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Is Your Diet Causing Inflammation?

Is Your Diet Causing Inflammation?

 

You might not know it, but inflammation plays a big role in our daily lives. Inflammation is essentially your body’s protective response to a stressor or harmful stimulus. These include bacteria, viruses, toxins, irritants, and physical trauma that cause cell damage. Our body uses inflammation as a way to eliminate the cause of cell injury, clear out dead cells and tissue, and overall repair the damage. However, though inflammation has a good end result in our bodies, the process is not very enjoyable.

The signs of inflammation include pain, redness, swelling, heat, and loss of function. Though inflammation is a very complex process involving our immune system (mostly innate immunity and not adaptive immunity which is more specific), there is a delicate balance we must have to stay healthy. No inflammation can cause progressive cell death (such as if you have an infection that you can’t fight off), but too much inflammation can lead to conditions like heart disease, rheumatoid arthritis, inflammatory bowel disease, and allergies to name a few.

It is known that stress, weight, and even medications can change the levels of inflammation in the body. However, studies have shown that DIET can actually play a huge role in inflammation.

Though there is no exact diet to reduce inflammation (as everybody is different), here are just some foods that have been shown to decrease inflammation:

Fruits and Vegetables:Fruits And Vegetables, Image courtesy of Suat Eman at FreeDigitalPhotos.net

One of the best and easiest ways to decrease inflammation is increasing your fruit and vegetable intake. Not only do they help with weight loss, but also contain antioxidants, carotenoids, quercetin, and loads of vitamins that lower inflammation. Try all colors! Bright colored produce, leafy greens, and “purple” fruits help fight inflammation. These include:

  • Broccoli, Celery, Beets, Kale
  • Cabbage, Bok Choy, Swiss Chard
  • Cherries, Raspberries, Blackberries, Blueberries, Pineapple

Anti-inflammatory Fats:Bottles Of Olive Oil, Image courtesy of m_bartoschat FreeDigitalPhotos.net

While saturated fats cause inflammation, weight gain, heart disease, and a whole slew of conditions, mono-unsaturated and poly-unsaturated fats help control inflammation. Omega-3 and Omega-6 fatty acids are great examples of anti-inflammatory fats. These “good” fats also help lower LDL cholesterol and triglycerides, help with blood pressure, and decrease blood clotting and risk of heart attacks. Examples of good sources of anti-inflammatory fats include:

  • Virgin olive oil, Avocado oil, Flaxseed oil, Walnut oil, & Hempseed oil
  • Whole Avocados
  • Chia seeds, Flax seeds
  • Almonds, Cashews, Pistachios, Walnuts
    • Avoid candied, honey roasted, or heavy salted nuts
    • Keep in mind that nuts are high in calorie, so servings should be limited to a handful a day.
  • Mackerel, Lake trout, Herring, Sardines, Albacore, Tuna, Salmon
    • AVOID FRIED!!!

Ingredients And Condiment, Image courtesy of Khotcharak at FreeDigitalPhotos.netHerbs and spices:

They have several antioxidants and boost the body’s natural ability to reduce inflammation. These include:

  • – Turmeric, oregano, rosemary
  • – Ginger, green tea

Bowl Of Muesli For Breakfast, Image courtesy of Serge Bertasius Photography at FreeDigitalPhotos.netWhole grains:

Unrefined grains are usually higher in fiber, which can help with inflammation. Try replacing carbs with more whole grain alternatives. These include:

  • Oatmeal, brown rice
  • Whole grain bread, rice and pasta
  • Quinoa, yams, plantains

Foods To Avoid

While the above mentioned foods help fight inflammation, there are foods have been associated with increasing inflammation in the body. As a general rule, you should try to avoid highly processed foods, overly greasy foods, and super sweet foods. Some of these foods include:

 

Lump Sugar, Image courtesy of Suat Eman at FreeDigitalPhotos.netRefined starches and sugary foods:

Usually, they do not have many nutrients and can lead to cholesterol issues, changes in blood sugar, and weight gain (all increasing inflammation).

  • – Sugar (any added sugar)
  • – Soda and sweet drinks
  • – Refined flour, Gluten
  • – Foods with high glycemic index

Sausages, Image courtesy of savit keawtavee at FreeDigitalPhotos.netHigh-fat and processed red meat:

These foods are high in saturated fats, increasing inflammation:

  • – Sausage, bacon, hot dogs, etc
  • – Other high-fat meats

 

Butter Isolated On The White Background, Image courtesy of khumthong at FreeDigitalPhotos.netButter, whole milk, and cheese:

Again, the problem is saturated fat. Instead, eat low-fat dairy products.
 
Fried Chicken”, Image courtesy of piyato at FreeDigitalPhotos.netFried Food:

Cooking them in vegetable oil does not make them healthy. Even if you use oils high in Omega 6, too much affects the Omega 3/Omega 6 balance, leading to more inflammation.
 

Nightshade Vegetables:Fruits And Vegetables” by Suat Eman

Some people states that they experience pain and inflammation when eating nightshades. Nightshades continue glycoalkaloids, which has been shown in some studies to cause inflammation. However, these vegetables affect people differently, and not everyone that eats them will have inflammation. The nightshades include:
 

  • Tomatoes, Tomatillos
  • Eggplants
  • Potatoes
  • Tobacco
  • Peppers (bell peppers, chili peppers, paprika, tamales, tomatillos, pimentos, cayenne, etc.)

These are just general guidelines, and dietary changes may help some people with inflammation and not help others. You should discuss diet changes with a physician.

References

https://www.uptodate.com/contents/an-overview-of-the-innate-immune-system?search=inflammation&source=search_result&selectedTitle=2%7E150
https://www.uptodate.com/contents/complementary-and-alternative-remedies-for-rheumatic-disorders?search=inflammation+and+diet&source=search_result&selectedTitle=1%7E150#H3533434742
Esposito, K, & Giugliano, D 2006, ‘Diet and inflammation: a link to metabolic and cardiovascular diseases’, European Heart Journal, vol. 27, no. 1, http://www.onlinejacc.org/content/48/4/677
Aeberli, I, Gerber, PA, Hochuli, M, Kohler, S, Haile, SR, Gouni-Berthold, I, Berthold, HK, Spinas, GA, & Berneis, K 2011, ‘Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial’, The American Journal Of Clinical Nutrition, vol. 94, no. 2, https://www.ncbi.nlm.nih.gov/pubmed/21677052
“Lump Sugar”, Image courtesy of Suat Eman at FreeDigitalPhotos.net
“Ingredients And Condiment”, Image courtesy of Khotcharak at FreeDigitalPhotos.net
“Fruits And Vegetables”, Image courtesy of Suat Eman at FreeDigitalPhotos.net
“Bottles Of Olive Oil”, Image courtesy of m_bartoschat at FreeDigitalPhotos.net
“Bowl Of Muesli For Breakfast”, Image courtesy of Serge Bertasius Photography at FreeDigitalPhotos.net
“Seeds On Wooden Spoon”, Image courtesy of adamr at FreeDigitalPhotos.net
Sausages, Image courtesy of savit keawtavee at FreeDigitalPhotos.net
“Butter Isolated On The White Background”, Image courtesy of khumthong at FreeDigitalPhotos.net
“Cheese”, Image courtesy of Suat Eman at FreeDigitalPhotos.net
“French Fries”, Image courtesy of artemisphoto at FreeDigitalPhotos.net
“Fried Chicken”, Image courtesy of piyato at FreeDigitalPhotos.net
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Polymyalgia Rheumatica

Polymyalgia Rheumatica

What is it?

Polymyalgia Rheumatica (PMR) is a relatively common inflammatory condition that causes aching pain and stiffness in the shoulders, hips, neck, and back. The term “polymyalgia” means many muscle pains.

 

Who gets it?
There are certain risk factors that make PMR more likely

Age:
– This condition is almost only seen in people over the age of 50
– The Incidence of the condition increases with age
– The peak incidence is around 70 – 80 years of age

Gender:
– Women are affected more than men (about 2-3 times more)

Ethnicity:
– People of Scandinavian and Northern European decent have a higher incidence of the condition

Genetics:
– The condition is associated with the HLA-DR4 haplotype
– A high level of IL-6 (a pro-inflammatory cytokine) has also been associated with this condition

What exactly happens in the disease?

The exact cause of the PMR is unknown, though it is believed to have a genetic factor to it. Environmental and infectious causes were studied, but have been inconclusive.

What are the symptoms?
Patients with this condition usually have symmetrical pain in the shoulders, hips, neck, back, and torso, described as an aching pain and stiffness. It has been shown that not only are the joints involved, but the bursa around the joints, making the pain in the arms and thighs a “referred pain”. The pain is usually abrupt onset, worse in the morning (with morning stiffness lasting > 1 hour), and usually limits normal daily activity, even simple activities such as putting on a shirt, getting to a standing position, and going up stairs, putting on shows or socks. The pain usually starts in the shoulders, and can be on one side, but usually becomes bilateral in a few weeks. Stiffness can occur after prolonged times of rest, known as the “gel phenomenon”. Patient can also have distal arthritis and even edema (swelling of the extremities)PMR

Main Areas of Pain in PMR

Systemic findings include:
– Weight loss
– Low-grade fevers
– Fatigue
– Malaise
– Depression
– Difficulty getting out of bed, out of a chair, or off the toilet
– Difficulty with daily activities (dressing, bathing, etc.)

Musculoskeletal findings include:
– Morning stiffness > 1 hour
– Muscle stiffness after prolonged inactivity (“gel phenomenon”)
– Arthritis in the distal joints (hands, feet, etc.)
– Joint swelling, particularly in the affected joints
– Carpal tunnel syndrome
– Swelling of the hands and feet
– Patients can also suffer from fatigue, decreased appetite, and sometimes low grade fevers.

In some cases (around 10% of patients with PMR), patients may experience a related condition known as Giant Cell (Temporal) Arteritis, also called GCA, in which patient get inflamed blood vessels and present with high fevers, headaches, blurry vision, and jaw complaints (GCA discussed here)

How is it diagnosed?
Unfortunately, there is not a specific test for PMR. The diagnosis is made based on the history, risk factors, symptoms, examination, and blood work. Blood work tends to show elevation in the markers of inflammation, specifically the Erythrocyte Sedimentation Rate (ESR) and the C – reactive protein (CRP). Though these labs are not specific, they are often elevated in PMR (though can be low in some cases). Imaging studies are usually not done as they tend to be unrevealing. MRI has been used before, and usually shows synovitis (inflammation) in the affected joints as well as bursitis. These findings are not specific, and hence why MRI is usually not used.

How is it treated?
The good news is that most cases are treated successfully with oral steroids (prednisone), and most patients notice an improvement within a few days. The bad news is that most patients must stay on prednisone for a prolonged period of time (anywhere from 6 months to 2 years +) as it is taper off slowly to prevent relapse. For more resistant cases or development of GCA, patients may need higher doses of steroids or the addition of stronger anti-inflammatory medications, such as Methotrexate or Tocilizumab. NSAIDs (Ibuprofen, Naproxen, etc.) can help with some of the pain, but do not address the underlying cause of symptoms. Physical therapy can help maintain activity, but again, will not resolve the underlying cause.

See Also
Giant Cell (Temporal) Arteritis

References
https://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-polymyalgia-rheumatica?source=search_result&search=polymyalgia+rheumatica&selectedTitle=1%7E84
https://www.mayoclinic.org/diseases-conditions/polymyalgia-rheumatica/symptoms-causes/syc-20376539
https://emedicine.medscape.com/article/330815-workup
https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Polymyalgia-Rheumatica
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