5. Gaining Control

When it comes to managing your chronic pain, take a close look at your lifestyle. Diet, weight, and inflammation (three modifiable factors) are to blame for much of our chronic discomfort.

Certain foods (sugar, processed meat, fried foods, and refined carbs) increase inflammation. Being overweight can have the same effect while adding extra pressure on already tender joints.

Diet and Pain

Habitually, consuming unhealthy foods  like processed meat can cause everything from cancer to chronic pain. While no one food is to blame, evidence proves that consuming highly processed, unhealthy foods (e.g. candy, baked goods, and chips) in large amounts can contribute to high levels of inflammation, leading to chronic pain.

Eating healthy foods (e.g. fruits, veggies, and fish) in a healthy amount, however, can improve your health, longevity and cognition while limiting inflammation, and therefore pain.

Give your diet an overhaul and avoid these inflammation-boosters:

  • Red meat (burgers, steaks) and processed meat (hot dogs, sausage)
  • Sweetened beverages
  • Fried foods
  • Margarine, shortening, lard
  • Refined carbohydrates (sugar, breads, rolls, crackers, white rice, white potatoes)
  • Mono-sodium glutamate (MSG)
  • Gluten and casein (wheat, barley, rye, dairy products)
  • Alcohol

Healthy Foods

The foods eaten in the Mediterranean diet can have a long-term effect on chronic pain, especially among overweight people.

A 2017 study at Ohio State found that anti-inflammatory foods such as fish, nuts, and beans (all of which are included in this diet) are keys to preventing and reducing pain.

This healthy diet includes:

  • Fruits
  • Vegetables
  • Whole grains
  • Legumes
  • Olive/Canola oil
  • Herbs and spices
  • Poultry (at least twice a week)
  • Red meat (no more than a few times a month)

Guide to Healthy Eating

Follow these tips suggested in the 2015–2020 Dietary Guidelines for Americans:

  • Eat healthy always: The more often you choose good-for-you foods and drinks, the better you’ll feel.
  • Eat a variety: Consume eight to nine servings of vegetables each day, including a couple of servings of whole fruit. Vegetables such as broccoli, Brussels sprouts, cabbage, and cauliflower are best.
  • Cut back on calories: Reduce the number of calories you consume from sugars and saturated fat. Also cut back on sodium.
  • Restrict dairy and grains: Eat dairy products in limited quantities. When choosing grains, stay away from simple carbohydrates with refined sugar. Opt for whole grains, including barley, buckwheat, oats, quinoa, brown rice, rye, spelt, and wheat.
  • Avoid red meat: Instead, include fish or vegetarian main dishes, if you can. Chicken is neutral—not harmful, but not beneficial in the anti-inflammatory sense.

Foods by Ailment

Eating certain foods can enhance (or reduce) their negative effect from certain chronic conditions.

Arthritis

Salmon, tuna, sardines, anchovies, and other cold-water fish (e.g., from a northern climate) top the list of omega-3-rich, inflammation-reducing fish that are good for combatting arthritis, according to The Arthritis Foundation.

Foods to eat to combat arthritis:

  • Three to four ounces of fish twice a week
  • At least 1½ to 2 cups of fruit and 2 to 3 cups of vegetables per day, including blueberries, blackberries, strawberries, spinach, kale, and broccoli
  • A daily handful of nuts; preferably walnuts, pine nuts, pistachios, and almonds
  • Beans for fiber, protein, folic acid, and several minerals
  • Include olive oil (2 to 3 tablespoons daily) in cooking or salad dressings. Extra virgin olive oil contains more nutrients than standard varieties
  • Onions for antioxidants and to reduce inflammation, the risk of heart disease, and LDL cholesterol
  • Carotenoid-containing foods like carrots, peppers, strawberries, and blueberries to lower C-reactive protein, which is a marker for inflammation

Foods to avoid:

  • Processed food, such as canned vegetables and soups
  • Salt
  • Alcohol
  • Possibly the “nightshade family of foods” including eggplant, tomatoes, peppers, and potatoes

Fibromyalgia

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, no specific diet has been proven to affect fibromyalgia. That said, the following foods can help improve energy and reduce inflammation.

Foods to eat to combat fibromyalgia:

  • Nuts and seeds (especially almonds)
  • Vegetables (especially crucifers, such as broccoli, cauliflower, and Brussel sprouts, as well as beans, avocado, and dark leafy greens
  • Oatmeal
  • Tofu

Foods to avoid:

  • Alcohol late in the afternoon and evening
  • Caffeine-containing coffee, soft drinks, chocolate, again late in the afternoon and evening
  • Liquids and spicy meals before bed

Headaches

It’s no secret that foods can trigger headaches. Chocolate, monosodium glutamate, aged cheese, and red wine are frequent offenders. In addition, dietary habits like fasting, skipping meals, and dehydration also may be to blame.

Foods to avoid:

  • Cheese, alcohol, and food additives found in hot dogs, ham, sausage, bacon, lunch meats, and pepperoni
  • Monosodium glutamate (MSG), the food additive and flavor enhancer, may trigger headaches in some people
  • Eating cold foods (ice cream, for example) rapidly or gulping ice drinks may cause headaches, especially if you are overheated

The National Headache Foundation says that dietary triggers do not necessarily cause headaches in every person, but certain foods may cause attacks in certain persons in certain situations. Keep a log of foods eaten before a migraine headache to determine those you should avoid.

Irritable Bowel Syndrome

Eat smaller meals more often and/or smaller portions, suggests the National Institute of Diabetes and Digestive and Kidney Diseases, if you’re battling irritable bowel syndrome (IBS).

Foods to eat to combat IBS:

  • Low-fat and high-carb foods (i.e. pasta, rice, whole grain breads, and cereals)
  • Fruits
  • Vegetables
  • High fiber foods

Fiber is essential to our health. While women need 25 grams (g) a day, men should aim for 38 g. The average adult consumes only 15 g of fiber a day, so you will need to put some effort into it. Add fiber-rich foods (fruit, veggies, whole grain and nuts) gradually to allow your body to adjust. Too much too soon may add to your discomfort.

Foods to avoid:

  • Milk, alcohol, caffeine
  • Drinks with large amounts of artificial sweeteners
  • Beans
  • Cabbage
  • Other foods that cause gas

Osteoporosis

Calcium and vitamin D are superstars when it comes to keeping your bones strong and preventing osteoporosis. (See “Daily Calcium Requirements.”)

Food, not supplements, is the best way to ramp up your calcium, says the National Osteoporosis Foundation: “Dairy products, such as low-fat and non-fat milk, yogurt, and cheese are high in calcium. Certain green vegetables and other foods contain calcium in smaller amounts.”

Some juices, breakfast foods, soymilk, cereals, snacks, breads, and bottled water have added calcium. If you drink soymilk or another liquid like orange juice that is fortified with calcium, be sure to shake the container well as calcium can settle at the bottom.

You can also add calcium to many foods with a single tablespoon of nonfat powdered milk, which contains about 50 mg of calcium. You can add 2 to 4 tablespoons to most recipes.

Vitamin D’s Best Sources. Sunlight, food, and supplements are the best sources of vitamin D. The amount of vitamin D your skin makes depends on the time of day, season, geographic latitude, and skin pigmentation.

Depending where you live, vitamin D production may decrease during the winter due to reduced sunlight. Midday is the best time to aborb sunlight; if your shadow is longer than your body height, the sunlight isn’t optimal. Most people must then opt to get vitamin D from eating foods rich in it and taking vitamin D supplements.

Food sources of vitamin D include milk and other dairy products, fortified orange juice, soymilk, cereals, and “wild-caught” mackerel, salmon, and tuna.

Only take a vitamin D supplement if you aren’t getting enough from sunlight and food. Check your other supplements to be sure they don’t contain vitamin D. There are two types of vitamin D supplements—vitamin D2, synthetically made from plant life, and vitamin D3, which is the form your body makes with the help of sunlight. Vitamin D3 is preferred, as it does a better job.

Weight

Losing control of your weight can cause major problems such as diabetes, heart disease, and chronic pain. More than two-thirds of Americans are overweight or obese, according to the CDC.

Studies over the past decade have shown that modest weight loss (15 pounds) in obese individuals can reduce the pain associated with knee osteoarthritis by almost 50 percent. Losing one pound reduces the load on the knees by four pounds per step. In addition:

  • A person’s diet can have a significant effect on the risk of developing rheumatoid arthritis.
  • People who are obese may be more sensitive to pain than others.
  • Obesity increases the risk of fibromyalgia.
  • Obesity (and being underweight) is associated with an increased risk of migraine headaches.
  • Obesity may trigger inflammation and complicate surgery.
  • More than 30 conditions are associated with severe obesity, which is a painful condition itself.

Inflammation

Acute inflammation is the body’s response to injury or irritation. While uncomfortable it is a healthy, short-lived process, during which your body heals. Chronic inflammation, on the other hand is an unhealthy process and is associated with most chronic degenerative diseases, which can lead to chronic pain.

People are more likely to suffer from chronic pain if they also have metabolic syndrome. This occurs when a person has three or more of the following measurements, all of which can be partially or entirely controlled by diet and weight management:

  • Waist circumference greater than 40 inches in men; 35 inches in women.
  • Triglyceride level of 150 mg/dL or greater.
  • HDL (good) cholesterol of less than 40 mg/dL; less than 50 in women.
  • Systolic blood pressure (top number) of 130 or greater, or diastolic blood pressure (bottom number) of 85 or greater.
  • Fasting glucose of 100 mg/dL or greater.

An anti-inflammatory diet is considered an integrative approach to pain management, along with exercise, stress management, and other complementary treatments.

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