The Importance of An Anti-Inflammatory Diet, Part 1

February 2, 2016 / Thomas Cohn, MD

The diet we eat appears to have more and more significant influence on how healthy we are overall. Diet crazes come and go, but more research is showing that the food we eat does affect many aspects of our life. The main problem is that it is easier to eat whatever foods are available than to choose things that are healthy and helpful to us.

Furthermore the food we eat is processed differently at least initially in each and every person depending on our own genetics and the bacteria that happens to be in our gastrointestinal tract. Lastly, if we are overweight, the fat in our body may be contributing to inflammation. Losing excessive fat, exercising and eating healthy foods are all part of controlling inflammation in our bodies, and that too can contribute to a healthy lifestyle.

Researchers have identified certain foods and diet characteristics that seem to help control inflammation. Below are some suggestions with regards to a diet to control inflammation.

Anti-Inflammatory Diet

1. Start eating fish regularly – At least two meals a week should contain fish that are rich in omega-3 fatty acids. These fatty acids are the ones that are good for you by reducing C-reactive protein and interlukin-6, two proteins that enhance inflammation in the body. Eating a portion of fish like salmon, tuna, sardines, or other cold water fish is ideal.

2. Eat more fruit and vegetables because they are packed with antioxidants – These are compounds that support your immune system and help protect it from dangerous compounds in the environment. They also may help prevent inflammation by protecting compounds in the body from breaking down and needing to be removed and destroyed. The best sources are fresh fruit and vegetables, and when cooking vegetables, just lightly steam or cook them, keeping them crisp. The daily amount should be at 2-3 cups of each a day, that would likely equal at least 2-3 pieces of fresh fruit plus your vegetables. This could also include your salads.

3. Try eating nuts and seeds more often – They are great to substitute for snacks instead of empty calories like sweets. Nuts are full of anti-inflammatory monosaturated fats and are high in protein and fiber. Nuts also tend to fill you up and decrease the desire for more calories. A quarter cup of nuts, such as almonds, walnuts, sunflower seeds or pecans are great for snacks. Keep a jar available and take a few when hunger strikes. Stay away from coated or salted nuts.

4. Beans are often known as the “magical” fruit – They have some unwelcomed properties for some people, producing gas since they may be hard for some to fully digest, but beans have several anti-oxidant and anti-inflammatory compounds. They are also a low cost source of protein, packed with minerals like magnesium, iron and zinc and are high in fiber. Cooked beans can serve as a substitute for meat in sauces, and can be used as a main protein source if properly balanced in a diet. Many vegetarians use beans as their main source of dietary protein and extensive recipes are available in how to incorporate them into meals.

5. Use olive oil as one of your main monounsaturated sources of heart healthy fats – This compound is rich in antioxidants and oleocanthal, a compound that can lower inflammation and pain. The Mediterranean region uses olive oil in most of its cooking, and many use it for salad dressing. It is fine for coating hot pans, but do not try to fry foods with this oil.

On Thursday, we’ll share part 2 which includes five more tips on how an anti-inflammatory diet can help prevent chronic pain.

Cognitive Behavior Therapy Helps Those With Chronic Pain

November 3, 2015May 10, 2016 / Thomas Cohn, MD

Research out of Europe suggests that cognitive behavior therapy (CBT) could help control or reduce chronic pain by helping patients sleep better.

We’ve discussed the link between poor sleep and chronic pain on the blog before, and while we’ve shared some tips for falling asleep and staying asleep, we’ve never examined CBT’s role in the equation. According to the University of Warwick, cognitive behavioral therapy was found to be moderately or strongly effective in the majority of chronic pain patients who suffered from insomnia. Lead research Nicole Tang, PhD, from the University’s Psychology department, said CBT is better alternative that long-term drug treatment for insomnia.

“This study is particularly important because the use of drugs to treat insomnia is not recommended over a long period of time therefore the condition needs to be addressed using a non-pharmacological treatment,” said Dr. Tang. “We believe that our results will be of particular interest to primary care physicians and allied health professionals who are taking up an increasingly important role in preventing and managing long-term conditions.”

CBT and Chronic Pain

For their study, researchers conducted a meta-analysis of 72 studies involving more than 1,000 chronic pain sufferers with insomnia. Treatments varied in the individual studies, but the most popular intervention strategies were education about sleep hygiene, stimulus control, sleep restriction and cognitive therapy. They also analyzed how these approaches were delivered to the subjects. Finally, researchers looked at documented pain levels before and after intervention techniques were administered.

After conducting the meta-analysis, researchers uncovered:

CBT was associated with a decrease in insomnia and mild to moderate decreases in pain levels.

Improved sleep was associated with a decrease in depressive feelings.

Chronic pain sufferers who received CBT experienced improved sleep and had a wider positive impact on pain, fatigue and depression feelings.

Interestingly, intervention techniques were less effective if they were delivered electronically, either by phone or the internet.

“We found little evidence that using therapies delivered either by phone or computer benefited insomniacs. The jury is still out on the effectiveness of using automated sleep treatments. We found that, at the moment at least, delivering therapies personally had the most positive effect on sleeplessness,” Dr. Tang said.

Dr. Tang said they want to pursue further research to establish if CBT is feasible and cost effective for treating chronic pain in the long run.

Related source: Sleep Review Magazine

Swearing Can Reduce Pain Levels

August 4, 2015 / Thomas Cohn, MD

Although the theory hasn’t been tested on patients with chronic pain, a study published in the American Pain Journal suggests that swearing makes pain more tolerable.

For their study, researchers asked two groups of people to stick their hands in a bucket of ice cold water. Both groups were told to remove their hand from the bucket when the pain became unbearable, but one group was asked to repeat a word that may describe a table, while the other group was encouraged to repeat one swear word while their hand was in the water. After the groups were recorded, they switched roles and repeated the exercise.

Swearing Study Results

As you might imagine, participants in the swearing group were able to hold their hands in the water for a longer duration than the non-swearing group. What you might not have guessed is just how long the swearing group could hold out. On average, swearers lasted an extra 31 seconds in the cold hand challenge, and 3 out of 4 people lasted longer in the bucket when they swore.

Interestingly, researchers noted that people who reported swearing more frequently on a regular basis were less effective cursing was during the cold hand endurance test. They believe people who frequently express their anger in a verbal manner seem to be more sensitive to acute and chronic pain. On the flip side, those who don’t regularly swear were able to better tolerate pain when they cursed.

The reason swearing can help ease your pain is because it can activate your brain’s endogenous opioids, which act as a natural pain reliever. These chemicals mimic the effects of morphine and oxycodone, albeit on a smaller scale. That said, like a lot of medications, once your body gets used to it, the effects may not as successful at relieving pain. Researchers believe that higher doses or more vulgar words may be needed to achieve the same effect, which can cause people to unknowingly start to add more cursing to their regular speech.

In all, letting out a curse word after hitting your thumb with a hammer may help you better handle the pain, but you shouldn’t sit on the couch all day cursing your arthritis.

Related source: Time

Could Alcohol Help Ease Chronic Pain?

July 22, 2015July 22, 2015 / Thomas Cohn, MD

People who regularly reported having a beer or two appear to be less likely to experience chronic pain, according to researchers at the University of Aberdeen in Scotland.

According to researchers, adding a beer or two to your regular routine could help ease pain and lessen the handicap caused by chronic pain. For their study, researchers examined 2,239 individuals who suffered from chronic pain caused by fibromyalgia. After taking a closer look at their alcohol consumption habits, researchers discovered that individuals who regularly reported having a beer or two experienced lower levels of disability than chronic pain sufferers who never drank.

“Although we cannot say that alcohol consumption causes less disability among people with chronic widespread pain, the observed link warrants further investigation,” said Gary Macfarlane of the University of Aberdeen.

Alcohol and Chronic Pain

The study asked patients to estimate their weekly alcohol consumption in an effort to see what role alcohol played in the chronic pain equation. Researchers uncovered that individuals who drank between 21 and 35 drinks a week were 67 percent less likely to experience inability to perform certain daily tasks. For reference, one drink was classified as an 8-oz beverage, or about the size of a small glass of win.

Although the findings are interesting, it doesn’t mean you should start pounding beers after dinner. The Arthritis Foundation wrote that moderation is key.

“The important part of that message is that “alcohol in moderation” means one or two glasses of wine, beer or spirits. Not three,” the Arthritis Foundation wrote on their website.

Related source: Mirror.Uk

The First Phase of Legal Marijuana

June 8, 2015June 10, 2015 / Thomas Cohn, MD

The start of legalizing medical marijuana in Minnesota began last Monday. The initial step for patients is to be certified that one has a condition approved for treatment by this medication. Pain is not a condition approved for marijuana in Minnesota. Once certified as having an appropriate condition, the process in Minnesota applying for the medication can begin, and then obtaining the approved medication can occur. One can assume, the medical marijuana oils obtained in Minnesota, will be far different from recreational use marijuana.

In June, 2015, the lead National Geographic article is titled “Weed, The New Science of Marijuana”. It is an excellent review of the knowledge and science of cannabis. The use of marijuana dates back to at least to 3000 B.C.E., but did not become demonized until 1970 when it became a Schedule 1 drug, meaning it had no valid medical purpose. The truth about marijuana is much more complex. The study of marijuana really began only in the early 1960’s compared to the early 1800’s when opium and cocaine became known. Those drugs, which were once taboo, led us to the discovery of morphine and coco leaves. Will marijuana follow a similar path?

The Science Behind Marijuana

In 1963, a young organic chemist by the name of Raphael Mechoulam began experimenting with the compounds in marijuana. After isolating a number of compounds, Mechoulam tested the compounds on monkeys. Only one compound produced a significant effect. As Mechoulam wrote, “normally the rhesus monkey is quite an aggressive individual,” but when injected with this compound, the monkeys became quite calm.

Flash forward a few years, and Mechoulam’s research is helping 20,000 patients get treatment in his home country of Israel for a variety of conditions, including Crohn’s Disease, glaucoma, Tourette’s Syndrome and asthma. Mechoulman says he doesn’t believe the substance should be legalized for recreational use, but he hopes the stigma of studying the compounds for medical research fades now that more people seeing the medical benefits it possesses.

“We have just scratched the surface,” he says, “and I greatly regret that I don’t have another lifetime to devote to this field, for we may well discover that cannabinoids are involved in some way in all human diseases.”

In fact, researchers are using marijuana to combat cancers as we speak. Research in Spain found that some rats with brain tumors were cured of their condition after being injected with THC. The results are quite encouraging, but as biochemist Manuel Guzmán noted, “the problem is, mice are not humans. We do not know if this can be extrapolated to humans at all.”

Think about that for a second. We may have found another potential ally in the war on cancer, but there’s still so much hate for the drug that it’s impeding medical progress. We need to study these compounds in order to provide the best care possible for our patients.

Related source: National Geographic