Nutrition’s Effect on Inflammation & Pain: PART I
Author: Kara M. Peters, MS, RD, LDN
What is Inflammation?
Inflammation is believed to be the underlying cause of most chronic (long-term) health conditions such as arthritis, autoimmune disease, inflammatory bowel disease, obesity, heart disease, type 2 diabetes, metabolic syndrome, cancer, and cognitive decline. The immune system creates inflammation as a natural response to injury or infection. Inflammation from injury or infection is a multifaceted process involving cellular signals that result in pain, redness, swelling, and heat at the injury or infection site. Pro-inflammatory cytokines, a protein that affects the behavior of other cells, are released, which cause the liver to induce systemic inflammatory responses. Acute (short-term) inflammation is normal as it heals and protects the body post-injury or infection. However, chronic inflammation is abnormal and adversely affects the entire body. In addition to the conditions already mentioned, chronic inflammation is involved in tendonitis, bursitis, rheumatoid arthritis, osteoarthritis, atherosclerosis, celiac disease, and schizophrenia. Among regular exercisers, failure to reduce inflammation can result in fatigue, muscle damage, soreness, poor mobility, delayed recovery, scar tissue, and can limit muscle growth and training progression.
Nutrition & Lifestyle
The inflammatory response is also affected by what the body is fed. Not only is the standard American diet one-third junk food, most Americans exceed the recommendations of animal proteins, unhealthy fats, processed grains, added sugars, and sodium. In addition, about 75% of the population’s eating pattern is low in vegetables, fruits, oils, and dairy. If that isn’t staggering enough, each American consumes about 150 pounds of processed sugar each year, which is 6 cups each week! Processed sugar and other foods that drastically and quickly raise and lower blood sugar can provoke irritability, food cravings, and increased inflammation. These types of foods include processed carbohydrates and their derivatives (white bread/rice/flour/pasta/crackers), sugar-sweetened beverages, candy, desserts, and low-fiber/high-sugar cereals. Foods with higher fiber content slows the rate of digestion and absorption, allowing a gradual rise in blood sugar, protecting against increased inflammation. The Recommended Dietary Allowance (RDA) of fiber for men and women 19 years and older are 38 and 25 grams per day.
Alcohol can have the effect of both increasing and decreasing inflammation markers, depending on the person and the amount consumed. High intake, especially for prolonged periods, can increase inflammation. Moderate consumption (about 1 drink equivalent which is 10 grams per day) was shown to improve lipid profiles, blood pressure, cell function, and inflammation levels. Research among both animals and humans have shown that many forms of physical activity reduce inflammation, both acute and chronic. Additionally, regular physical activity is critical in the prevention and treatment of obesity and other inflammatory diseases. However, over-exercising can increase inflammation and suppress immune function. Resolving prolonged inflammation may enhance recovery and reduce soreness.
Inflammation’s Effect on Pain
Various foods, nutrients, and dietary patterns can reduce inflammatory markers along with objective and subjective measures of inflammation. Omega-3 and omega-6 essential fatty acids are two of those nutrients that can impact inflammation in the body. They are deemed “essential” because they must be obtained through the diet as the body cannot synthesize them. Both serve crucial functions throughout the body and work together to promote health. One function includes regulating multiple pain-related biochemical pathways. Research has shown that higher intakes of omega-6, saturated, and trans-fats are pro-inflammatory whereas omega-3, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) are associated with reduced inflammatory biomarkers and promote anti-inflammatory pathways. Omega-3s have been shown to reduce systemic inflammation among those with rheumatoid arthritis, increasing physical function, and improved vitality. Fairly consistent evidence indicates modest benefit of seafood sources of omega-3s on joint swelling, pain, and reduced duration of morning stiffness. A meta-analysis of 10 randomized control trials suggested that greater than 2.7 grams of omega-3 per day for more than three months reduces nonsteroidal anti-inflammatory drug (NSAID) (aspirin, ibuprofen etc.) consumption by patients with rheumatoid arthritis. A meta-analysis of 17 randomized control trials showed a soothing effect with omega-3 supplementation for inflammatory joint pain. In another study, increasing omega-3 and reducing omega-6 in the participant’s food choices reduced chronic headache pain, improving the quality of life. Diets supplemented with omega-3 have been shown to reduce post-exercise delayed-onset muscle soreness and inflammation, promoting healing. Supplemental omega-3 is recommended post-injury during the inflammation stage, especially when the diet is deficient. Those taking an anticoagulant, antihypertensive or have a clotting disorder should consult their doctor before taking an omega-3 or fish oil supplement.
Supplements
With all of this said, it may seem easy to simply consume supplements and call it a day. However, too much of a good thing can most certainly be dangerous. The usefulness of supplements depends on the individual, medical history, and current lifestyle. All vitamins and minerals rely on several other vitamins and minerals to be properly absorbed and utilized within the body. This is one of the many reasons why consuming a variety of whole, unprocessed, naturally colorful foods in a balanced manner each day will provide adequate nutrients the body needs to properly function and fight inflammation. In most cases, overall dietary and lifestyle habits are more important to consider rather than any single change. Of course, there are certain circumstances and individuals where supplementation is appropriate. However, concern exists regarding the sources of omega-3 supplements and fish oils because they can be contaminated with mercury and polychlorinated biphenyls (PCBs), toxins dangerous to humans. Supplements may cause harm if they contain inaccurate dosing information and take caution in that some supplements make unsubstantiated health claims. Please consult a registered dietitian and/or physician before taking nutritional supplements to ensure validity and safety.
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About the Author: Kara obtained her bachelor's degree in Exercise and Health Science from UMass Boston in 2016 and Master of Science in Nutrition from UMass Amherst in 2018. She completed her ACEND accredited dietetic internship at the University of Saint Joseph in 2019 and became a certified Registered Dietitian in July 2019. During her educational career, Ms. Peters was a research assistant for the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. She has worked with, educated, and counseled collegiate and youth athletes since 2017 and has recently advised the United States Rowing National and Olympic Teams. She currently works as an Clinical Dietitian at Baystate Medical Center in Springfield, MA. Ms. Peters is continually fascinated by the intricate relationship between nutrition and exercise and is deeply invested in learning more about how these variables dictate both mental and physical performance and health.