How our diet can relieve pain: the link between nutrition and pain

Understanding the connection between nutrition and pain and how the food we eat affects us

In one way or another, the food we put into our bodies has an effect on our system. Maybe you feel wired after having sugar or you have realized you feel better when you eat less processed foods. When it comes to specific illnesses, the food we eat also has an impact. Chronic conditions can worsen or improve with our nutrition. Furthermore, there is a link between our nutrition and pain. This week, I am super excited to share with you the expertise of two amazing physicians. They will speak to us about this very topic and share their tips.

Dr. Reema Jawairia is a gastroenterologist (follow her in Instagram @dailydosebydrJ) and expert in diseases of our intestine. Dr. Angie Neison is a family medicine physician and culinary medicine expert (get her healthy recipes by following her on Instagram @flavors4wellnessmd).

So, let’s get the conversation started by discussing problems with our gut with Dr J and talk about the gut microbiome.

What is the gut microbiome?

In order to understand the connection between nutrition and pain in diseases that involve our bowel, such as Inflammatory Bowel Disease (IBD) or Crohn’s disease, we must first understand the role of gut microbes and their relation to health and disease. The alimentary tract is our interface between the human body and the external environment. Within it lives an intricate ecosystem. This bio-network interacts with the internal and external environment and plays a key role in health and certain diseases. You can learn more about the microbiome here.

Our gut lining is frequently exposed to bacteria, viruses, fungi (yeasts), toxins and the by-product of the foods we consume. 

Did you know that the length of the barrier that keeps harmful bacteria and toxins out of our bloodstream is only once cell thick? Yes, only one cell thick! Hence, it is quite vulnerable. 

This thin layer is protected by a layer of mucus that vigorously fights any bacterial invasion. Therefore, it is vital to gut health and is under attack repeatedly by certain substances, such as artificial food additives.

The effect of these additives include stimulating the growth of disease causing bacteria, such as E. coli, within the microbiome. It also causes disruption of the protective mucus layer. This allows bacteria to adhere directly to the intestinal lining cells and fosters invasion through the gut barrier. These attacks leave us geared up for a second disease-causing hit. Hence, this leaves us vulnerable and leads to a decreased capacity to combat infections. This is strongly associated to the development of inflammatory bowel disease.

In previous studies, we have learned that a diet high in animal fat increases the inflammatory“bile-loving” gut microbiome, which in turn increases a molecule called Trimethylamine N-oxide (TMAO) resulting in inflammation. A diet high in saturated fat increases intestinal permeability. This is known as “leaky gut” in layman terms.

How to reduce inflammation in our body and prevent “leaky gut?”

We need to eat a diet rich in fiber and low in saturated fats. No supplements please! A fiber supplement doesn’t work because it lacks the variety of nutrients found in natural foods. A study from 2018 found that eating more than 30 unique types of plants a week produced the most abundant and diverse gut microbes. In addition, participants who ate less than 10 types of plants per week had by far the least diversity.

Short chain fatty acids (SCFA) are products of colonic bacteria that break down fiber. Three main SCFA are acetate, propionate, and butyrate; these are essential for gut health. Acetate increases colonic blood flow and enhances small bowel movement. Butyrate is the preferred energy source for the colon cells, and may have a role in preventing inflammation of the colon.

In summary, in order to decrease inflammation and improve gut and intestinal integrity, consider a diet low in saturated fat and high in fiber. Dr. J encourages her patients to consume a variety of plant foods with different types of fiber in order to produce SCFA in different areas of the gut. Along with healthy eating, she also recommends doing yoga or meditation to help alleviate stress. 

What about pain and diet?

Let’s read what Dr. Neison says about this topic!

It may seem like magic when someone tells you they ate something and it helped them with the pain in their body.  Is there any truth to that?  Is there a link between nutrition and pain? The answer is yes. The pain mediators are similar to the pro-inflammatory molecules. So, the answer to decreasing pain can be simplified by reducing the foods that cause inflammation.  The reality is that the Western lifestyle is rich in inflammation. We have inflammatory foods, harmful chemicals, artificial preservatives and sweeteners, refined grains and alcohol.

So how can we beat all the inflammation with just food? 

One way to visualize this is to imagine a balance beam, on one side are things that cause inflammation, on the other side are things to help combat the inflammation. So, when we think about food, we have evidence now that if we eat foods that are less inflammatory with high anti-oxidant effects, we tip the scale to balance the beam.

One of the prime examples of evidenced-based research relating pain and inflammation is the NF-kB cell-signaling molecule and its direct link to pain expression. Pain medications inhibit NF-kB to relieve pain.  However, this complex is also involved in activating the inflammatory cascade when it encounters foods that cause inflammation. We can clearly see the connection between nutrition and pain here. So what foods cause this NF-kB complex to switch “ON” the expression of genes involved in the inflammatory response and lead to increased pain?

Here are the top 3 foods to limit

1. Trans-fats and Saturated fats: Most of those are found in commercially baked goods. Saturated fats include fatty animal meat and whole dairy products. An occasional doughnut or steak dinner won’t hurt, but it shouldn’t be every day.
2. Processed foods: Most things in a package are processed, but some foods to limit are sausages, hotdogs, bacon, deli meat and pre-packaged snacks.
3. Sugar!!:  Elevated sugar circulating in the blood stream causes a cycle of inflammation. Eliminate sodas and sugar-sweetened beverages.  It’s also best to limit the hidden sugars from foods like white pasta, white bread, cereals, and pre-packaged snacks.

Here are the top 3 Culinary Tips to decrease inflammation:

1. Increase your ratio of Omega 3: Omega 6 fatty acids: If the diet is high in Omega 6 (typical in Western diets), then you produce a thrombotic type of harmful inflammatory cascade. If you have a diet rich in Omega 3s, you get anti-inflammatory responses. Your goal should be to aim for a 4:1 or 2:1 ratio of omega 3: Omega 6.
2. 1. Add Oils rich in Omega 3s like olive and avocado oil.
   2. Increase your intake of cold-water fatty fish like salmon, sardines, mackerel.
   3. Add flaxseeds, chia seeds and hemp seeds high in Omega 3.
   4. Add walnuts and avocados to smoothies, salads, entrees and desserts.

2. Cook your meats low and slow:  Cooking meats at higher temperatures can lead to excess Advanced Glycation End Products (AGEs), which cause an inflammatory response, mostly in tissues around the heart, lung and skeletal muscle, ultimately leading to stiffness in those tissues. However, this doesn’t occur with grilled fruits and vegetables, so enjoy those grilled summer vegetables (zucchini, sweet potatoes, eggplant, corn) and grilled summer fruits like peaches and watermelon.

3. Increase your vegetable and fruit consumption:  One of the easiest ways to combat the constant inflammation is to fill your diet with rich antioxidants like flavonoids, carotenoids and Vitamin C (all found in fruits and vegetables) to help buffer the inflammatory response. Eating the rainbow from the local farmer’s market will give you the highest nutritional content, but just increasing your produce consumption in general can add so many benefits to your health.

To end

And there you have it, by manipulating something as simple as the food we eat we can improve inflammation, manage pain and chronic conditions! Thanks to our amazing contributors for demystifying the nutrition and pain connection. 

Stay tuned for our next post as we continue exploring this topic with two other incredible docs, an internal medicine physician and an obstetrician, will talk about pain management with herbs and what to expect during pain management for labor!

Till next time,