C urrent and growing research indicates a strong link between chronic inflammation and diet. As a chiropractor, creating a dialogue with patients about nutrition is essential to wellncss-bascd treatment. Shifts in diet based on each patient's physical uniqueness can potentially diminish the symptoms often seen with chronic inflammation and may decrease the risk of serious health issues associated with inflammation. Chronic Health Issues Caused by Inflammation Acute inflammation is the body's innate reaction to injury' or infection—this response could cause heat, swelling, loss of function, and pain, all of which arc essential to proper healing. Unlike this appropriate healing response initiated by the immune system, chronic inflammation is systemic in nature, affecting wide-ranging parts of the body and attacking healthy tissue. This twist on a natural process is caused by many different factors and can create serious health issues and diseases that affect joints, cells, tissues, and organs. Inflammation lias proven difficult to diagnose and the testing available for inflammation is not without flaws. However, more doctors and researchers are beginning to perform blood tests for an inflammatory marker produced in the liver, high-sensitivity C-rcactivc protein (hs-CRP). to assist with diagnosing chronic inflammation and conditions such as cancer, connective tissue disease, lupus, rheumatoid arthritis, and more. The medical community notes a correlation between inflammation and a host of seemingly unrelated conditions such as Parkinson's disease or asthma. Research indicates chronic inflammation contributes to these diseases and their respective symptoms. Top diseases associated with chronic inflammation include arthritis, cardiovascular disease (including hypertension and stroke), and some cancers. Rheumatoid A rlhritis and Osteoarthritis Unlike the inflammatory disease rheumatoid arthritis, it was previously thought osteoarthritis was unrelated to chronic inflammation, but a developing body of research is pointing to a strong correlation. A study published in the Oxford Journal Rheumatology entitled "Osteoarthritis. angiogenesis and inflammation" states angiogenesis and inflammation have a causal relationship, which may directly affect the progression of ostcoartliritis and its symptoms. Cardiovascular Disease People who suffer from heart disease or stroke often experi- cncc inflammation. The medical community is at consensus: Inflammation plays a role in heart disease, but this role is not entirely understood yet. While aspirin, an anti-inflammatory medication, is often prescribed to patients who have experienced heart disease or arc considered to be at risk, at this time there is no definitive proof anti-inflammatory medications alone can reduce the risk of heart attack or stroke. Cancer A rather large and growing body of research indicates chronic inflammation could be a causative factor to cancer. A study by the American Cancer Society (ACS) connects inflammatory bowel disease to a predisposition to cancers of the large bowel and/or terminal ilcum. Research supported through grants from the National Institutes of Health. ACS. and the American Association of Cancer Research provides evidence inflammation plays a significant role in the development of tumors. Additionally, this research acknowledges cancer can often originate in areas of infection, irritation, and inflammation. How the Body Becomes Inflamed While there arc several suspected factors, one of the largest triggers for chronic inflammation is diet. Certain foods can place acute stress on the body and higher levels of consumption cause normal inflammation to become chronic. Both medical doctors and chiropractors recognize that highly acidic foods, such as breads, pastas, grains, trans fats, dairy and sugars, cause inflammation when eaten in excessive amounts. Symptoms such as joint pain or nausea may be incorrectly associated with illness and aging rather than reactions to food consumption. Prescription Medication and Inflammation There arc anti-inflammatory dnigs on the market and many people with chronic conditions such as rheumatoid arthritis arc prescribed NSAIDs (nonstcroidal anti-inflammatory dnigs). which work to block certain chemicals the body produces. While these anti-inflammatory dnigs can often relieve some pain associated with chronic inflammation in the short-term— long-term usage of any prescription medication can have adverse effects. Issues with Long-Term Prescription Use As chiropractors, our goal is to promote a dmg-free lifestyle, if possible. However. I do not advise against the dnig recommendations of a medical doctor licensed to diagnose the patient's condition, and I acknowledge taking medication in moderation may be necessary. Consuming low levels of medication to help or appease pain will not necessarily result in long-term damage, when prescription usage becomes chronic, the risks increase. Long-term prescription use is known to damage the liver and the kidneys, but now there is evidence that prolonged use can have a deleterious effect on joints. Specifically, chronic usage can damage the lubrication of the joints and elicit different chemical reactions that prevent proper healing. Helping Patients Decrease Prescription Use As a chiropractor. I cannot legally recommend that a patient decrease or cease prescription use. If a patient notices positive changes to blood pressure or sugar levels over the course of wcllncss-bascd treatment. I am more than happy to create an internal dialogue between the prescribing medical doctor, the patient, and myself. Another option is to give the patient literature from the medical community to review and take to his or her doctor. This supports the patient in initiating a conversation about the benefits and risks of prescription use. Through any of these options, it is critical for the patient to remain in control of his or her health as the future of health care is moving toward a patient-centric approach. Also, in my opinion, the chiropractic profession and other wcllncss professions will move to the forefront of wcllncss management in the future. I work to build a bridge between the patient, the medical doctor, and myself by continuing to offer nutritional and lifestyle advice that will provide benefits to the patient's overall health. These changes may or may not relieve or cure symptoms or an ailment, but there is no doubt the patient will positively benefit from certain dietary changes. Natural Alternatives for the Treatment of Inflammation Mam healthcare professionals, both in medical and chiropractic fields, agree certain foods can cause aggravation in the body and arc linked to inflammation. While additional research is needed to understand the link between diet and inflammation, evidence is building. Independent research shows diet soda and bread provokes serious issues such as inflammatory bowel disease, ecliac disease, joint pain, and more. Main experts agree that decreasing intake of acidic foods, such as grains and dairy, and increasing intake of alkaline foods, such as vegetables and healtln proteins, can help combat inflammation. I approach all of my patients—those with and without chronic ailments—with nutritional recommendations to work alongside chiropractic care. These dietary recommendations have shown to decrease inflammation and the symptoms associated with inflammation, such as chronic pain. Finding the Right Plan for Your Patient Generally when a patient begins care. I explain micro and macronutricnts: micro includes vitamins and minerals, and macro consists of carbohydrates, proteins, and fats. This leads to a discussion about the patient's current diet. I advise the patient to continue the same diet for the first week of care. This allows me to gauge if improvements arc due to adjustments and therapies versus dietary or exercise changes. I instruct each patient to create a log over this week, and to detail each item honestly. I ask each to note even seemingly insignificant details, such as whether the item was genetically modified food (GMO) or organic. A particular diet may work for one person but may not be congruent for another person's mechanics. For instance. I can personally cat some level of dairy without gut or metabolic reactions, whereas mam arc lactose intolerant or unable to absorb the proteins in dairy and will experience allergic reactions or belatedness. The Elimination Diet The elimination diet is an excellent tool for uncovering the correct diet for each individual's body. Instruct the patient to eliminate foods one at a time over four to six weeks. For example, start with dairy first and record any physical, mental, or emotional responses. Have energy levels improved? Has general mood or disposition shifted? Docs sleep come easier? After four weeks, rcintroducc foods into the diet while taking note of all reactions. This method allows the patient to identify the foods that do not work for his or her body. Once the aggravating foods have been identified, it is much simpler to build an accurate nutritional plan. An Alkaline vs. Acidic Diet As previously mentioned, there is a correlation between a highly acidic diet— grains, sugars, trans fats—and inflammation. I recommend patients maintain an alkaline-rich diet, relying heavily on vegetables, certain fniits. lean meats, and a moderate to low level of carboln drates (unless an allergy or sensitivity has been uncovered). There is still a pervasive belief in the old food pyramid. This carbohydratc-hcavy diet has created insulin, hormone, and metabolic problems, among many other issues. I recommend a diet consisting of about 60% organic vegetables. A good rule of thumb for lean meats, eggs, and fish is one gram of protein per kilogram of lean body mass. Fniit consumption should stay below 25 g a day. Fniits containing lower levels of fnictose arc optimal: coconut, berries, papaya, avocado, mango, pineapple, guava. and kiwi arc some of the top performers. Decreasing Sugar Intake A vast amount of research is proving sugar is toxic to the body and may be the largest dietary culprit of inflammation and joint damage. It also may be the root of manv other detrimental health issues. The University of Utah just published a study that reported female sugar-fed mice died at two times the rate of those not fed sugar. In addition, the sugar-fed male rats were 25% less likely to keep their territory in terms of reproduction. Most Americans are unaware of their level of sugar consumption. Two hundred years ago. the average American consumed 2 lbs of sugar per \ car. Today, this number has skyrocketed to 152 lbs per person, peryear. Typical Americans cat more sugar in a week than our ancestors ate in a year. This is partly due to the high level of fnictose and sugar in common foods. For example, two slices of whole-grain bread can spike insulin as much as a candy bar. Adding Supplements Fulfilling vitamin and mineral quotas through macronutricnts is optimal, but due to today's nutritional insufficiency in most foods, this is difficult. I suggest organic, third-party tested supplements to many patients. The top three supplements recommended for inflammation arc probiotics. omcga-3s. and vitamin D. Probiotics arc critical to combat inflammation. Probiotics arc critical to combat inflammation; and regulate the immune system by balancing the normal flora within the gastrointestinal tract. This immune regulation balances proinflammatory and anti-inflammatory cytokincs. Omcga-3s arc known for their anti-inflammatory effects—and are not the same as omcga-3 fatty acids. These two supplements are best taken in a balance because too main omcga-3 fatty acids can contribute to chronic inflammation. Tell your patients to choose foods such as wild Alaskan salmon, grass-fed meat, Haxsccd. and beans as wealthy resources for omcga-3 s. Many people arc deficient in vitamin D. Typically, patients will need to supplement this vitamin as the macronutricnt resources are limited and the other source is sun exposure. The only food sources for vitamin D are fatty fish, shiitake mushrooms, beef, egg yolks, and Swiss cheese. The most effective way to get vitamin D is the way nature intended, the sun. We recommend short periods of sun exposure, typically 15 to 20 minutes, but this amount can vary depending on main different variables such as skin type, skin color, geographical location, and environmental factors. Native to C 'hicago. Dr. C 'liirag Shah serves as (. Inropractic Director ofChiro One Wellness Center of Burr Ridge, Illinois. An alumnus of the University ofWisconsin-Madison andLogan College, Dr. Shah holds degrees in zoology, biology .and a Doctorate ofC 'hiropraclic. Seurological research during Ins undergraduate degree inspired him to pursue a career in healthcare, focused primarily in preventative medicine.
