Diet and Pain
What is wrong with our health?
And why do we have so much pain?
One out of 5 adults is afflicted with chronic pain and we have higher levels of chronic diseases and illnesses than at any time in recorded history.
Although we do have better safety standards with reduced risk of accidental death, and we have excellent public health measures that have reduced the risk of infectious illnesses, our risk of heart disease, diabetes, cancer, arthritis and chronic pain is higher than it has ever been.
The health of Americans, and people in all industrialized nations, is rapidly deteriorating. Illnesses that were once rare, are becoming common.
These illnesses are called Lifestyle Diseases or Diseases of Civilization. These are diseases that increase in frequency as countries become more industrialized. A short list of Lifestyle Diseases include Alzheimer's disease, arthritis, atherosclerosis, asthma, cancer, chronic liver disease or cirrhosis, COPD and other lung problems, diabetes, heart disease, metabolic syndrome, chronic renal failure, osteoporosis, stroke, depression, chronic pain and obesity.
These chronic illnesses are NOT due to old age. Some experts have suggested that the Lifestyle Diseases and Diseases of Civilization are just old age diseases, and because citizens of industrialized nations live longer they have higher rates of these diseases. However many of these diseases, such as diabetes, dental cavities, cancer or asthma are appearing at greater rates in young people living in industrialized nations; suggesting that longer life span does NOT explain all of this increased disease.
In every way that we can measure, Americans are more miserable than ever before.
Americans currently have more chronic illnesses and more chronic pain than at any point in the past, and it continues to get worse.
It is not just an epidemic of pain. Americans are in poor health, and it is getting worse. The chronic pain that afflicts 1 out of 5 adults in the USA is a part of a general health problem. Pain doesn't happen in a vacuum, and if Americans want to control their pain, they need to improve their health.
The standard excuse that we are living longer is not factual and does not explain why chronic illness and pain have become so wide spread. If we are to understand why our health is deteriorating we must look at what has changed in the last 100 years since we have become an industrial society.
Food and Skin allergy hospitalizations are up 400%. For example over a 10 year period of time the percentage of children with food allergies almost doubled, and the percentage with skin allergies increased from 7% to 11%. Food allergy related hospitalizations has quadrupled in 10 years (that is a 400% increase). Living longer does not explain this.
Peanut allergies in children have more than tripled in the United States from 1997 to 2008, and government health officials have no explanation according to WebMD. Peanut allergy, unlike other food allergies, is seldom outgrown and is one of the most dangerous food allergies and the most frequent cause of food allergy related deaths.
Asthma has doubled. The prevalence of asthma in the US doubled in 20 years from 1980 to 2000 according to the Centers for Disease Control. Outdoor air pollution is often cited as a “cause” of asthma. Yet, air quality has improved since the 1970s while asthma prevalence has steadily increased.
Latex allergy is epidemic, although it was uncommon before 1980. During the last five years, increasing evidence has been presented showing that latex allergy is now a major occupational health problem, and is epidemic among healthcare workers. Approximately 8% to 17% of healthcare workers, (numbering well over one hundred thousand employees), now have latex allergies.
Childhood eczema has quadrupled. It afflicted about 5% of children in the 1950’s but in recent years has been as high as 20%.
Celiac disease is up 400%. This is an immune system reaction to gluten in the diet, is over four times more common today than it was 50 years ago, according to a Mayo Clinic study published in the journal Gastroenterology.
Skin cancer rate has increased by 1,800%, death rate is up 400%. Before the 1930s, skin cancer was rare. Currently the number of new skin cancer cases and deaths from skin cancer are rising. Since 1930 the incidence of melanoma, the most dangerous skin cancer has gone up 1,800% (not a typo: eighteen hundred percent!). In just the last 30 years, the death rate from melanoma has increased more than fourfold, while the incidence of other types of skin cancer has more than doubled.
Skin cancer increase is not due to increased sun exposure. Some so-called health experts try to blame this increase in skin cancer and melanoma deaths on too much sun exposure, but the melanoma rate has gone up as less and less Americans work outside in the sun. Melanomas are more common in office workers, less common in farmers that actually work in the sun. And melanomas are more frequently diagnosed on the body parts that are not sun exposed. Melanoma is the second leading cause of cancer death for young people age 15 to 30, and the rate is still increasing.
Pancreatic cancer and leukemia are up 150% and 300%. Compared to 1930 the pancreas cancer death rates are 150% higher and leukemia death rates are 300% higher.
Depression and anxiety treatment is up 500%. Between 1988 and 2008, the percentage of adults taking prescription antidepressants increased almost 500%, while the percentage taking anti-anxiety medications increased 50%.
Diabetes is increasing in young adults, under age 44 and has increased around 35% in the last 20 years. It has been predicted that diabetes will double in the next 25 years and will afflict one-third of the U.S. population by 2050. The incidence of childhood diabetes (type I diabetes) began to steadily increase from the 1950s onwards.
Hypertension has increased by 50%. In the last 20 years hypertension among adults 20 years of age and older increased by 50%.
Chronic migraines have increased by 60%. From 1980 through 1989, the prevalence of chronic migraine headaches in the United States increased nearly 60%. Two thirds of the increase occurred among persons less than 45 years of age.
Rheumatoid arthritis and lupus have increased by 20% and 300%. The incidence of rheumatoid arthritis in women increased by about 20% from 1995 to 2007. Over the past 4 decades, the incidence of lupus in both genders has nearly tripled.
Low back pain, shoulder pain and widespread pain is up 200% to 400%. The rates of low back pain, shoulder pain and widespread pain was assessed 50 years ago in a large population of adults. After forty years the rates had at least doubled, and in some case had quadrupled (yes a 400% increase).
Why is our health so much worse?
Why do we have so much more pain?
Correctly answering this question, may allow you to escape the health problems that are plaguing this society. More specifically, answering this question may be the key to overcoming your chronic pain.
Inflammation is now known to be the underlying cause, or major contributing factor, of the chronic illnesses and chronic pain plaguing Americans.
There are two dietary factors that promote inflammation:
Omega 6 fats
We eat 30-40 times as much sugar and 15-25 times as much omega 6 fats as our healthier ancestors. These 2 factors cause, or contribute significantly, to the inflammation causing our poor health and out of control pain levels.
Sugar and Pain
There are 2 problems with sugar.
Guide to Diet and Pain
And inflammation causes pain and sickness. Inflammation is the underlying cause of most of the illnesses that plague modern society. Inflammation is the cause of, or at the very least, contributes significantly to the chronic pain that is making Americans so miserable.
Sugar is a big part of why you have chronic pain.
The fact that sugar is behind so many of our problems is not a secret. Published studies tell the story. For example, in 2002, Dr. Simian Liu with the American Society of Clinical Nutrition published a study that showed that sugar consumption promotes inflammation.
If the inflammation in your body gets high enough, things will quit working right. Organs will begin to malfunction or quit working altogether, and you will begin to hurt. You may feel the pain in your low back, your neck, or that shoulder you injured playing high school football, or you may just begin to ache all over. But you will begin to hurt, somewhere, if your inflammation level gets high enough.
1) Sugar promotes inflammation.
How does sugar increase
inflammation and pain? As you consume more sugar, your body produces more insulin, which increases the production of arachidonic acid. Arachidonic acid is the building block for all of the inflammation in your body. If you decrease the amount of sugar you consume, you will produce less insulin, causing less arachidonic acid. Less arachidonic acid means you will have less inflammation and less pain.
2) We eat too much of it.
One hundred years ago, before 1 out of 5 adults had chronic pain, Americans consumed about 4 pounds of added sugar per year, per person. Current estimates: Between 66 and 156 pounds per year of added sugar.
Soft drinks account for about a third (about 50 pounds a year) of all added sugars consumed, says Kristine Clark, PhD, RD, a spokeswoman for the Sugar Association. Most of the rest comes from candy, cake, cookies, pie, pastries, fruit drinks and ice cream. Getting that stuff out of your diet would eliminate almost all added sugar.
Is all sugar bad? Or just added sugar? You would have to eat 39 servings of beets, that sugar is made from, to get the same amount of sugar in 1 can of pop. And if you did eat 39 servings of beets (which you couldn't do because your stomach is not big enough) the sugar would absorb slowly because of the fiber in the beets. Drinking one soda floods your body with an amount of sugar that far exceeds what your body was designed for.
What about fruit and fruit juice? An apple is very sweet, but the sugar is "packaged" with about one-fifth of our daily requirement of fiber. Because it takes our bodies a long time to digest that fiber, the apple's sugar is slowly released into our blood stream, giving us a sustained source of energy.
Most people eat just one apple, but a glass of apple juice has the same amount of sugar as 2 apples, so by switching to juice you have already doubled your sugar dose. Because the fiber is missing, it aborbs 4 times as fast, which means your body has to deal with about 8 times as much sugar in the hour after you drink the apple juice, compared to eating an apple. That increases insulin leading to increased arachidonic acid, which causes higher inflammation and more pain. Over time, it can also overload the pancreas and liver, leading to serious diseases like diabetes, heart disease and liver disease.
Is fruit juice better than soda? Not much difference. Both have about the same amount of sugar, and no fiber. The fruit juice may have some vitamins, but the impact of the sugar on your inflammation is the same as drinking soda.
If sugar really does cause
inflammation and pain there should be a study showing
that eating less sugar decreases pain.
And here it is.
In September of 2014 the Diabetes Research and Clinical Practice Journal published a study dealing with overweight diabetics (about 60% of all diabetics have chronic pain, and the percentage is even higher for overweight diabetics). In this study overweight diabetics were randomly assigned to a low sugar diet or to a low fat diet. Both groups lost weight, but only the low sugar group experienced an improvement in quality of life. They had improved physical function, better general health and LESS PAIN. The low fat group lost the same amount of weight, but experienced none of these improvements. Losing weight is good, but if you want less pain, you need to decrease your sugar!
Dr. Elissa Epel, a professor at the University of California, San Francisco, and senior author of a study published in the American Journal of Public Health (2014) said “Regular consumption of sugar-sweetened sodas might influence disease development, not only by straining the body’s metabolic control of sugars, but also through accelerated cellular aging of tissues.”
Sugar causes accelerated cellular aging.
His study looked at aging on a cellular level and found that adults who regularly consumed pop had evidence of increased cellular aging. The amount of premature cellular aging was consistent with an approximate 5 year shorter lifespan than their peers who did not consume sugar-laden soda. This explains why sugar consumption is associated with chronic illness such as heart disease and arthritis. Sugar is literally making the cells grow old and wear out.
Could sugar cause premature death? Another recent study answers that question. This study demonstrated that people with diets that promote inflammation -- such as those high in sugar -- are in fact at increased risk for early death. Susan Steck, an associate professor at the University of South Carolina and co-author of the study said, "diet can modify inflammation." Her study included more than 10,500 people who were followed from 1987 through 2003 (16 years).
If sugar causes accelerated cellular aging, doesn't that mean you would die early?
Those with diets most strongly associated with inflammation were 53 percent more likely to die early than those with the most anti-inflammatory diets. These findings were presented Nov. 7, 2013 at the annual meeting of the American Institute for Cancer Research, in Bethesda, Md.
inflammation and pain
premature cellular aging
is associated with premature death
increases quality of life
reduces chronic pain
Omega 6 fats promote inflammation, Omega 3 fats fight inflammation. Omega 6 and omega 3 fatty acids are both essential to our health, and we get them through our diet. However they have opposite effects: omega 6 fats (primarily from vegetable oil) promote inflammation and pain by increasing production of arachidonic acid. Omega 3s (best source is fish) do the opposite; they reduce inflammation and pain. As long as we eat the correct ratio of omega 6 and omega 3 fats we remain healthy. Historically that ratio has been around 1:1.
Omega 6 Fatty Acids and Pain
Omega 6 fats increase inflammation and pain.
Omega 3 fats fight inflammation.
With the advent of modern technology we gained the ability to extract omega 6 rich vegetable oils, the main sources of omega 6 fatty acids. By 1935 the ratio of omega 6 to omega 3 fatty acids had already increased to 8:1, much higher than the historical ratio of 1:1. The ratio continued climbing and by 1985, we were up to 10:1. Today, estimates vary but most experts agree we currently consume at least 15 times as much the pro-inflammatory omega 6 as we consume of the anti-infammatory omega 3, and possibly 25 times as much. Prior to the 1900s we consumed virtually no vegetable oil. Now we consume 70 pounds of vegetable fat a year. During the same time we decreased fish consumption, the main source of omega 3s.
According to a study published in 2011 in the American Journal of Clinical Nutrition, our soybean oil consumption alone has increased 1000 fold since 1909. Soybean oil is our major source of omega 6 fatty acids, and Americans now get almost 20% of their calories from soybean oil, which is ubiquitous in processed foods. Other sources of omega 6 fatty acids include corn oil, safflower oil, cottonseed oil, sunflower oil, peanut oil, and sesame oil. These oils were never available to humans until the 20th century, because we simply didn’t have the technology to extract them.
Currently we consume 15 to 25 times more omega 6 fatty acids then our healthier ancestors consumed.
Soybean oil and other vegetable oils are the main sources of omega 6 fats.
Guide to Diet and Pain
Dr. Simopoulos, in 2002 published an article in Biomedical Pharmacotherapeutics. He said excessive amounts of omega-6 fatty acids and a very high omega-6:omega-3 ratio, as is found in today's Western diets, promotes many diseases, including cardiovascular disease, cancer, and inflammatory and autoimmune diseases, whereas increased levels of omega-3 fatty acids (a low omega-6:omega-3 ratio) exert suppressive effects. Other sutudies have shown patients with chronic pain have higher omega 6 levels.
Lowering omega 6 and increasing omega 3 reverses Diseases of Civilization and decreases pain.
High omega 6 diets promote chronic pain and inflammatory
illnesses, the so called
"Diseases of Civilization."
Correcting the omega 6:3 ratio (decreasing omega 6 and/or increasing omega 3) reverses the major chronic illnesses of Americans. Examples include studies that have shown that a ratio of omega 6 to omega 3 of 4:1 will decrease the death rate by 70% for people with known heart disease. A ratio of 2.5:1 reduced the growth of cancer cells in patients with colorectal cancer. A ratio of 2:1 or 3:1 suppressed inflammation in patients with rheumatoid arthritis. A ratio of 5:1 had a beneficial effect on patients with asthma, whereas a ratio of 10:1 aggravated their condition.
These studies indicate that the optimal ratio may vary depending on your medical condition, but if you get the omega 6 low enough, you will improve.
A study published in the Pain Journal in 2004 showed that the pain level in mice with injured sciatic nerves could be increased with omega 6s and decreased with omega 3s. Multiple recent human studies demonstrated reduced arthritic pain by decreasing the omega 6:3 ratio. Recent discoveries have shown that decreasing the omega 6:3 ratio not only reduces arachidonic acid, but also increases production of potent natural anti-inflammatories, which are particularly affective against inflammatory and neuropathic pain. It appears that anybody with chronic pain will benefit from decreasing omega 6 and increasing omega 3 to get the ratio down to a healthy level.
Isn't my condition a little too advanced to think nutrition could help me?
If I already have chronic pain will lowering my omega 6 level make any real difference at this point?
If sugar & omega 6 fats increase my arachidonic acid, aren't there other ways of decreasing the arachidonic acid to control my inflammation and pain?
Here are the basic methods to control arachidonic acid.
Corticosteroid drugs such as cortisone or prednisone prevent inflammation by blocking the formation of arachidonic acid.
Corticosteroid drugs are very effective but too dangerous for long term use. Side effects include cushings syndrome, obesity, diabetes, bone weakness, etc.
Anti-inflammatories: NSAIDs (aspirin, Advil, Celebrex, etc) and natural anti-inflammatories such as curcumin and boswellia allow the arachidonic acid to form, but block the arachidonic acid from producing the inflammation.
NSAIDs are also unsafe for long term use, particularly in the elderly. Over 16,000 people die each year from internal bleeding caused by NSAID use, in addition to kidney failure and other problems. Natural anti-infammatories are probably safer and equally as effective, (see the Supplements page, here, for details) but are costly and generally not covered by insurance.
Dietary changes: Reducing sugar consumption will reduce your bodies production of arachidonic acid.
Reducing omega 6 consumption will decrease the raw material your body uses to produce arachidonic acid.
These dietary changes are easily implemented by motivated patients, will reduce or eliminate your pain and improve your general health. Published studies have shown these nutritional therapies are highly effective without the toxic side effects of prescription strength NSAIDs or corticosteroid drugs.
Whoa! I thought cholesterol and saturated fat was the enemy?
Many people were taught that, and many people believed it. But there was never any real evidence to support it, and people who followed the low fat diet did worse, not better. As Americans consumed less fat they increased total carbs and sugar and their health got worse, and this has been reported in multiple medical journals. There are some websites, here, here and here that explore this issue in detail. Please go to some of these web sites and become informed on this important issue.
Here is a link to a heart surgeon who has performed over 5,000 open heart surgeries. Go to his website, here, to read his discussion of the cholesterol myth and a review of the evidence on what really causes inflammation and heart disease.
Are there laboratory tests that will help me control my inflammation and pain?
A CRP test measures your inflammation level. Eliminating added sugar from your diet, decreasing omega 6 fatty acids and supplementing omega 3s will generally result in the CRP level decreasing, even if it was in the normal range to begin with. When the CRP level is lower it means you have less inflamation and your pain will decrease.
HA1C measures your average blood sugar level (BSL). Your BSL fluctuates after meals and through out the day based on activity level. The HA1C gives an average BSL and if you decrease sugar consumption, your HA1C will decrease. Aerobic exercise will also lower your HA1C. Regardless of whether you lower your HA1C through exercise or reduced sugar consumption, or a combination of the two, when your HA1C
level decreases, you will produce less insulin, which will decrease arachidonic acid production, resulting in less inflammation and pain
3. Your triglycerides level will also decrease as you decrease sugar consumption.
4. You can measure your omega 6 and omega 3 levels and the ratio between the two. Your goal should be to get your ratio of omega 6:3 fatty acids down to at least 2:1.
Changing the Diet to Reduce Pain.
Guide to Diet and Pain
Hopefully at this point you are beginning to understand that diet has a big impact on your general health, as well as your pain. The studies we have reviewed above are just a few of the thousands of published studies, and we have only scratched the surface. And new studies come out every day. I hope that you will add to what you have learned here, by doing additional research of your own. Talk to other medical providers, your primary care provider, friends and family members, search the web, seek information from many sources.
Some people feel a little overwhelmed with all of the changes they need to make to their diet. And quite frankly, most people don't make any change at all. And that is fine. Nobody wants to force anybody to make any change they don't want to make. But by supplying this information to you, I have fullfilled my responsibility. You can do with it what you will.
I sincerely believe that if this information was implemented fully by all of my patients, I would be out of work. I have seen countless patients implement these principles over the years with astounding improvements in hopeless medical conditions. Multiple patients over the years have completely eliminated or experienced major improvements in asthma, arthritis symptoms, fibromyalgia, high blood pressure, heart disease, migraines and chronic neck and low back pain.
You too can see these types of improvment in your health. If you make a little change, you will see a little improvement. If you make a big change, you will see a big improvement. If you make no change.......don't expect any improvement.
How do I get the sugar and omega 6 fatty acids out of my diet?
Decide that you really can control what you eat.
Remind yourself frequently why you are making better choices: because you want to feel better and be healthier.
Remember: the best way to beat the outrageous cost of medical care is to get healthier so that you need less medical care.
Don’t eat anything with an ingredient list on it. If it has an ingredient list it will probably have omega 6s or sugar or both.
Stick to real foods; meat, fish, chicken, eggs, fresh or frozen vegetables and fruits.
If you have to eat something with an ingredient list, compare labels and make the best choice.The further down the list it is, the less there is of it. Being 5 or 6 on the list is a lot better than being #2 or 3.
How to quit eating sugar.
Anything in the ingredient list that ends with “ose” is a sugar (Sucrose, Maltose, Dextrose, Fructose, Glucose, Galactose, Lactose, High fructose corn syrup, Glucose solids). Don’t buy it and don’t eat it.
Be aware of all the cute names such as “dried cane juice” that are used to hide sugar and dupe consumers.
After you have broken the sugar addiction foods will start tasting better, even without added sugar.
Eliminate all sugary drinks. Water is the best beverage for your thirst. Stopping all sugary drinks (soda, fruit juice, lemonade, hot chocolate, chocolate milk, energy drinks, sports drinks) will get rid of about a third of the added sugar for most people.
Eliminate candy, cake, cookies, pie, pastries, and ice cream. After eliminating these foods and sugary drinks you will have eliminated almost all added sugar.
How to decrease omega-6 and increase omega-3.
Start by supplementing omega-3s. That is the easiest and most effective way to start bringing your omega 6:3 ratio back into balance. You should expect to feel better (less pain and less stiffness) in 2-4 weeks. See our Omega 3 page, here, for more information and correct dosage.
Cook with olive oil, canola oil or butter.
Eat salmon and oily fish frequently. Avoid tilapia and cat fish.
Read every label and don't buy anything with soybean oil or corn oil. There are other oils to avoid as well but soybean and corn oil are the two main culprits.
You need to find a salad dressing that isn't made out of soybean oil. You can find salad dressing that isn't made out of soybean oil, but you will have to read quite a few labels to find a good salad dressing.
Most breads will have soybean oil but if you look hard enough you can find some good choices. At Natural Pantry they use safflower oil in their bread and I have seen the 55 gallon drum the oil comes in and it is all *high oleic safflower oil which is a good choice.
Improving your diet and reducing your pain.
Avoid the Bad Oils:
corn oil, soybean oil, safflower oil*, margarine, wheat germ oil, sunflower oil, poppy seed oil, cottonseed oil, palm kernel oil, peanut oil, sesame oil
Use the Good Oils:
olive oil, canola oil, avocado oil, almond oil, apricot kernel oil, butter, lard, hazelnut oil, rapeseed oil, high oleic safflower oil*
*high oleic safflower oil is a good oil. But if the label doesn't clearly say "high oleic" it is regular safflower oil and it is high in omega 6s and you should avoid it.
Read the Label. Here are some of the many names for SUGAR: Cane juice, Dehydrated cane juice, Cane juice solids, Cane juice crystals, Dextrin, Maltodextrin, Dextran, Barley malt, Beet sugar, Corn syrup, Corn syrup solids, Caramel, Buttered syrup, Carob syrup, Brown sugar, Date sugar, Malt syrup, Fruit juice, Fruit juice concentrate, Dehydrated fruit juice, Fruit juice crystals, Golden syrup, Turbinado, Sorghum syrup, Refiner's syrup, Maple syrup, Yellow sugar, Cane sugar, Dextrose, Fructose, Galactose, Glucose, Glucose solids, Golden sugar, Grape sugar, High-fructose corn syrup, Honey, Invert sugar, Lactose, Maltose, Molasses, Raw sugar, or Sucrose.
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