DIET AND WEIGHT MANAGEMENT

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 The following information was taken from this website.

• Chronic Pain Patients tend to have a low protein diet with high carbohydrates. This can result in weight gain, muscle weakness, fatigue and mental fog. 
• Chronic pain can result in excess secretion of cortisol and catecholamines. This tends to result in unstable glucose levels. Overall, this leads to uncontrolled pain, loss of appetite, decreased protein intake, and “comfy carbs” (sugars and starches). 
• I now advise my patients that sugar is the new fat. 
• Sugar can also lead to inflammation in the body. 
•  Opioids as well as some other pain medications including amitriptyline, gabapentin, and Lyrica can cause “sugar-desire effect” which can lead to weight gain.

1. Proteins are the building blocks of endogenous pain relievers such as endorphins, dopamine, serotonin, and GABA.

2. Protein builds muscle/cartilage including the collagen that holds the intervertebral disc together. Muscle is important to help offload the joints. 

3. Higher protein intake leads to less fat storage.

4. Protein decreases inflammation. Many foods that contain protein such as fish and green vegetables contain anti-inflammatory agents.

Some conditions in the spine, hips, knees, and feet may be aggravated by excess weight. Other condition such as fibromyalgia or neuropathic pain may not be affected by excess weight.

Protein supplements through powders and protein bars may be useful. If your nutrition is inadequate, then a vitamin/mineral preparation may be of benefit. Osteoporosis prevention with vitamin D, magnesium, and calcium are considerations. Regular vitamin B12 may also be of benefit.

Much of this information was taken from this site.

I am a big believer in the anti-inflammatory diet. Research shows that foods and drinks that reduce inflammation can reduce chronic pain and improve your mood. Even small changes, such as switching to whole grains and eating more fish and less red meat, can make a difference in your health.

Types of food that reduce inflammation:

1. Whole grains: Whole grain bread, oats, brown rice, barley, bulgur, quinoa, couscous, polenta and rye bread. You can also switch to whole wheat tortillas and pasta. You can use potatoes, sweet potatoes and plantains in recipes the same way as whole grains. Avoid having these fried very often because fried foods can cause inflammation.
2. Beans, nuts, seeds and plant foods that have a pod, such as peas: Black beans, kidney beans, garbanzos (also called chickpeas), white beans (also called navy beans or cannellini beans), hummus, nuts and seeds. Nuts can include walnuts, almonds, pecans and peanuts. Seeds include sunflower seeds, pumpkin seeds, pine nuts and more. Peas and soybeans are a type of plant called a “legume” that comes in a pod. You can eat sugar snap peas, regular peas, roasted soy nuts, edamame and any type of tofu.
3. Fruits: Berries, pomegranates and cherries. Dark-colored fruits are especially good for preventing inflammation. Any other type of fruit. Avoid drinking fruit juice or drink a small glass and mix it with an equal amount of water. (Fruit juice contains a lot of sugar, which makes inflammation worse.)
4. Vegetables: Yellow, orange and red peppers and tomatoes. Spinach, chard, kale, leaf lettuce, Romaine lettuce, arugula (rocket or roquette) and mixed greens, especially dark, leafy greens. Purple and green cabbage, onions, garlic, broccoli, Brussels sprouts and cauliflower. Radishes, cucumbers, green beans and green onions (scallions).
5. Olive oil: Use this instead of butter and other oils for cooking foods, when possible. You can use flavored or extra virgin olive oil in dips and dressings.
6. Fish: Choose fish that lived in cold water, including salmon, herring, anchovies, sardines and mackerel. Wild salmon is healthy to eat, but farmed salmon is not because it usually has a lot of antibiotics in it. Look for recipes using fresh sardines, herring and mackerel, or buy them canned from the supermarket.
7. Chicken, turkey and other birds: Eat white meat chicken and turkey. Avoid frying or deep frying except as a special treat. Game birds such as pheasant and quail, and farmed birds such as Cornish hens, are fine to eat.
8. Eggs, cheese and yogurt: Low-fat or skim milk, yogurt, natural cheese (not processed cheese such as cheese slices or spreads). Some people do not digest cow’s milk. You can buy milk that does not include lactose (milk sugar) or avoid milk. Check labels on yogurt to avoid brands with a lot of added sugar.
9. Herbs and spices: Cinnamon, ginger, turmeric, garlic, rosemary, cayenne pepper, black pepper.
10. Tea: Black tea, green tea, white tea, herbal tea.
11. Chocolate: Choose dark chocolate with 70% cocoa or higher. Eat 1 or 2 ounces per day. If you are the type of person who can't stop at 1 then you are better off not keeping it around. 

Avoid or eat less of these foods:

• Red meat, such as beef—If you do eat beef, have it only on special occasions. Grassfed beef is the best, but it costs more than regular beef, so you might want to plan for it in your grocery budget. Eat less of other beef, including hamburgers, steaks, ribs and beef in tacos, stir-fry and sandwiches. 
• Processed meat, such as ham, bacon, sausage and lunch meat 
• Certain oils and fats, including margarine, shortening, lard and oils from soybean, safflower, corn and sunflowers 
• White bread 
• Rice and corn cereals and instant oatmeal 
• Instant or white rice, packaged stuffing 
• Foods with high-fructose corn syrup 
• Soda, including diet soda, fruit juice and other drinks with added sugar, such as energy drinks and coffee or tea drinks with flavorings

The anti-inflammatory diet is similar to the Mediterranean diet. This diet is one of the most studied diets and has repeatedly shown multiple benefits including mood, cholesterol, heart disease, and longevity.

Core foods to enjoy every day:

• Whole grains, fruits, vegetables, beans, herbs, spices, nuts, and healthy fats such as olive oil.
• Twice weekly servings of fish and seafood.
• Moderate portions of dairy foods, eggs, and occasional poultry.
• Infrequent servings of red meats and sweets.

This is an excellent article which looked at various diets. It showed that regardless of the diet, the three most important things to weight loss boil down to the following:

1. Eat more vegetables.
2. Eat less sugar.
3. Eat more whole foods.