakes easily when tested with a fork. Heat the oil in a Dutch oven over medium-high heat. Add garlic, salt, and one package of spinach; sauté 1 minute or until spinach wilts. Add remaining spinach, and cook 2 minutes or until the spinach wilts, stirring frequently. Remove from heat; toss with rice vinegar. Arrange 2/3 cup spinach mixture on each of 4 plates; add 1 salmon fillet. Garnish with onions, if desired.  

Information

Calories 272 Caloriesfromfat 42 % Fat 12.6 g Satfat 2.7 g Monofat 4.8 g Polyfat 3.9 g Protein 31.8 g Carbohydrate 8.6 g Fiber 4.1 g Cholesterol 65 mg Iron 4.5 mg Sodium 807 mg Calcium 161 mg      

Food Allergies and You

Food allergies are on the rise in the United States and it isn’t just infants and toddlers. More and more teens and adults are developing food allergies.  A food allergy occurs when the body has an adverse reaction to a food, triggered by the bodies immune system.  The most common antibody in food allergies is IgE (immunoglobulin E). IgE antibodies bind to specific molecules in food and trigger an immune response. Symptoms of food allergies are:

• Itching and/or swelling of the mouth
• Vomiting, diarrhea, abdominal cramps and/or pain
• Hives/rash
• Troubling breathing and throat tightening
• Drop in blood pressure.

But you don’t have to have a formal allergy to a food to have a negative reaction.  A food intolerance is NOT an allergy, but can also cause distress none the less.

• Lactose intolerance-an inability to digest the lactose (milk sugar) in dairy.  This can cause GI (gastrointestinal distress), diarrhea, bloating and general discomfort.  AS we age, the enzyme we need to digest lactose diminishes greatly. Using Lactaid pills can assist with this intolerance, but if your reaction to dairy is severe you will have to play with dosage and might have to eliminate dairy altogether.
• Gluten intolerance- Although this is related to Celiac disease, it is not an allergy and does not involve an IgE response.  It is the bodies inability to tolerate gluten:found in wheat, barley, rye and some oats.  It can cause GI discomfort, brain fog, insomnia and an overall feeling of malaise. If you have gluten enteropathy/intolerance you should remove gluten in total.
• Food additives-Certain food enhancers and preservatives can also cause a reaction to foods, most notably sulfites (found in wine, dried fruit and sprayed on fruits and vegetables to keep them fresh) and MSG (used as a flavor enhancer, frequently used in Chinese cuisines). Headache, flushing, and difficulty breathing are the most common symptoms. If you are sensitive, you should avoid.

What should you do if you suspect you are having a food allergy or intolerance?

• Always talk to your physician first. Simple blood tests and possible further testing (such as breath tests and biopsies) might be necessary to rule out other conditions and to narrow down sensitivities.
• Start to keep a food journal. No one is a better detective about how things make you feel than yourself.  Write down everything you eat in a day and how foods make you feel.  You might notice you are able to connect dots to why you are feeling badly.  A  Registered Dietitian is always helpful in guiding you through this process.
• Once you have kept a food journal for awhile, consider eliminating one food at a time, not many foods at once.  The top allergen foods are: wheat, eggs, soy, nuts and dairy.  Pick the one you feel is possibly your issue and remove it entirely for two weeks.  If you feel better, it may be the culprit.  If not, put it back into your diet and choose the next food and repeat the process.  It is beneficial to go through this process with an RD.
• Identifying the allergen is the first step.  Then you have to create a diet that eliminates the offending food/s but to make sure you have not lost any nutrients along the way.

Finding out the food or foods that create discomfort can improve quality of life greatly and make you feel tremendously better.  Pay attention to how you feel when you eat, and if you suspect you have developed and allergy or intolerance, it is important to address it as soon as possible.   Pork, White Bean & Kale Soup From EatingWell:  September/October 2007   Makes: 6 servings, about 1 2/3 cups each Active Time: 40 minutes Total Time: 40 minutes     INGREDIENTS 1 tablespoon extra-virgin olive oil 1 pound pork tenderloin, trimmed and cut into 1-inch pieces (you can substitute with boneless chicken cubes) 3/4 teaspoon salt 1 medium onion, finely chopped 4 cloves garlic, minced 2 teaspoons paprika, preferably smoked 1/4 teaspoon crushed red pepper, or to taste (optional) 1 cup white wine 4 plum tomatoes, chopped 4 cups reduced-sodium chicken broth 1 bunch kale, ribs removed, chopped (about 8 cups lightly packed) 1 15-ounce can white beans, rinsed (see Tip)   PREPARATION Heat oil in a Dutch oven over medium-high heat. Add pork, sprinkle with salt and cook, stirring once or twice, until no longer pink on the outside, about 2 minutes. Transfer to a plate with tongs, leaving juices in the pot. Add onion to the pot and cook, stirring often, until just beginning to brown, 2 to 3 minutes. Add garlic, paprika and crushed red pepper (if using) and cook, stirring constantly, until fragrant, about 30 seconds. Add wine and tomatoes, increase heat to high and stir to scrape up any browned bits. Add broth and bring to a boil. Add kale and stir just until it wilts. Reduce heat to maintain a lively simmer and cook, stirring occasionally, until the kale is just tender, about 4 minutes. Stir in beans, the reserved pork and any accumulated juices; simmer until the beans and pork are heated through, about 2 minutes. TIPS & NOTES Tip: While we love the convenience of canned beans, they tend to be high in sodium. Give them a good rinse before adding to a recipe to rid them of some of their sodium (up to 35 percent) or opt for low-sodium or no-salt-added varieties. (Our recipes are analyzed with rinsed, regular canned beans.) Or, if you have the time, cook your own beans from scratch. NUTRITION Per serving: 262 calories; 6 g fat (1 g sat, 3 g mono); 45 mg cholesterol; 26 g carbohydrates; 25 g protein; 7 g fiber; 627 mg sodium; 1024 mg potassium. Nutrition Bonus: Vitamin A (290% daily value), Vitamin C (190% dv), Potassium (29% dv), Iron (20% dv) Carbohydrate Servings: 1