A strategic diet could help to reduce inflammation that maintains or worsens chronic pain. We explore the mechanisms behind the theory.
If you’re living with long-term or chronic pain (pain that persists for three months or longer), you’ve probably searched widely for sources of relief. Perhaps you’ve tried medications. You may have sought out holistic therapies such as acupuncture. But have you considered how your diet may affect your pain? Should you?
Why would food affect pain?
It would be unrealistic to suggest that including or excluding certain food types from your diet could ‘cure’ serious health conditions or injuries that cause pain. Yet it would be equally unrealistic to suggest that medical interventions such as opioid medications actually reverse underlying conditions or diseases or injuries. This is why health professionals commonly use the term ‘management’ to describe interventions that may reduce the severity of symptoms. Indeed, diet may be used as part of pain management. Why? The basic premise supporting dietary interventions in chronic pain relates to inflammation, which is often elevated in individuals with chronic pain (many experts suggest that chronic inflammation can be a causative or perpetuating factor of chronic pain). In a nutshell, it is thought that manipulating diet to include and exclude certain foods may assist with reducing inflammation.
What is inflammation?
Inflammation is actually a necessary and helpful process in the body’s recovery from an injury or infection. The process involves your immune system sending white blood cells to affected to areas to repair tissue or fight infection. In an ideal world, this inflammation abates when the injury or infection heals. However, in some cases, this inflammatory response can outstay its welcome, in effect turning from ‘good’ to ‘bad’. Prolonged inflammation can contribute to pain in muscles and joints and increase risk for coronary disease, diabetes, cancer and even Alzheimer’s disease.
How does food affect inflammation?
Some research has found that the immune system can respond similarly to certain foods and diet compositions as it would to an injury or infection. While there is no specific evidence-based diet directly targeting inflammation, certain foods and constituents have been found to assist in reducing inflammation and improving pain outcomes. A 2019 study suggests that dietitian-delivered interventions may improve pain scores and increase quality of life in subjects experiencing chronic pain. What’s more, reducing inflammation may help to prevent ‘flares’ of painful auto-immune conditions such as psoriatic arthritis.
What to look for?
What makes a food anti-inflammatory? While there is no definitive list or set of criteria, foods touted as anti-inflammatory tend to positively impact inflammatory biomarkers, which have been found to be lower in those with a high regular intake of fruits and vegetables and those whose diet includes staples of the so-called ‘Mediterranean diet’. Why? These recommendations are rich in polyphenols (a type of antioxidant). That is, they combat oxidative stress, which correlates with inflammation. Omega-3 fatty acids found in olive oil and fatty fish such as salmon have also been found to potentially moderate inflammation, which is why fish oil supplements are widely promoted for inflammation and painful conditions such as arthritis.
Easy anti-inflammatory menu tips
- Load up on fruit and veg
Aim to consume up to seven servings of fruits and vegetables daily. It sounds like a lot, but when you consider that a single serving is only one cup of leafy greens or half a cup of cooked vegetable, or a medium piece of fruit, it’s relatively easy to split across breakfast, lunch, dinner and snacks. For maximum nutrients, choose an array of richly coloured fruit and veg (e.g. red capsicum, eggplant, leafy greens, pumpkin or sweet potato, berries).
2. Snack smart
Trade snacks such as crackers for nutrient-dense nuts. While many people avoid or minimise nut intake due to their high concentration of fat and kilojoules, when consumed in moderation (a serve is a small handful or ¼ of a cup), nuts are an efficient way to consume minerals, antioxidants, fibre and healthy fats.
3. Trade your grains
Exchange nutrient-empty carbohydrate foods such as white bread, rice, pasta and refined cereal for wholegrain alternatives. As well as looking for wholegrain versions of your favourite staples, consider seeking trading meal accompaniments such as rice for quinoa. For breakfast, rolled oats (not the highly-processed ‘quick’ oats or flavoured varieties) are a great option.
4. Moderate meat
While lean meats can be excellent sources of protein and iron, high intakes of red meat have been found in some studies to increase oxidative stress. When consuming meat, stick to a palm-sized portion. If your meals tend to rely on meat as the main ingredient, consider halving the quantity of meat in dishes such as spaghetti bolognese or stews with beans and lentils, which are great sources of protein and fibre.
5. Set the mood for seafood
Research has found links between the omega-3 fatty acids in oily fish and lower levels of inflammation. Consider scheduling two or more servings per week. (This may mean a dinner of cooked salmon with sides of vegetables and quinoa and a lunch meal of wholegrain rice mixed with a small tin of tuna in olive oil, brine or springwater and cooked vegetables. Get creative.)
6. Shelve the sugar
Added sugar such as that found in chocolate, cakes and baked goods, ice-cream and soft drinks and many processed foods (even bought pasta sauces and flavoured yoghurts) has been linked to higher inflammation. To minimise sugar intake, try to make sauces from scratch and opt for plain varieties of foods like yoghurt (look for ‘natural’ or Greek) and add your own flavour with fruit and/or a drizzle of honey. Also avoid white carbohydrates (bread, rice, pasta), which quickly break down into sugar.
7. Skip the drive-thru
While an occasional stop at Macca’s isn’t the end of the world, regular consumption of fast food items such as burgers and fries has been associated with increased inflammation. This is likely to be due to the high concentrations of unhealthy fats (e.g. saturated fat) and/or trans fats and salt coupled with a dearth of anti-inflammatory ingredients in fast food meals. If you do opt for takeaway food, consider finding a fish and chip shop offering grilled salmon or white fish and order a salad rather than chips. Minimising fast food consumption will also help with maintaining a healthy weight or losing weight if your BMI exceeds 24.9 (research shows that simply losing 10 per cent of body weight may contribute to a reduction in inflammatory markers).
This information is general and may not apply to your personal situation. If you are suffering chronic pain related to a diagnosed condition or disease or experience ongoing pain after injury, consider consulting an accredited practising dietitian (APD) for personalised recommendations that may assist you to manage your pain or condition for greater wellbeing and quality of life.