Nutrition & Supplements

• Studies looking at the impact of diet on chronic pain are quite limited.
• The studies that do exist are beginning to find that both the amount you eat and what you eat can affect chronic pain.
• The amount a person eats is one of the most important factors in how much a person weighs.
  • This is true even more so than how much a person exercises.
  • Studies show that people who are overweight (BMI of 25 to <30) or obese (BMI of > 30) are much more likely to experience chronic pain.
• This includes pain in the joints (e.g., osteoarthritis), abdominal area, back pain, fibromyalgia, and headaches including migraines.
• When people who are overweight or obese lose even as little as 10% of their body weight this can reduce their pain by about 20 to 50%.
• One way to lose weight while still being able to eat a wide variety of food is increasing the quality of your diet.
• People who eat a high-quality diet tend to weigh less, be better able to maintain weight loss, and feel fuller than people who eat low quality diets.

Our diet can affect the symptoms that occur with chronic pain, such as stiffness and depression. The United States Department of Agriculture (USDA) has used many years of studies to define what makes a high-quality diet.

TABLE 2

Dietary Serving Sizes

*Serving sizes as defined by the U.S. Department of Agriculture's 'Choose My Plate

Do I need to eat a special diet such as ketogenic, Mediterranean or Paleolithic to have a healthy diet?

• Focus first on eating a healthy and balanced diet.
• Studies have shown that people can eat different types of diets as long as they eat the foods consistent with a healthy diet.
  • Example: Having half of your plate filled with fruits and vegetables (see Tables 1 & 2 above).
• There is not enough evidence available to conclude that any special diet is indicated specifically for chronic pain.

What about food allergies and intolerances to foods such as dairy or gluten and their impact on chronic pain?

• Different people react differently to food and nutrients.
• No studies have shown that any given food causes pain, but some people may have unique reactions to foods and nutrients.
• Just make sure you are also eating a wide variety of healthy foods if you choose to cut certain foods out of your diet.

What about anti-inflammatory diets?

• Some foods will help you make anti-inflammatory chemicals.
• Including these foods can help you feel better.
• Your diet will be naturally anti-inflammatory if you eat foods like:
  • Blueberries
  • Vegetables like kale or broccoli
  • Whole grains like brown rice
  • Whole grain bread
  • Foods that are rich in healthy fats such as nuts, seeds and fatty fish.

Dietary Resources

• Nutrition & Cirrhosis | (wellnesstoolbox.ca)
• Cirrhosis and a High Protein Diet Video
• Cirrhosis and a Low Sodium Diet Video
• American Academy of Family Physicians Patient Information Resource
• Americans in Motion – Healthy Interventions
• Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity
• Harvard University Nutrition Source
• U.S. Department of Agriculture, Choose My Plate

Healthy Recipe Resources

• Harvard University Nutrition Source: Recipes
• OldWays: Traditional Diets: Recipes
• American Institute for Cancer Research: Recipes

Resources For Healthy Eating on a Budget

• National Institute of Aging "10 Tips for Eating Healthy on a Budget" accessed August 19th, 2019.
• What is SNAP: S.N.A.P. stands for the Supplemental Nutrition Assistance Program. The program provides you with money to help you afford food each month.
• Supplemental Nutrition Assistance Program: If you need help completing the SNAP application, contact the Department of Human Services (DHS) at 1-855-275-6424 or here are directions for applying online for SNAP from the nams,vnma.x, Food Gatherers.
• Women, Infants and Children (WIC) - Provides supplemental nutrition support for low-income pregnant, breastfeeding, non-breastfeeding postpartum women, infants and children up to five years of age who are at nutritional risk. To determine if you are eligible and to apply for benefits visit - https://www.fns.usda.gov/wic

Resources if You Want to Lose Weight

• BMI Calculator and other useful weight loss tips
• American Institute for Cancer Research: Weight Loss Tips and Myths
• Centers For Disease Control (CDC): Resources for Losing and Maintaining Weight

Do you need have enough money to buy groceries that include vegetables, fruits, nuts, and fish?

• Many people in America have a hard time paying for enough food to feed themselves and their families.
• Having enough money to pay for food can be especially hard when you are trying to add foods such as olive oil, nuts, vegetables and fruits, which can be expensive.
• If you are having trouble getting enough food or if you are skipping meals, see if you qualify for the U.S. Department of Agriculture's Supplemental Nutrition Assistance Program (SNAP).
• This program helps people buy healthy food.
• You may be eligible for the USDA's Women's Infant and Children program if you are pregnant, nursing; or if you have a young child (see links to more information in the "Resources For Healthy Eating on a Budget" section).

• Ask about discounts.
  • Ask your grocery store if they have a senior discount or a loyalty or discount card.
  • Besides getting items at a lower price, you may also get store coupons.
• Use coupons when you can.
  • Coupons only help if they are for things that you would buy anyway.
  • Sometimes, another brand costs less even after you use the coupon.
• Consider store brands- they usually cost less.
  • These products are made under a special label, sometimes with the store name.
  • You might have to look on shelves that are higher or lower than eye level to find them.
• Be aware that convenience costs more.
  • You can often save money if you are willing to do a little work.
  • For example, buy whole chickens and cut them into parts.
  • Shred or grate your own cheese and avoid instant rice or instant oatmeal.
  • Bagged salad mixes cost more and might not stay fresh as long as a head of lettuce.
• Look at unit prices.
  • Those small stickers on the shelves tell you the product price and the unit price – how much the item costs per ounce or per pound.
  • Compare unit prices to see which brand is the best value.
• Try to buy in bulk.
  • Only buy a size that you can use before it goes bad.
  • If you buy meat in bulk, decide what you need to use that day and freeze the rest in portion-sized packages right away.
• Focus on economical fruits and vegetables.
  • Bananas, apples, oranges, cabbage, sweet potatoes, dark-green leafy vegetables, green peppers, and regular carrots are less expensive than other fruits and vegetables.
• Think about the foods you throw away.
  • For less waste, buy or cook only what you need.
• Resist temptations at the checkout.
  • Those snack foods and candy are put there for impulse buying. Save money and avoid empty calories!