A true professional will help his / her client become more independent and less in need of her / her services. We are all about helping our patients become “Independently Healthy”. We have had so many patients respond to the following lifestyle changes that we want to make the ideas more available.
Acknowledgments go to the many instructors I have learned from in the new specialty of Functional Medicine and to Julia Ross, author of the book “Mood Cures” and “Diet Cures,’ as well as to the authors of so many other books about diet and nutrition who all seem to be humming closer to the same tunes now. Thanks also to my patients who have taught me more than I have learned from the books and seminars.
Inflammation (characterized by redness, pain, swelling, warmth, and sometimes fluid build up) is part of the course of almost all diseases.
The immune system mounts this inflammatory response to help defend against infection and cancer, and to heal injured tissue. Too often, however, our immune system “overdoes it” and causes too much inflammation with resultant excessive redness, swelling, pain, and warmth.
Whenever we are sick or injured, we should consider looking at our diet and lifestyle to see if there is something we can do to help our immune system function better, so as to limit the suffering from unnecessary inflammation.
The following is a list which I drafted over two evenings. It certainly is not exhaustive, but I hope you find something interesting and helpful.
Things which decrease inflammation:
1. Avoid trauma, infection, toxic exposures (Use common sense, be careful, use good hygiene, learn about and avoid potential toxins and triggers of the immune system).
2. Keep skin, lung, and gut barriers healthy with healthy diet (see below).
3. Essential fatty acid supplement, especially, take omega 3 fish oil (EPA and DHA). Also consider flaxseed (which has ALA) and primrose oil (which has GLA). The typical “Sad American Diet (SAD)” has far too much omega 6 oils compared with omega 3 oils, and this leads to inflammation. Omega 6 oils which should be avoided are found in margarine, Crisco, and store-bought red meat. Cows fed corn in feed lots have more omega sixes in their meat. Range-fed cows and wild game eat grass and “greens” and have more omega threes. Alaskan wild salmon is full of the healthy omega 3’s.
People with depression, rheumatoid arthritis, heart disease and diabetes ought to know they are getting enough of the essential fatty acids. Too little of these can lead to more arachidonic acid and prostaglandins and thus more inflammation. If you are not sure of your diet, and you have some inflammatory condition, consider checking essential fatty acid levels.
4. Take a quality multivitamin and mineral supplement. This is a very short statement for a very big subject. There will be more on this later in our web site and more in our clinic handouts. Recognize that you can now measure vitamin and mineral levels, at a somewhat reasonable cost, but you need to know what tests to order. Vitamin B12 levels, for instance, fluctuate so much that a serum B12 level is unreliable. Consider measuring a urine methylmalonic acid level instead, as an indicator of B12 deficiency.
5. Limit other unhealthy oils and fats, including all oils other than olive oil, and flaxseed oil, and all fats other than butter and coconut butter.
6. A diet low in refined carbohydrates. Refined carbs are the starches and sweets. This includes flour, rice, noodles, bread, potatoes, corn, sugar, honey, fruit juice, soda pop, candy, cakes, cookies, and pastries; Especially avoid high fructose corn syrup. Also do not eat more than two cups of fruit in a day).
7. A diet rich in nutrients (including protein, healthy fats (olive oil, butter, coconut oil), healthy carbohydrates, fiber, antioxidants, and other important vitamins and minerals). Have all the different colors of vegetables every day. Adults should eat 7-8 servings (4-5 cups) of vegetables every day. Eat nuts, beans, and seeds.
One goal for adults, especially if they have depression or pain, or diabetes, is to have 25 grams of whole protein (meat, cottage cheese, eggs, etc) three times a day.. This is about the size of your palm, and the thickness of your palm.
You might notice that all of the successful diet programs (South Beach, Ultra-Wellness, Fit For Life, Weight Watchers, others) include a healthy serving of protein several times a day.
One reason for their success is that these proteins serve as precursors for serotonin, endorphins, GABA, adrenaline, thyroid hormone, and glutamine which give us improved mood, decreases pain, helps us relax, gives us energy and suppresses our appetite (respectively).
One of the most exciting parts of my practice in the last 15 months has been replacing pain pills and addicting relaxants with amino acids / and more protein in patient’s diets. Amino acid therapy is becoming more of a “science” and certainly should be considered in preference to the less-safe addicting meds whenever possible. Before trying these on your own, you should consult with someone familiar with side effects and supplement-drug interactions.
The typical American diet has only 12 grams of fiber per day. By increasing the intake of fiber (in vegetables, nuts, seeds, whole grain, fruits), to 50-60 grams, we decrease our risk of most chronic diseases including cancer, heart disease, diabetes.
A high fiber diet also helps the food that you eat with the fiber last longer so that your blood sugar is more stable and you stay full for longer periods of time.
The fiber also serves as healthy “food” or “prebiotics” for the healthy bacteria (probiotics) in your GI tract, and this has a definite effect on decreasing inflammation in the rest of your body.
Healthy fats are a very important part of our diet. The brain, for instance is 60% fat (hence the term: “fathead” may be more accurate that previously thought). Every cell in the body is surrounded by a cell membrane that is mainly fat particles.
Some 20 to thirty years ago, fat was given a “bad rap” and all the agencies were advising “low fat diets.” The problem was, they did not differentiate between good fats and bad fats. I feel bad that I was part of the conventional medicine approach and I advised all my patients to eat a low fat diet, because that is what was advised by the agencies. Despite these good intentions my patients all gained weight and moved towards diabetes. We have all been frustrated. Over the years I still asked all of my patients who lost weight and kept it off (a very small, independently-minded group, indeed), how they did it.
Inevitably, they said: “I started grazing on vegetables, and I avoided the white stuff.”
There is enough information in the literature now to substantiate why this diet low in refined carbs works.
In the last 3-4 years I am excited about all the success of so many of my patients. Many of my diabetic patients are exercising their independence from me and from prescribed meds and from the oppression of obesity by focusing on dropping refined carbs eating more vegetable and protein, and not worrying so much about the fats, except that they eat healthy fats.
8. If you have persistent allergies, reflux, depression, arthritis, ADHD, difficulty focusing, low energy, irritable bowel (among many other disorders), then consider a very hypoallergenic diet by limiting the top 10 allergenic foods (we call this a “comprehensive elimination diet”) for six weeks, but be prepared to take fortified supplements if you are not real familiar with how to do this without creating nutritional deficiencies.
9. Ensure healthy GI flora by taking probiotics, especially while taking antibiotics, or, if you are not allergic to dairy, take full-fat, non-sweetened yogurt.* Eat a diet high in fiber, both soluble, and insoluble, to feed the healthy bacteria in your GI tract.
Did you know that there are more bacteria in the GI tract than there are of your own cells in your body? I think it must be a conspiracy – just kidding.
Some of the bacteria perform essential functions such as synthesis of vitamin B12 for optimal nerve health. You can imagine what might happen if you change the types of organisms with (especially unnecessary) antibiotics or eat too many sweets (which can make fungus grow rampant where you don’t want fungus to grow).
There are now tests available which evaluate the stool and can show if your stool is friendly or foul (sorry, pun intended, but the tests actually exist).
9. Exercise. Exercise is important, except that you should avoid overuse of already-inflamed muscles, joints, and ligaments. Exercise has been found to decrease inflammation in many different ways. In order to bring healing nutrients and oxygen into an inflamed tissue, the muscles around it often need to be exercised. Even people with degenerative arthritis have less symptoms if they exercise moderately.
10. Drink lots of water. Adults should drink 6-8 glasses of water every day. By being well-hydrated, the inflammatory mediators can be carried away from the site of inflammation, and healing factors can move in as needed to calm the inflammation.
11. Adequate sleep. One dramatic example of this is the effect of sleep on migraine sufferers. Migraines have been found to be another disease partially-mediated by inflammation, and almost all migraines subside when the patient takes a nap. To limit inflammation, most adult patients should get 7-8 hours of sleep per night.
12. Treat sleep apnea. Any vitamin or mineral or fatty acid or protein deficiency can cause inflammation, but the worse stressor is a deficiency of oxygen. Sleep apnea leaves a patient without oxygen for long periods at night, and has been found to be a cause of many chronic diseases because of the damage in it’s’ wake. This includes diseases like obesity, diabetes, heart disease, depression, high blood pressure, and congestive heart failure.
One of my patients has “inoperable heart disease”, and had his first heart attack in his mid forties, and his only risk factor for heart disease was sleep apnea. Consider doing an overnight pulse oximeter test (costs in the range of 200-300 dollars, but misses as much as 10-15% of actual sleep apneas) or a sleep study (may cost from $3,000 to $14,000). One of the most disturbing things for my patient population is the cost of these sleep studies and someone should solve this problem –fast—please!!
13. Avoid foods that cause inflammation (this varies among individuals, but can include gluten, milk, eggs, peanuts). Consider doing IgE testing (for immediate sensitivity) and –perhaps more important – IgG testing (for delayed sensitivity) to see what foods you are sensitive to.
I have seen many health problems cured by stopping foods that people are allergic to, such as: allergic rhinitis, asthma, irritable bowel syndrome, unexplained abdominal pain, unexplained fatigue, rashes, depression, and psoriasis. Many other diseases (for example, rheumatoid arthritis, ADHD, autism, Crohns) are ameliorated (lessened) when the patients eliminate foods they are reacting to.
14. Avoid environmental toxins and optimize your body’s ability to remove toxins. We are exposed to thousands of more chemicals than our ancestors were exposed to in the form of heavy metals, phthalates in plastics, pesticides and hormones in our foods, and many others.
Eating food grown close to home without pesticides, learning about heavy metals, and other toxic substances are all important things to do. Although we appreciate the efforts the government agencies put forward to try to protect us, they are unable to do all the research necessary, and we the consumer must stay as “green and clean and close to home” with our food growing and purchasing as we can.
15. Minimize emotional stressors, learn coping strategies to deal with stressors. Every one (at least all whom I have asked) of my rheumatoid arthritis patients and Crohn’s patients and psoriasis patients can testify that emotional stressors worsen the severity of their illness.
Type A persons are also at higher risk of heart disease, and stress of any kind makes it more difficult to control blood sugar in diabetics. Part of the reason for this is the cortisol and adrenaline that are released which hormones increase blood pressure and blood sugar. This may help you deal with the stress over the short run, but it is unhealthy to have a chronically elevated cortisol and adrenaline level over the long run.
This does not have to be as much of a guessing game as it used to be. Salivary cortisol levels correlate fairly well with serum cortisol, and a 4- or 5- panel cortisol salivary test can now be run for a fairly reasonable price. There are health food supplements to take which seem to work for both high or low cortisol.
I have found the salivary cortisol levels to correlate well with the patients’ symptoms. These levels may also help you adjust your lifestyle if your are “burning the candle at both ends” and think that there is no end to cortisol production (another common misconception not unlike the thought that the supply of insulin coming from the pancreas is infinite).
If you cannot bring yourself down from the frenzied pace, consider seeking professional help, pray more, let go and let God, learn some relaxation techniques—your life may depend on it more than you think.
16. Good dental hygiene. It could be easy to minimize the sore tooth, or think that it is “just another minor ailment.” In actuality, the gums and teeth are the cardiologist’s most feared source of blood borne infection to infect the heart valves. It is no surprise that one of the two most common causes of an elevated CRP ( “C-Reactive Protein”, a nonspecific indicator of inflammation in the body) is dental infections. If you have any chronic inflammatory condition, and also have a tooth or gum infection, get the mouth taken care of and see what happens to the other inflammation.
Note: The other common cause of “idiopathic” / unexplained elevated CRP is truncal obesity—which is one of the key factors in prediabetes / Syndrome X / Metabolic syndrome). Speaking of C-reactive Protein, many years ago, I noticed that patient’s CRPs decreased when they ate a diet rich in vegetables. I did not understand why at that time, but I understand it now.
17. Check Vitamin D level and take vitamin D if it is low. A low vitamin D causes inflammation. Maybe this is one of the reasons low vitamin D is related to so many disorders including heart disease, cancer, osteoporosis, and depression. Most Alaskans are low in Vitamin D. I have tested hundreds of patients, and I have only had 2 patients whose level was in (what I call) the normal range (e.g., above 40), unless they were on vitamin D supplements.
The tough thing about vitamin D is that the test is kind of expensive. Our clinic is actively lobbying for better prices with the available labs.
You should probably check a baseline level and then recheck levels about 2 months after supplementing your diet with extra vitamin D. You should check your calcium level along with vitamin D level, because some people elevate their calcium level to dangerous ranges when they take vitamin D (although this is not common). Vitamin D is a fat-soluble vitamin and should be taken with olive oil or butter or coconut oil or fish oil capsules or nuts. It should also be taken with Vitamin A in your daily multivitamin.
18. Consider taking natural antiinflammatories such as Bromelain, garlic, boswellia, or cat’s paw (my cat would not appreciate this) instead of ibuprophen, naproxyn or other nonsteroidal antiinflammatories (NSAID’s). I recently took bromelain capsules (bromelain comes from pineapple) for a tendonitis in my left wrist. It worked great. I was pain free in 2 hours.
The natural antiinflammatories act “upstream” in blocking the inflammatory cascade, whereas the NSAID”s act “downstream” in blocking prostaglandins, which can have good and bad long term effects. We will have more in our web site about the contraindications of the natural antiinflammatories later, so if you are on different medications, or have chronic or serious health problems, you may want to wait until we post more information about these or you talk to a health-care provider about them.
*This brings up the subject of whole vs non-fat milk. I advise all of my diabetics and overweight patients to drink whole milk, along with eggs, and bacon from pigs fed things other than buckets of corn. Each of them who do this brings their blood sugar and weight down easily as long as they eat these foods in moderation. Skim, or 1% or 2% milk is low in nutrients other than sugars (lactose and galactose), and should be classified as another “refined carbohydrate” – one of the “white foods” that you want to avoid.