Inflammation and Diet

[Brunneria]

Hi all,

The subject came up on another thread here, and rather than derail the thread, I suggested starting a new one on the subject of inflammation.

So here it is.

Have at it!

 

[Brunneria]

the discussion in the other thread was partly about whether diet has an effect on inflammation, and whether there is any evidence to back it up.

I have no knowledge about the scientific evidence and study side of things, but I know from experience that if I eat a diet high in sugar and grains (which also sends my BG high too, of course), then I get sore stiff knees, swollen finger joints and various aches and pains.

Not having ever had blood tests for inflammation markers, I cannot, of course, support this with any evidence whatsoever - but I can assure you that I find my repeated personal experience extremely convincing.

 

[Indy51]

Likewise - every time I accidentally get ''glutened'' (quite apart from the disastrous GI after effects), I get joint pain - particularly left elbow for some reason. Works like a charm.

 

[Indy51]

A quick pubmed search for ''diet and inflammation'' comes back with 611 results, so have at the research:
http://www.ncbi.nlm.nih.gov/pubmed/?term=diet+and+inflammation

 

[Brunneria]

And the best bit (for me) is that this was a totally accidental discovery.

First noticed when I cut down on carbs. The joint pain would start easing by about the 3rd day.
Repeated whenever I fell off the carb wagon, and crawled back on.
And then absolutely confirmed (in my mind) when I went very low carb at the beginning of last year.

I can now actually do the happy dance that my joint pain would have previously prevented!

 

[Brunneria]

Mind you (and I promise not to hog this thread, after this) there is another factor in my joint pain that I feel I should also mention,

The worst my fingers and knees ever got, were while I was habitually using a laptop (on my lap) and a cordless mouse. The battery magnetic fields were strongest over my knees and right hand - exactly where I had the most pain.

When I switched back to a corded mouse and a desktop PC, my symptoms improved significantly. But not enough to be pain free.

Again, no case study and scientific evidence for my experience, but I am convinced they had an impact.

 

[Pdiabet]

Mind you (and I promise not to hog this thread, after this) there is another factor in my joint pain that I feel I should also mention,

The worst my fingers and knees ever got, were while I was habitually using a laptop (on my lap) and a cordless mouse. The battery magnetic fields were strongest over my knees and right hand - exactly where I had the most pain.

When I switched back to a corded mouse and a desktop PC, my symptoms improved significantly. But not enough to be pain free.

Again, no case study and scientific evidence for my experience, but I am convinced they had an impact.

High carb diet leads to presence of high insulin levels in the body (insulin resistance also adds to this). Higher insulib levels are finally leading to inflammation in body.
This happens in prediabets most of the time.

So high carb leads to high insulin that leads to inflammation.

 

[donnellysdogs]

From my experience:

Inflammation: I have previously been diagnosed with Paiindromic Rheumatism; Pernicious Anaemia and Fibromyalgia. I have RF levels dancing on the ceiling and an odd ANA results....

I was in constant, horrendous pain for approx 20 years..

About 6 weeks ago I was informed that in 2003 a note had been left off my file and I had not been informed. Aspartame and sweetener allergy / intolerance.

Since dropping any food with un-natural ingredients in I am now as good and fit as any other 'normal' person...

It concerns me that so many people are being diagnosed with illnesses that I believe the majority of these inflammatory, stomach problems could be stopped if people looked at eating just meat n veg and fruit with the natural processed products such as cheese, butter, cream etc.

If I won the lottery I would select 20 people that are suffering pain and health problems to a remote island with chefs... Coking purely "natural foods" for 3 months and would get in medics to monitor...and to change peoples lives....

 

[Winnie53]

Post copied and moved here from this topic... http://www.diabetes.co.uk/forum/threads/dietary-fat-and-dementia.80528/#post-899974

I'm aware of Terry Wahls' work. I still have yet to see any evidence in the form of published articles in well-regarded peer reviewed journals (not anecdotes/testimonials), demonstrating that, or which kind of, food choices reduce inflammation in the body.

Clearly, medication alone is not intended to be sufficient in managing diabetes or other chronic conditions. Medical advice is meant to (and often does) include advice and support on lifestyle factors such as diet and exercise. Correcting vitamin and mineral deficiencies also comes under the umbrella of medicine. I don't see any scientifically demonstrated value-add from naturopathy. The advice given by a naturopath, that has evidential support, can also be given by a medical doctor. Obviously, people often find their naturopath has more time to give such advice and support than their available medical doctor, but I see that as a separate issue to the demonstrated effectiveness of the advice or treatments.

I'm glad you have found the strategies you use to be helpful to you.

CatLadyNZ, I read your profile to get a better understanding of where you're coming from. I'm not a skeptic, but do question, question, question. I strongly believe in the value of science, but, here's where we part ways, I also strongly believe in the value of clinical experience.

And I assure you, I'm not into "woo woo" - "unfounded or ludicrous beliefs...any belief not founded on good evidence, the poorer the evidence the more woo woo the belief."

I take no medication or nutritional supplement, and make no dietary changes until I have a reasonable understanding of what's known and understood about each change I make. I do that by regularly listening to lectures by healthcare practitioners who have extensive clinical experience and keep up with and regularly report on what's known through research, both current and past. In addition, I regularly read reviews of the research, abstracts, and, sometimes, research studies. The latter is not easy. I find myself having to Google unfamiliar terms a lot, but I manage to plod through it.

When you say you're "aware of Terry Wahl's work", what does that mean?

If you haven't already, I again encourage you to take the time to listen to this 18 minute lecture by her in which she describes her diagnosis of multiple sclerosis (MS), how her condition significantly worsened despite receiving the best standard of medical care available at the time, and how she restored her health through use of diet, nutritional supplements, and new and innovative therapies...

My experience with standard medical care differs from yours. In the US, doctors receive minimal to no training in nutrition, so if they do provide diet or nutritional advice, it's sometimes right, but too often wrong. I personally prefer that doctors refer their patients to nutritionists.

As for checking for nutritional deficiencies, out of the four specialists - (psychiatry, gastroenterology, endocrinology) - I've seen, not one checked my vitamin B12, D, or magnesium levels, though my general practice doctor did check my vitamin D level once when all the doctors were doing same more than 12 or so years ago.

In regards to your comments about naturopaths, some are excellent, some are not, and most fall somewhere in between, but at least they do have training in nutrition, and are helpful in sorting out common chronic health issues with the thyroid and gut by ordering the appropriate lab work, and screening for nutritional deficiencies and food sensitivities. I'm sure they do other things too, but these are the things I hear about the most.

I'm just beginning to learn about functional medicine approaches to chronic diseases. It's an exciting field formalized in 1991 in the US with the founding of the Institute for Functional Medicine. To learn more, I encourage you and others to read Dr. Jeffrey S. Bland's book, The Disease Delusion (2014).

Hopefully, Indy51 addressed your question/concern: "A quick pubmed search for ''diet and inflammation'' comes back with 611 results, so have at the research: http://www.ncbi.nlm.nih.gov/pubmed/?term=diet+and+inflammation"

 

[Brunneria]

High carb diet leads to presence of high insulin levels in the body (insulin resistance also adds to this). Higher insulib levels are finally leading to inflammation in body.
This happens in prediabets most of the time.

So high carb leads to high insulin that leads to inflammation.

I do agree. Sort of.

But as an obese type 2 with polycystic ovary syndrome plus being on insulin resistance increasing meds (for something other than diabetes), i still have plenty of insulin resistance even on less than 30g carbs a day. I can actually feel it reducing during my daily dog walks, and rising if i eat too many carbs in a sitting. The muscle heaviness and apathy is a dead giveaway.

Yet i only have the inflammation when i eat grains and sugar. Other carbs raise my bg and my insulin resistance, but apparently not my inflammation.

 

[Winnie53]

I'm enjoying reading everyone's experiences with dietary changes.

My father had his first surgery for ulcerative colitis at age 3. His sister developed it in her adult years. I was diagnosed with the pre-curser to ulcerative colitis in 2000.

Thanks to the specific carbohydrate diet (SCD), I've only had one flare since, which began in March. I'm back on the SCD diet, and slowly getting better, but it's taking longer than normal this time because I was so resistant to giving up my daily dark chocolate, and in my case only, coffee - (which gives me tinnitus, which I'd attribute to inflammation, every time I resume drinking it again). [sigh...]

In 2011, I was formally diagnosed with non-celiac gluten sensitivity (NCGS), but I have no gastrointestinal symptoms when exposed to gluten. When I was unintentionally exposed to gluten at a restaurant last summer, I had headaches over the week that followed. My main problems related to gluten are a long history of vitamin and mineral deficiencies, which is why I take nutritional supplements. Thyroid problems are often associated with gluten sensitivity, but I don't know if it caused my subclinical hyperthyroid condition or not. I need to research it.

Starting the low carb, high fat (LCHF) diet in February has been a huge help to me. By giving up sugar and all grains, and greatly limiting legumes, starchy vegetables, and fruit, and walking daily, my blood glucose levels have improved so much.

I'm still thinking about taking probiotics after having read Perlmutter's book, Brain Maker (2015), and doing Tom Malterre's elimination diet, fully explained in his book, The Elimination Diet (2015), to determine once and for all which, if any, foods I'm reacting to with inflammation. Probably dairy. Not looking forward to it, but needs to be done.

 

[Winnie53]

Brunneria, you attribute "muscle heaviness and apathy" to rising blood glucose levels? That's so interesting. I've been struggling with that a lot this last week or so. The only thing that seems to help is forcing myself to walk every day, which...lowers my blood glucose levels...

 

[Brunneria]

Brunneria, you attribute "muscle heaviness and apathy" to rising blood glucose levels? That's so interesting. I've been struggling with that a lot this last week or so. The only thing that seems to help is forcing myself to walk every day, which...lowers my blood glucose levels...

Oh, no. Sorry if i didn't make it clear.

I attribute muscle heaviness and apathy with insulin resistance. The insulin resistance 'burns off' with exercise, but reasserts itself every morning, or after too long without being active.

Rising bg (which may or may not happen at the same time has very few symptoms, until it gets over about 11mmol/l, at which point i start getting sleepy.) but the knock on effect of too many carbs is increased ir.

I suppose anything that i do/eat that raises insulin secretion will ultimately increase insulin resistance. But i dont think my bg needs to be particularly high to require insulin secretion.

 

[Winnie53]

Thanks for the clarification Brunneria. I think increased insulin resistance (IR) better fits what I've been experiencing these last 10 days. My routines were disrupted, at one point I hadn't walked in three, maybe four days, my blood glucose levels began to inch up, likely due to the IR, and the muscle heaviness and apathy set in. So I forced myself to walk a mile every day to get back to where I was before, and I added a B-complex to my daily regimen. B vitamins energize me, so can't take them in the evening.

I'm very interested in your observations and insights because you have so many of the issues that I have or have had that are not typically discussed here. I'm going to pay closer attention now to when I experience the muscle heaviness and apathy. Not sure if I experience it or not first thing in the morning, maybe...

 

[Brunneria]

The zombie lurch down the landing to the bathroom is what gives it away, for me

 

[Indy51]

@Winnie53 If you haven't heard the interview, here's a link for a recent Abel James interview with Dr Terry Wahls where she talks about the various research studies she is setting up to test her protocol:

 

[ButtterflyLady]

Part one

Hi Winnie53

I don't want to get into an endless back and forth about medical science vs alternatives so I will try to keep this as focused as I can and just comment on a few things.

I don't think I will be able to persuade you to change your mind about the subject, but I hope to raise questions and issues for you and others who are reading. I also don't think you will be able to persuade me to change my mind on the subject, but I do believe in keeping an open mind.

My experience
Some personal context that might be helpful to know is that over the years I have read extensively about and tried a large number of alternative options for my various illnesses, mostly with not much effect. I have watched the Wahls video you mentioned, as well as reading a lot of stuff on her website and subscribing to her emails for a couple of years. I don't think there is any new information on her website that would make a difference to my current views. As I live with chronic illness, the time I can spend on reading and viewing videos is limited.

Skepticism
You say you are not a skeptic. But I would bet that you are a skeptic about many other things in life, such as whether the moon landings were faked, or whether crop circles are made by aliens. (FWIW, I think the moon landings were real, and crop circles are human made). We are all skeptical about some things, the difference is that some of us try to apply skepticism to as many things as we can. I think when it comes to our health it is in our interests to be as skeptical as possible. There are lots of websites with information on how to assess claims and figure out what kinds of evidence are more likely to be reliable than others. My ability to assess evidence has grown over the years but I am always learning new things.

Clinical experience
Like you, I also strongly believe in the value of clinical experience. But there is a fine line between that and personal anecdote. My own experience can tell me something about treatment options, but high quality science based evidence is at least as important, and probably more important. If it wasn't for science, we wouldn't know we had diabetes, how to monitor it, or how to treat it. If it's good enough for the scientific method to show us how to do these things, then why isn't the same method reliable in showing us which treatments are more likely to be effective and safe?

Science and drugs
Science doesn't say everyone who takes a certain drug will respond the same way; it provides data on how the majority of the people will respond, and also on how others are likely to respond. Science also updates itself constantly with new information. So, when a drug is approved and starts being used by the population, if a significant number of reports about a side effect or risk are made, warning information can be released to all doctors and the public, or in some cases, the drug can be withdrawn completely. This is rare, though, because of the lengthy and detailed process a drug has to go through before it is approved.

Alternative products
Alternative products do not have to go through this process, so the information we have about effectiveness and safety is much lower. Such products are not regulated to ensure the active ingredients are as potent as what is said on the label or what was found in pre-marketing research. We really cannot know with certainty what we are taking.

Nutrition training
Supporters of alternatives to medicine often say that doctors don't receive much training in nutrition, and that naturopaths receive more training and can therefore give better advice about nutrition. In fact, doctors do receive adequate training on those aspects of treatment where diet has been shown to make a significant difference. Perhaps the most important piece of dietary advice that anyone can give is to not consume more calories than you need. I am guilty of ignoring this advice for most of my life until the last few years. Doctors are certainly trained in why this advice is so important, and they do give the advice. If patients ignore it, it does not mean that doctors are ignorant about nutrition. I agree that a registered dietician has the best training about nutrition and anyone with specific needs in this area should see one. However, most people do not need to.

Your psych, gastro and endo doctors should have checked for the deficiencies you mentioned, as it is current mainstream practice for those specialties, and for general practice, and well supported by evidence.

Again, none of the things you mention that naturopaths do cannot be done by a GP. Checking thyroid function is mainstream.

Gut health
Many of the claims about gut health that are made by supporters of alternatives are not adequately supported by evidence. This does not mean you can't experiment with an exclusion diet and find you feel better avoiding certain foods. However, if you do, that doesn't mean everyone would be likely to find similar things, nor does it mean doctors are ignoring an area of health that makes a difference to diabetes management, morbidity or mortality. I was gluten and dairy free for 3 years. Currently I'm not convinced that such dietary changes improved my health or that resuming eating these things worsened it. I certainly enjoy the varied, tasty, and more convenient diet. I feel lucky that I can eat these things, as I know for example people with coeliac disease can't eat gluten.

Functional medicine
I have read a lot about functional medicine over the years. Many diseases are functional more than they are structural, and this has always been known about in medicine. For example, I have a type of GORD/GERD that is a functional illness. Despite testing, no physical evidence such as a hiatal hernia or h.pylori infection was ever found. But I and my GP and gastro doc know I have GORD and we also believe that in my case it is best controlled with medication. It doesn't matter what I eat or whether I eat, I would still get symptoms. If I don't take medication, I get intense pain, sweating and shortness of breath that feels like a heart attack. So I am not going off my GORD medication any time soon.

Continued in next post

 

[ButtterflyLady]

Part two


Inflammation
Searching keywords on pubmed isn't the same as reading a carefully written, relevant research report in a peer reviewed journal. It's a scattergun approach. I looked at the titles of the first page of cited articles and found most of them irrelevant to the question at hand. None of us would be willing to read the abstracts of all 611 articles, to find the small number of relevant ones. Let me explain my point about inflammation.

It is well known within medicine that (to summarise) eating too much food over a period of time leads to excessive fat deposits in the body, particularly around the abdomen. These deposits change the way the body processes insulin and increase the production of insulin. This leads to insulin resistance and T2 diabetes. As part of this process, inflammation increases, particularly in the cardiovascular system, leading to increased risk of heart disease and stroke.

This is why when you search for "diet" and "inflammation" you will get hundreds of results. It does not mean that some foods increase inflammation and some foods reduce it. I assume all of us want to reduce our risk of cardiovascular disease caused by inflammation. According to the scientific evidence, the best way to do this is to be a normal body weight, exercise regularly and, if necessary, to take certain medications.

If you find that when you avoid gluten you have less knee pain, that is great, and I'm really happy for you. But at the moment despite a lot of research, no one has been able to show that avoiding gluten reduces joint pain, and so it can't yet be medically recommended as a treatment option. However, there is nothing stopping people from trying it and seeing if it works for them. It's unlikely to cause malnutrition, but to be on the safe side, people should monitor this, especially in children.

Why I prefer medicine over the alternatives
I am convinced that I am managing my diabetes and other illnesses optimally with careful use of medications, exercising, and eating a balanced diet low in refined carbs, high in fibre and restricted in overall calories. I don't think people need to do more than this, unless there is a specific reason for them, such as coeliac disease or high HbA1c results despite doing the above. I think the most important thing is to have regular monitoring of HbA1c, body weight, thyroid, liver and kidney function, cholesterol, blood pressure, eyes, feet, and other things I've probably forgotten to include. Correcting vitamin and mineral deficiencies is also necessary.

I know when I was obese, my blood results and symptoms were all over the place. So until the healthy weight range for one's height is reached, limiting calories and exercising are probably the most important things we can do. Metformin also helped me a lot, and if I went off it now, I think it would be harder to keep those blood levels in the healthy range. I tried going off my hypertension meds and I started showing signs of declining kidney function. I'm not prepared to take risks like that.

Ideally I wouldn't need to take any meds. But according to my symptoms, blood pressure, and blood test results I do. It enables me to have one less worry in life, knowing that my organs and blood vessels are not being damaged and I am likely to have the longest and highest quality of life possible, given the illnesses that I unfortunately have. I don't see medications as "bad" and "unnatural". I'm grateful that I live in an age where using the scientific method has enabled us to treat certain conditions.

 

[Winnie53]

CatLadyNZ, I think if we had the opportunity to get to know one another, we'd find that we're each working toward the same goals, but have chosen sometimes similar, sometimes different paths. I get how frustrating it is to have multiple health conditions that can be managed but not healed. I could, but never have, listed them in one place (nor have I ever wanted to do so).

My concern is the belief held by some that "nutritional supplements are too problematic to be safely and effectively used" for a variety of reasons. I think the same argument can be made about medications.

I have been harmed by medications and I have been harmed by nutritional supplements, but I've been helped by both too, so I'm careful if and when I use them. My husband has a heart condition. Without the medication and nutritional supplements he takes, not one or the other, both, he would have been taken from me long ago. I'm grateful to live in a time when we have so many choices, and I will continue to explore and talk about those things that I think may be helpful for myself and others. And if I learn that something can cause harm, I will talk about that too. And I support you in doing the same.

I just want to add that I appreciate your thoughtful responses.

 

[ButtterflyLady]

Winnie53, I appreciate your thoughtful responses too. I don't think I would ever say "nutritional supplements are too problematic to be safely and effectively used". First, I don't know exactly what is meant by "nutritional supplements" in this statement. What I would say about supplements/products that haven't been rigorously tested in the ways that drugs have, is that we have less information about the effects of these substances, and the information we have is not as reliable, because it has not been gathered and checked in a consistent manner. I am all for using these products, after they have been appropriately studied.

I don't think the same argument can be made about medications. When used as directed, their safety and effectiveness among a very large number of people has been demonstrated and is well known. Of course there are always going to be adverse events, and the law requires that doctors consider the risks and enable their patients to give informed consent. Usually I go home and read about a drug before taking it, and I have been known to decline a recommendation based on what I have found. Usually there is an alternative, or I accept the trade offs, or I accept the symptoms and manage as best I can.

I am curious to know what medications you have found harmful, but please do not feel you have to share about it if you don't want to. I'm also curious to know what nutritional supplements your husband takes for his heart condition. I admit I have had some negative side effects from drugs over the years, but the effects were temporary and not serious. Sometimes people have permanent harm from a drug and that is very unfortunate. I hope each case is reported to the authorities so other people can be forewarned about the risk.