Did you know that what you eat can influence chronic pain? When you eat, you change your body chemistry. As a result, this can either increase or decrease inflammation and pain. Whether chronic pain is associated with arthritis, fibromyalgia, or injury, the foods used to fuel your body make a difference.

Read or listen to an interview with Emily Clairmont, registered dietician, and Leah Pryor, chef educator, both from University of Vermont Medical Center.

What foods fight pain and how do they work?

Clairmont: There are several approaches to how we can manage pain with food. Some of those are dietary patterns, so perhaps the style of the food that we eat or the type of meal preparation that we have, but it can also come down to specific nutrients.

To give you specific examples, there are some herbs and spices that are known to influence our levels of inflammation in the body. Many of you have likely heard of turmeric and ginger as being kind of gold star members of the anti-inflammatory team, but also some very specific nutrients. Magnesium, which is found in a lot of our dark green leafy vegetables, and our whole grains. Vitamin C, so very rich in the brassica family, so broccoli, collards, kale, as well as all of our citrus.

How does plant fiber affect pain and inflammation?

Clairmont: I would say if we were to take a broad spectrum look at our culture and our culture’s eating habits, we do not get enough fiber in our diet. Fiber works in our bodies to help bring down levels of inflammation. Carbohydrates are essential for the health and function of our body, but nonetheless, fiber is a carbohydrate. In the body, it can help to slow down the digestion of our food. If we have a meal that contains other carbohydrates, proteins, and fats, that fiber can actually slow down the digestion of food through our system, and what that would do is it would prevent any spike in blood sugar.

Now, a spike in blood sugar or a rapid rise in blood sugar can result in the release and production of pro-inflammatory compounds in our body, so if we can prevent that rapid rise or that spike in blood sugar after a meal or after a snack, we’re essentially preventing the production of those pro-inflammatory compounds.

How do fats and phytonutrients fight inflammation?

Clairmont: There are specific types of fats that are called essential fats. Some are pro-inflammatory. Some are anti-inflammatory. On their own, if we were just talking about fat, then I would say it’s the fat balance. It’s the ratio of those Omega-6s to Omega-3s which translates into a balance of inflammation in the body.

Then again, on its own, if we were talking about phytonutrients – otherwise known as phytochemicals, bioactive compounds, or even antioxidants – they have their own unique set of reactions in the body that can actually diffuse some inflammation in the body. However, together, what’s really neat is that a lot of our phytonutrients are fat soluble. Fat soluble means that we actually need to ingest it as part of that same meal, as part of that same snack. We would need to ingest them together to be able to absorb them and metabolize them efficiently, and to their greatest potential.

What recipes use fats and phytonutrients to fight inflammation?

Pryor: The kimchi avocado salad is a favorite of mine. It is a wonderful salad of avocado. Take your avocado, split it in half, scoop it out, and fan it onto your plate. You can take some kimchi, which is readily available. Actually, most stores now have it, but for sure you can see it at Healthy Living, or City Market, or any of those places. We have a local brand here in Vermont, which is delicious.

We’re going to take the kimchi, and we’re going to place it onto the avocado. What we do next is we make a little dressing of apple cider vinegar, a little bit of maple syrup, a little salt, a little pepper, and a little extra virgin olive oil. We’re going to shake that up. Very basic. Then put that right on top. Then we garnish it with a little bit of nutritional yeast, which is wonderful for flavor, as well as some toasted pecans.

The great thing about this recipe is that it’s just a diving board. You can kind of go with it with how you would like to add to it by adding cilantro or more vegetables. Perhaps, even putting it on a bed of leafy greens. It’s quite a nutritious, fun salad to enjoy.

I think miso-poached cod with bok choy, ginger, and scallion is wonderful. Like I was saying earlier, method versus recipe is something we like to teach in our classes, because recipes can be scary to a lot of people. I find that if we remove that recipe book and we teach people how to use method, then people are a little more comfortable with cooking.

Back to the method of the recipe; we’re just going to take miso, which is a wonderful fermented bean paste, and we’re going to make a broth out of it, just with water. We’re going to bring that up to a very slow simmer, because miso, having the fermentation in it, it can kill it with too much heat, so we always want to keep it nice and low and slow.

After we have it come up to that simmer, I’m going to add some bok choy and scallions. I’m going to have some grated ginger in there, maybe a splash of soy, and then I’m going to make a little bed for the cod. Next, we take a nice four-ounce piece of cod. We’re going to nestle it into the lovely miso sauce, and we’re just going to steam it. Once that cod starts to turn opaque and starts to basically fall apart, that’s when it’s done. I think it’s a really good example of using fermentation for our gut.

Are foods or a way of eating a substitute for medications?

Clairmont: No. I think there’s so much room in research, and I’m sure there are plenty of individuals that are studying this around the world, but for right now, the best thing that diet and nutrition can help with is it can help reduce sustaining amounts of inflammation. It can help your body achieve balance. There are some studies out there that demonstrate that following an anti-inflammatory diet or choosing some of these anti-inflammatory foods to include on a regular basis, that perhaps over time, you may not need as much medication. But it is not a replacement for the medication.

Are there any challenges with exploring foods that fight pain?

Clairmont: Absolutely. This is very real, and I think at the University of Vermont Medical Center we now have our pulse on what food security looks like in our community and in our patients. The very real challenge of whether or not healthy foods can make it to a person’s table is one very real challenge. Another, which is what we try and work on in our classes, is the knowledge and awareness of how to prepare healthy foods. Like Leah was saying, removing this roadblock of how to use a knife, how to use a knife safely, or how to prepare a particular vegetable safely and effectively, that right there can help remove that roadblock of having access to those foods.

From the chef’s perspective, what do you like about the shift in food for health?

Pryor: Well, the one thing that all of us have to do in this world is eat. It’s a great equalizer. Food is something that all of us have to understand and do, and I think if we can provide education to our community, we’re really doing them a service so that they can get back to the table with their families, which I find to be really key. And it’s really helpful to reset of how we look at food and how we have a relationship with food. We’ve really lost our way, but the good thing is, with programs like we’re doing here at the University of Vermont Medical Center, we’re really giving accessibility to our community. It’s a real gift.

I’ll say one little story. We do a lot of our cooking classes at the Burlington Food Shelf, and when we start our classes, I really like to invite the people in and to remind them … Actually, I ask, “Do you know where you are?” And they say of course they know where they are. They’re at the Food Shelf. But I say, “But do you understand what that means? It means that we’re in a place where people come daily so that they can get enough food to feed their families, because they don’t have enough.” Bringing that awareness, being able to share what we know about food, being able to show the wonderful duo that we have between the dietician and the chef is really important. And I find it to be the key to success for a lot of people when they go on this journey.

Should foods be used preventatively, or only when having pain?

Clairmont: Absolutely, 100% preventatively. Again, this is something that I talk with all my patients about. The education that we provide, the food choices that we talk about, and the eating plan, is all a long-term plan. If we eat this way and choose these foods, the road ahead should be or hopefully will be a healthier one.

If someone is interested in exploring foods that fight pain, what do you both recommend they do?

Clairmont: Well, I would say especially from a medical standpoint, if you are experiencing chronic pain or discomfort in your body, and you would like to talk to somebody about possible foods that could help, I would talk to your doctor. I would talk to your doctor or primary care physician, and ask, “Is there anybody that you could refer me to? Is there a dietician in the community that you could refer me to talk about food?” You could also explore online resources of who’s available locally.

Why are we just now hearing about a nutritional approach to fight pain?

Clairmont: I think the reason why we’re just now hearing about it is that it’s a multifaceted problem, and that nutrition is just one of them. To kind of liven up or to explore all the different options and avenues for pain, we have to look at the whole person. So if there is a structural concern, that that needs to be addressed before a person can maybe even think about making dietary changes. I think we’re just now hearing about it because the concept of an integrative approach to managing a person’s health is now on the table in our medical community.

Emily Clairmont is a registered dietician and Leah Pryor is a chef educator, both from The University of Vermont Medical Center.

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