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Pain-Free Through Food James N. Dillard, MD, DC, CAc Columbia University College of Physicians and Surgeons reprinted from Daily Health News, June 28, 2004 URL: http://www.bottomlinesecrets.com/blpnet/article.html?article_id=34013 Believe it or not, the foods you eat may be making your chronic aches and pains worse. To learn about the dietary approach to chronic pain, I spoke with James N. Dillard, MD, DC, CAc, assistant clinical professor at Columbia University College of Physicians and Surgeons in New York City and author of The Chronic Pain Solution (Bantam). Dr. Dillard is formally trained in three health professions -- acupuncture, chiropractic and conventional medicine -- and is an all-around pain specialist. He emphasizes an integrative approach to pain management -- one that combines the best in conventional and traditional medicine, including his own pain-control diet. THE PAIN-CONTROL DIET As you've read many times in Daily Health News, the typical American diet is pretty terrible. To save time, we fill up on processed products and fast foods, which leave us tired, irritable and overweight. We eat few healthy foods, particularly fresh fruits and vegetables, whole grains, deep-water fish and nuts, which naturally make us feel better. If you don't feed your body well, it will not heal well, according to Dr. Dillard. He says that making good food choices can help control the inflammatory process, strengthen resistance to pain and lessen side effects of medications. Good food choices also help ease the side effects of pain, such as listlessness, fatigue, insomnia, weight gain and digestive problems. In contrast, poor food choices increase pain and the accompanying need for medication. Just one fast-food order of a greasy burger and fries can bring on a flare-up of arthritis or PMS or nerve pain, says Dr. Dillard. To lessen pain and feel better overall, he recommends making small, incremental changes to gradually work your way toward a healthier diet. FRESH FRUITS AND VEGETABLES When your body is worn down by pain, fresh fruits and vegetables act as tonics, says Dr. Dillard. Their nutrients strengthen your body. Plant substances called phytochemicals bolster your immune system and enhance your resistance to heart disease, cancer and other illnesses. Good sources of phytochemicals include richly colored, market-ripe produce, such as berries, red grapes, leafy greens, carrots, pumpkins, tomatoes and peaches. Green vegetables are especially beneficial. These contain B-complex vitamins (often deficient in people with chronic pain), magnesium (which helps relax smooth muscles and possibly ease stress) and chemicals that encourage the production of serotonin (a brain chemical or neurotransmitter important for sleep and the regulation of mood states). Among Dr. Dillard's favorites are broccoli, chard, kale and spinach. THE RIGHT FATS Some fats increase inflammation, while others relieve it, explains Dr. Dillard. Chronic inflammatory pain, experienced as muscle and joint tenderness, angina and headaches, is a signal that hormones called prostaglandins are out of balance. There are two kinds of prostaglandins -- one encourages inflammation while the other discourages it. The predominant type in your body depends on the food you eat. Pro-inflammatory fats. When you eat excess animal fats and the partially hydrogenated oils that permeate processed, fried and fast foods, you encourage the production of pro-inflammatory prostaglandins, says Dr. Dillard. The good news is that not only will replacing one fast-food meal a day with a healthful alternative go a long way toward reducing painful inflammation, it will also encourage weight loss, which means less pressure on your back and joints. Dr. Dillard recommends that you steer clear of what he views as pro-inflammatory fats... * Butter * Corn oil * Full-fat dairy products, such as whole milk and ice cream * Margarine * Safflower, sesame, or sunflower oils * Tropical oils (such as coconut or palm) * Vegetable shortening Anti-inflammatory fats. Anti-inflammatory prostaglandins are derived from omega-3 fatty acids, which are found in foods, such as deep-water fish, flaxseed and walnuts. A diet that emphasizes anti-inflammatory fats also may inhibit the production of Substance P, a neurotransmitter associated with pain and inflammation. If you eat salmon, one of the most popular deep-water fish, Dr. Dillard recommends the wild variety. He notes that farm-raised salmon do not consume the plant substances that make wild salmon rich in omega-3 fatty acids. If you're not a fish eater, Dr. Dillard recommends 10 capsules to 12 capsules of fish oil concentrate, or 15 milliliters to 20 milliliters of cod liver oil daily. If the oil repeats on you, try an enteric-coated pill called Fisol (soft gel) daily. A simple way to incorporate flaxseeds and walnuts into your diet is to sprinkle them on salads. Caution: Check with your physician before taking fish oil if you are taking any type of blood-thinning medication... and stop taking omega-3s two weeks prior to any major surgery. Dr. Dillard advises the inclusion of plenty of anti-inflammatory fats in your diet, such as... * Water-cooked eggs fortified with omega-3 fatty acids. Omega-3 fatty acids are often added to eggs now, and that information is clearly marked on the cartons of eggs in your grocery store. * Flaxseeds and flaxseed oil * Herring * Pumpkin seeds * Mackerel * Olive oil * Salmon * Sardines * Walnuts. AN EMPHASIS ON WHOLE GRAINS Whole grains are an excellent source of nutrients vital to pain control, such as the B-complex vitamins. More often, however, people consume refined grains that aggravate inflammation. Dr. Dillard notes that many of his patients experience severe flare-ups of pain after consuming refined products, especially sweet baked goods. An important part of his pain-control diet consists of whole-wheat and oat breads, with an emphasis on fresh loaves from the bakery or health-food store. Oatmeal for breakfast and brown rice for dinner are also healthful alternatives. When it comes to chronic pain management, don't overlook the simple but effective strategy of a healthful diet. Test yourself. For two nights this week, eat fish instead of red meat. If nerve pain is bothering you, add two servings of green vegetables to your plate each of those days. Cut out the sugars and see how you feel. Source * James N. Dillard, MD, DC, CAc, assistant clinical professor at Columbia University College of Physicians and Surgeons, New York City. His clinical practice at the Columbia-Presbyterian eastside offices focuses on musculoskeletal rehabilitation, spine pain and headache, integrative pain medicine and general complementary and alternative medicine. Dr. Dillard's most recent book is The Chronic Pain Solution (Bantam).