Diet, Neuroinflammation, and Pain
As science advances, we are learning more about ways to control our pain by controlling our diets. There are many ways to approach your pain management through healthy dietary changes and habits. Diets such as the Anti-inflammatory Diet, the Mediterranean Diet and intermittent fasting have been shown to be excellent for all-around health promotion, as well as helping with neuroinflammation and pain.
These diets have certain common dietary principles and themes. We now know that healthy diets, which reduce neuroinflammation and general body inflammation, prevent neurodegenerative diseases such as Alzheimer’s Disease, promote cardiovascular health, help prevent cancer and certain chronic diseases, and have a huge impact on our mental health and cognitive function.
- Caloric intake – We need adequate carbohydrates, protein, and healthy fats in our diet. Excessive eating, however, produces oxidative stress and promotes inflammation in our bodies. Combining health choices of what we eat with moderation of amounts leads to very positive health benefits, above and beyond weight control.
- Carbohydrates – Those food items that are converted by the body into sugars for energy for our cells are called carbohydrates. It is important that we consume adequate carbohydrates, but the choice of our carbohydrate sources can play a huge role in controlling our level of inflammation. Foods that are too quickly converted into sugar, including the obvious sweets, but also starchy vegetables such as potatoes, as well as refined and processed flours lead to sugar spikes in the blood stream and the release of insulin. Too strong and frequent a release of insulin, leads to increased inflammation, including neuroinflammation. This in turn worsens pain. Healthy carbohydrate choices include whole grains (which release carbohydrates and sugars very slowly), high fiber and leafy vegetables, and fruits in moderation combined with meals. Watching both the selection of good carbohydrate choices and total amounts provide a means for pain management.
- Proteins – The building blocks of our cells and tissues, blood and even antibodies are called proteins, and are needed for healing and health. It is important to choose healthy protein sources as a part of your overall dietary efforts. Protein sources that also come with increased amounts of saturated fats, are not wise choices in this context. Examples include chicken with the fatty skin, fatty red meats, or cold cuts, as the combination with saturated fats makes these unhealthy sources. Lean meats, fish, eggs, and plant-based protein sources make excellent choices and promote health in many ways. Healthy plant-based sources of protein include whole grains such as oatmeal, quinoa, beans, peas, nuts, seeds and others.
- Healthy fats – Our choices of fats and oils in our diet is very important. Certain oil sources not only provide healthy mono and poly unsaturated fats, but may also have additional compounds such as polyphenols (extra virgin olive oil) that have a direct anti-inflammatory effect. The balance between saturated and unsaturated fats is one determinate of our level of inflammation, unsaturated fats being very good. Omega 3 fatty acids are excellent at directly reducing inflammation. The best oils for your health include olive oil, canola oil, flaxseed oil, avocado oil, walnut oil, sesame oil, grapeseed oil and sunflower oil. Three oils to limit or avoid would be coconut, partially hydrogenated and palm oils. Good natural sources of omega 3 fatty acids include oily fish such as salmon, flax seed and walnuts, to name a few. The use of healthy oils, for cooking, on salads and for flavoring of foods, and considering supplementation with additional omega 3 fatty acids can go a long way towards reducing neuroinflammation.
- Intermittent fasting – Research has shown that intermittent fasting can provide multiple health benefits, including your cardiovascular health, cancer prevention, and other medical positives, and our context, can have a beneficial effect on depression, anxiety, and pain. Intermittent fasting is not as hard as it sounds and can be entered into gradually. One target goal would be to limit eating to an eight-hour window, with fasting for the remaining 16 hours. This may look like having a healthy lunch and healthy dinner, but not snacking and eating breakfast until the following day’s lunch. If you are a coffee drinker, you would avoid putting sugar or creamer in your coffee, but you can have black coffee. You may feel a little grumpy or goofy the first couple of days, but your body does adapt, and you should eventually feel good during your fast. You will have a general sense of improvement in mood and energy level over the first few weeks of starting intermittent fasting. You can still benefit if you do this a few or several times a week, even if it is not every day. Some people narrow the window towards six hours or less, limit calories during their feeding, and add in full fasting days (with plenty of hydration). You can make this fit your needs and receive some degree of benefit no matter how far you dive into the intermittent fasting lifestyle. This will reduce neuroinflammation and thus improve pain, mood, reduce anxiety, and have other quality of life benefits.
- Sleep – Sleep has long been a mystery, but we are learning more and more about not only the importance of sleep, but beginning to understand some of the mechanisms for why sleep is so restorative to our mind, cognition, and energy levels. Sleep allows for various brain functions to change patterns during the night, and although we do not fully understand this process is restorative, we are learning that there is also a washing away of toxins, lactic acid and other chemicals that is helpful for restoring normal brain function on a day-to-day basis. We are also learning that adequate and good quality sleep can have a positive preventative effect for Alzheimer’s disease and other neurodegenerative diseases, as well as other long-term benefits which are important for pain management. On the flip side, we also know that pain interferes with sleep by disrupting sleep during the night. The more that this occurs and the lower the quality of sleep, the lower your tolerance for pain becomes. This is a vicious cycle. There are many ways with which we promote good sleep, and thus good control of neuroinflammation, noted on our Sleep page.
- Exercise – Regular exercise has many positive effects on our health and well-being, including decreasing neuroinflammation and normalizing immune function in general. It is recommended that you exercise to your level of tolerance and seek guidance from your medical provider and physical therapist for strategies with which to maximize your ability to exercise. The American College of Sports Medicine has recommended 2.5 hours of moderate intensity exercise per week. This ideally involves a combination of aerobic high intensity cardiovascular exercise and weight training. The intensity should be high enough to elevate your heart rate and sense of effort. This can be broken down into 5 30-minute sessions or a few longer sessions.