Friday, October 5, 2007

Should I be on a certain diet when my joint is so inflammed?

I like the way Andrew Weil makes choices for dietary restrictions in those with inflammation. This is usually asked of me when a patient is going through a sprain or strain of a body part and I am putting them on the trifecta of:

1 an antiinflammatory
2 a muscle relaxant
3 a pain reducer

We can sometimes get by without this "cocktail" but people present in extremes and the discofort is agonizing to the point of the patient and family being desperate for immediate change. I had mentioned in the post on "which protein powder is good for gaining muscle" that white willow bark, turmeric, boswelia and ginger are good for antiinflamatory properties. I have tried New Chapter's Zyflamend and Natures Sunshine's IF relief. Both had great results with nostomach upset. There should be limitations to duration used and in some with true joint disease a compound with glucosamine sulfate would also be useful. (As an aside, I was using glucoasamine in the mid 90's with my patients using European studies as a basis for trying it. Also my older patients were developing ulcers and reflux with typical NSAIDs used for joint arthritis. Only a few years later did I see some of the orthopedic surgeons trying the same for teh arthritic patients we sent them. This was one or two "pods" in Wheaton Illinois. You can imagine the thrill I had when Whole Foods was built behind my office and this was the first I heard of this concept.)

I will usually involve my patients immediately in some form of movement (physical therapy, yoga, tai chi) and a diet. The diet is more of a restriction diet. The American culture is based on fast cars, fast money, fast food and built into this is a very poorly calculated diet rich in milk, sweetners, fat and salt. Everything to make you release serotonin and feel great after eating. The normal post prandial wave or parasmpathetic hormone release that occurs after a meal is increased with the ingestion of simple carbs that have a very high glycemic index and fill the blood stream with immediate glucose for that tsunami of hormone to be released from the gut and stimulate the brain cells. Well, the average american is eating to set him or herself up for inflammation whether in the form of poor tolerance to exertion and resultant muscle soreness or that deadly inflammatory response that occurs in the blood vessels laden with cholesterol plaques called CAD (coronary artery disease).

"The Saguil Approach" to an antiinflammatory diet:

No dairy
Change animal protein to plant protein-switch from red fatty meats to soybean, tofu soymilk or lean cuts
Avoid processed meats (nitrites cause inflammation)
Multiple colors of fruits and veggies daily(shoot for 5)-(Berries are great)
Start cooking with ginger and turmeric (try indian dishes)
Start preparing cold water fish dishes (SLASH-M see omega 3 post in the herbal411review blog)
...or take omega 3 fish oil
Use extra virgin olive oil as the main fat and eliminate anything that is deep fried containing transfatty acids.
Avoid Nightshade family?
Increasing fluid intake is mandatory

Reinforcement of goals achieved if very useful. The person suffering from acute or chronic inflammation has 24 hours of pain they experience so any applause that they have made it through to a first or second goal is helpful. When under duress, concentration is lost and sometimes the one in pain forgets they are actually able to move a joint now or walk with less limp. Our ER is built on determining if the treatment is successful by lowering the pain scale from 10/10 to a lower number. Problem with this mentality is a patient will keep on saying it's a 10 until mental faculties and so distorted that either they are asleep or slurring their speech.(oh but they are still a 10/10 because the pain is still in the same place-remember, we didnt fix the inflammation, we only dulled the brains' interpretation of it so even if they are now drunk, the joint or body part still aint moving and is still as hell.) Occasionally we do win and that patient states the headache or back pain is better but these are also the patients that are moving the extremity and pumping the muscle to the previously guarded area....maybe more blood flow, less lactic acid or just the golgi tendon organs in the muscle are getting a massage?

So next time the doc whips out a script of three different medicines for that pain.....try adding this diet to the next 1-2 weeks and see if it gets better faster.....maybe you might like the diet and save your heart too!