Healthy Eating

 Healthy diet- a tool for self-management

 

Healthy eating and dietary changes may be one component of your chronic pain self-management plan.

Research shows that healthy nutrition has a positive effect on our health. What we eat influences our health. In Canada, dietary risks are one of the three leading risk factors for disease burden. 

To date, there are no scientifically proven “Chronic Pain Diets”, however healthy eating can benefit people with chronic pain in many ways.

It can:

  1. Reduce fatigue and improve energy levels
  2. Maintain a healthy weight
  3. Reduce the risk of (or help improve) certain diseases such as diabetes, high blood pressure, some cancers and heart disease

 The typical “Western” diet is low in fiber, micronutrients and anti-oxidants, and high in fat, calories, sugar, additives (chemicals, colouring agents, artificial sweeteners). It has often been processed in some way.

This type of diet is considered to be pro-inflammatory, meaning that is causing some amount of inflammation within your body.

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In this module you will learn about:

  • Healthy food choices and habits
  • Reducing inflammation through diet
  • Eating well on a budget
  • Special considerations for endometriosis, interstitial cystitis/bladder pain, irritable bowel syndrome

Healthy Eating

The Canadian Food Guide has recently been updated to reflect the best available scientific evidence. The goal of the Canadian Food Guide is to promote healthy eating and overall health. Dietary choices made on a regular basis form a person’s pattern of eating. Over time, patterns of eating can lead to better or worse health outcomes. The guide below focuses on the regular intake of foods that make up patterns of eating associated with positive health outcomes.

 

 

Healthy Habits

 

Key concepts:

  • Be mindful of your eating habits, take time to eat, notice when you are hungry and when you are full
  • Cook more often, plan what you eat, involve others and make eating social
  • Enjoy your food- culture and tradition can be a part of healthy eating!
  • Prepare meals and snacks using ingredients that have little to no added sodium, sugars
    or saturated fat- choose healthier menu options when eating out
  • Make water your drink of choice
  • Use food labels and be aware that food marketing can influence your choices
  • For more information on fats please visit: https://www.heartandstroke.ca/get-healthy/healthy-eating/fats-and-oils

Inflammation and pain

  • Acute inflammation is the body’s attempt to protect us from infections, irritants, or tissue damage. It can signal that something is wrong within the body and can be a sign that the body is healing.
  • Chronic inflammation is inflammation that lasts months to years. It can have negative impacts on your body and overall health. Some diseases can cause chronic inflammation such as diabetes, auto-immune diseases (Lupus, Rheumatoid Arthritis.
  • Factors that can also promote inflammation include: smoking, chronic stress or distress, insomnia, obesity, and increasing age. 

  •  Acute Inflammation

    • Body’s natural ways of protecting
    • Fight off infections
    • Promote healing
    • Sign that something is wrong
    •  signs include pain or discomfort, redness, heat or warmth, swelling, or a loss in function.
  • Chronic inflammation

    • Can be harmful to us i.e. cancer or rheumatoid arthritis
    • Linked to allergies, asthma, diabetes, irritable bowel syndrome (IBS) and chronic (persistent) pain conditions
    • Signs of chronic inflammation may include: weight gain, body pain, fatigue, insomnia, depression and anxiety, gastrointestinal problems like constipation or diarrhea, and frequent infections. 
  • Contributing Factors

    • Stress, lack of exercise, genetic predisposition, exposure to toxins (tobacco smoke)
    • Diet plays a big role – Positively and Negatively
    • Incorporating an anti-inflammatory diet can help reduce the intensity of pain, regardless of condition
  • Potential Benefits

    • May lower the risk of developing other chronic diseases such as diabetes, cancers and heart disease
    • For those with chronic diseases like diabetes, may improve blood sugar control, cholesterol levels and blood pressure
    • May help with weight loss or weight maintenance
    • Prevent and/or treat constipation
    • Prevent nutritional deficiencies

Following an anti-inflammatory diet can help to reduce pain!

 

General Principals:

  1. Aim for variety (eat the rainbow!)
  2. Include as much fresh food as possible
  3. Minimize processed foods and fast food such as soda, white bread and white pasta

           “If it comes from a plant, it’s good. If it’s made in a plant, it’s (likely) bad.”

Potential Benefits

  • May lower the risk of developing other chronic diseases such as diabetes, cancers and heart disease
  • For those with chronic diseases like diabetes, may improve blood sugar control, cholesterol levels and blood pressure
  • May help with weight loss or weight maintenance
  • Prevent and/or treat constipation
  • Prevent nutritional deficiencies

For more information and food recommendations- click and download this resource from the BC Women's Centre for Pelvic Pain and Endometriosis

Key concepts:

  • Anti-inflammatory diet can help reduce your pain
  • Dietary changes = one component of your self-management plan (medications, stress reduction and exercise)
  • Consult with primary care provider and/or pharmacist before starting any new medication, supplement or vitamin

 

Tips

  • Cook at home
  • Pre-prepared foods such as grated cheese, salad mixes, and vegetable sticks cost more
  • Make extra to store in the freezer
  • Plan ahead and make a list. Stick to your shopping list!
  • Buy on sale, look at flyers or phone apps like FLIPP
  • Plan your meals based on the sales
  • Buy fresh fruits and vegetables when in season
  • Buy large bags of frozen vegetables Cook what you need and keep the rest in the freezer
  • Eat before you shop. Prevents impulse buying and unhealthy food choices.
  • Purchase no name brands or store brands
  • Use meat alternatives like dried beans, peas, lentils for some meals

Special considerations for specific types of chronic pain 

Disclaimer: when making dietary changes, speak with primary care provider if you have previously been given a specific diet.  Diets can be confusing because specific diets for diabetes, kidney disease, gout, IBS can sometimes be conflicting.

  • Endometriosis

    • Increase Magnesium rich foods in your diet or possibly with a magnesium supplement
    • Magnesium can relax the smooth muscles found in the uterus and intestines
    • Examples: nuts & seeds, bananas, asparagus, beets, broccoli and peas
    • B vitamins (especially cruciferous veggies) to reduce stress in the body
    • Examples: fortified cereals, whole grains, dark leafy greens, nuts & seeds, eggs
    • Iron-rich foods to replace any iron lost during heavy menstrual bleeding
    • Examples: dark leafy greens, legumes/lentils, meat/fish/poultry, meat alternatives, fortified cereals/oatmeal

    Avoid or reducing: wheat gluten, citrus fruits, foods that produce digestive issues such as dairy

  • Interstitial cystitis/Bladder pain

  • Irritable Bowel Syndrome

    • Experiment with fiber.
      • Reduces constipation and diarrhea
      • Can worsen gas
      • Increase gradually!
    • Avoid problem foods.
      • Eliminate foods that trigger your symptoms
      • A food diary can help detect problematic foods or drinks
    • Eat at regular times.
      • Don't skip meals
      • Try to eat at about the same time each day to help regulate bowel function
      • If you have diarrhea, you may find that eating small, frequent meals makes you feel better
      • If you're constipated, eating larger amounts of high-fiber foods may help move food through your intestines

  • Constipation in Persistent Pelvic Pain

    • The relationship between persistent pelvic pain and constipation is often multifactorial
      • Dietary patterns
      • Lifestyle factors (chronic stress)
      • Physical and mental health conditions
      • Activity levels
      • Medications
      • Supplements
    • Chronic constipation
      • Contribute to issue within the pelvic floor muscles and supporting structures (ligaments)
      • Cause stretching of the pudendal nerve due to prolonged and repetitive straining
      • Creates more pressure on the bladder and urethra which may cause increased urinary frequency and difficulty urinating
      • Can be a side effect of many medications such as opioids like codeine, morphine (about 90% of people)
    • Typical Western diet = not enough fiber rich foods
    • Decreased fiber and reduced fluid intake (a strategy for some to avoid frequent urination) = Worsening pain
    • Tools for constipation: diet changes, toilet habits and positions, exercise
    • When adding fiber to your diet is it very important to do this slowly and to make sure you also increase the amount of fluids you are drinking

Conclusions

  • For some pain conditions, an anti-inflammatory diet can help reduce your pain
  • Dietary changes = one component of your self-management plan (medications, stress reduction and exercise)
  • Everyone is different! Takes time and testing to find what works and does not work for your body
  • Use the food guide and read the food label
  • Consult with primary care provider and/or pharmacist before starting any new medication, supplement or vitamin

 

References

  • BC Women’s Centre for Pelvic Pain & Endometriosis | www.womenpelvicpainendo.com
  • Children’s and Women’s Hospital & Health Centre of BC (2012). Continence clinic workbook.
  • Bell, R., Borzan, J., Kalso, E., & Simonnet, G. (2012). Food, pain, and drugs: Does it matter what pain patients eat? PAIN, doi: http://dx.doi.org/10.1016/j.pain.2012.05.018
  • Davis, J. (2010). A few hallmarks of healthy eating are at the core of an endometriosis diet: Find out which foods can help. Accessed October 27, 2012 at http://www.everydayhealth.com/womens-health/essentials-of-endometriosis-diet.aspx
  • Levett, C. (2008). Endo diet e-book: The recipe book customised for women with endometriosis. Endo Resolved. Accessed October 27, 2012 at http://www.endo-resolved.com
  • Levett, C. (2007). Recipes for the endometriosis diet. Endo Resolved.
  • Mayo Clinic. (2011). Irritable bowel syndrome. Accessed March 25, 2013 at http://www.mayoclinic.com/health/irritable-bowel-syndrome/DS00106
  • Rakel, D. (2007). The anti-inflammatory diet: How the “Western” diet promotes inflammation. Accessed October 27, 2012 at http://www.fammed.wisc.edu/integrative/modules
  • Rakel, D., & Rindfleisch, A. (2005). Inflammation: Nutritional, botanical, and mind-body influences. Southern Medical Journal, 98(3), 302-310.
  • Mills, D. S., & Vernon, M. (2002). Endometriosis: A key to healing and fertility through nutrition. Thorsons.
    University of Wisconsin School of Medicine and Public Health (2007). The anti-inflammatory diet. Accessed October 27, 2012 at http://www.fammed.wisc.edu/integrative/modules
  • Weil, A. (2013). Dr. Weil’s anti-inflammatory diet. Accessed January 5, 2013 at http://www.drweil.com/drw/u/ART02012/anti-inflammatory-diet
  • Weil, A. (2013). Dr. Weil’s anti-inflammatory food pyramid. Accessed January 5, 2013 at http://www.drweil.com/drw/u/ART02995/Dr-Weil-Anti-Inflammatory-Food-Pyramid.html
  • Weil, A. (2005). Q & A Library: Influencing inflammation? Accessed October 27, 2012 at http://www.drweil.com/drw/u/QAA359518/Influencing-Inflammation.html

 

76 Grenville St. Toronto, ON M5S 1B2 Canada

TAPMI Hub Clinic

Phone: 416-323-6269 Office Fax: 416-323-2666 Hours: 8:00 a.m. – 4:00 p.m. Monday – Friday

Administration

Dr. Tania Di Renna, Medical Director William Cachia, Administrative Director