Book Review:

We’ve all read about the connection between obesity, inflammation, inflammation, and diseases such as diabetes and 
cardiovascular disease. According to Dr. Harris McIlwain, a Tampa-based pain specialist and board certified 
rheumatologist, there is a similar link between obesity, inflammation, and pain. While aging results in an increase 
in pro-inflammatory destructive chemicals in the body that increase the risk of pain and other diseases—being overweight 
(even just 10 pounds) triggers these same chemicals--and unending pain.

Over the past decade, McIlwain has developed the first ever Pain-Free Diet—a fish and plant-based anti-inflammatory diet 
that led hundreds of his patients to reduce their pain by as much as 90 percent by losing as little as 10 pounds - on a diet 
that lets them eat all day long. Once only available to his patients, McIlwain’s Pain-Free Diet is presented for the first 
time as a doctor’s simple 4-step diet and lifestyle program in the new book DIET FOR A PAIN-FREE LIFE (Marlowe & Co/January 2007.

 

Take the Quiz: Are You Pain-Free?

by Harris H. McIlwain M.D., Debra Fulghum Bruce, PhD authors of Diet For A Pain-Free Life: A Revolutionary Plan to Lose Weight, Stop Pain, Sleep Better and Feel Great in 21 Days (paperback)

• Are you more than 10 pounds overweight (from your normal weight)?
• Do you have belly fat?
• Do you have difficulty finding pain relief with medication?
• Do you eat meat (beef, veal, lamb, pork) regularly?
• Does your diet lack in fresh fruits and vegetables?
• Do you exercise regularly?
• Did your pain and weight increase once you hit middle age?
• Do you suffer with back, knee, hip, neck, or shoulder pain?
• Does pain keep you from being active? 
• Do you have pain from arthritis or fibromyalgia?
• Do you wake up each morning aching with joint or muscle pain?
• Do you wish you could be more active without taking daily pain     medications?
• Do you have disc disease?
• Do you feel stressed out most of the time?
• Are you unable to sleep at least 7 hours each night?
• Does pain interrupt your sleep at night?

If you answered "yes" to 2 or more of these questions, you need to assess your weight (on the scales) and evaluate your diet--in order to end your pain. Until recently, it's been unclear whether losing weight may influence the symptoms of pain. While losing weight or being a normal weight is necessary to avoid problems as hypertension and diabetes with aging, we now believe that weight loss is crucial to decrease the markers of inflammation in the body--inflammation that increases the pain you feel.

 

But, let’s be honest. Losing weight is not easy. The older you get, the more difficult it is to drop pounds. And even if you do lose weight, the chance of gaining it all back is huge. That’s why the Pain-Free Diet can change your life. The Pain-Free Diet - is plant-based with fish, low-fat dairy, and eggs. This diet will let you eat more food and have even larger portions than a meat-based diet. Aside from that, the recommended foods are filled with potent phytochemicals, the biologically active substances that give plants their deep colors, flavors, odors, and protection against disease.

 

Dr. McIlwain has spent more than 20 years studying the overweight-inflammation-pain connection. Here are some suggestions he makes in his revolutionary book Diet For A Pain-Free Life that can help you drop pounds and decrease pain at the same time.

 

 

While researchers continue to seek the perfect pill to end pain, we believe there is a better way. Years of clinical research and treating patients have shown that the key intervention to preventing pain is a 4-pronged approach that involves the following steps:

 

Step #l. Lose weight with the Pain-Free Diet

Step #2. Exercise daily

Step #3. Control your stress

Step #4. Get quality sleep

 

1. Lose weight with the Pain-Free Diet.

 

Losing weight reduces inflammation and pain. Published studies associate a reduction in fat storage and pro-inflammatory compounds in the body with a diet comprised of an abundance of fresh fruits and vegetables, whole grains, legumes, nuts and seeds, low-fat dairy (including yogurt), and soy products and reduced quantities of white bread, white rice and potato products. This mostly plant-based diet also causes an extensive and positive change in the blood fats (triglycerides and LDL and HDL cholesterol) in the body.

In study after study, researchers have found that key nutrients from the foods recommended in the Pain-Free Diet rival the effects of nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, yet without any of the detrimental side effects. If you’ve lived on NSAIDs for any length of time to ease pain, you’ve probably experienced the gastrointestinal problems that often occur.  With the recommended Pain-Free Diet, you can take advantage of the pain-relieving benefits of anti-inflammatory foods but without the stomach distress of NSAIDs.

The Pain-Free Diet is high in fiber, which keeps you full as you cut back on calories, saturated and trans fats (both destructive to the body), and potatoes, pasta, and sugary desserts. In the first step, we include pertinent information on changes you can make today in your diet to reduce inflammation, including:

·    Avoiding foods that trigger inflammation such as beef, pork, fried foods,

   junk food, and grilled food

·    Eating anti-inflammatory “good” fats found in olives, fatty fish, and 

   avocados

·    Drinking red wine to block inflammation

·    Taking anti-inflammatory supplements.

           

Sample Foods on the Pain-Free Diet

 

·  Black cherries contain antioxidants; dark berries (blueberries,

   blackberries, cherries, and raspberries contain anthocyanins,  

   special chemical components that block free radicals that trigger

   inflammation. They also help to strengthen the immune system.

 

·    Blackberries have salicylic acid, which is the same active ingredient in aspirin.

 

·    Broccoli is a powerful antioxidant. It contains vitamin C and calcium.

 

·    Cheese (dairy and soy) contains calcium for stronger bones. Strong bones are important to prevent osteoporosis and fractures.

 

·    Chili peppers are filled with capsaicin, which gives food a spicy kick and fights inflammation. The hotter the food, the more capsaicin, and the greater the benefit. It is thought that capsaicin reduces levels of substance P, the compound in the body that triggers inflammation and pain impulses from the central nervous system. Red peppers are also filled with salicylates, aspirin-like compounds.

 

·    Curry, ginger, mustard, and turmeric, contain curcumin, an anti-

   inflammatory.

 

·    Green tea (or black tea that contains theaflavins) has strong

   phytochemicals that help protect the body. They short-circuit the 

   process

   that leads to inflammation. Green tea also contains polyphenols

   (epigallocatechin-3 gallate or EGCG) that have been shown to

   promote weight loss and reduce the activity of COX-2, the key

   inflammatory enzyme in arthritis.

 

·    Olive oil forms chemicals in the body that decrease inflammation.

 

·    Omega-3 fatty acids can decrease inflammation. Such fish as  salmon, sardines, and tuna are good sources.

 

·    Pineapple contains bromelain, an enzyme that helps reduce inflammation.

 

·    Red grapes and red wine contain resveratrol, which blocks the activation of the COX-3 enzyme, the real culprit in igniting inflammation and pain in the body. Some believe that resveratrol may turn out to be an improvement over aspirin in treatment painful diseases associated

     with COX-2, such as osteoarthritis.

 

·    Soy milk may decrease pain. It is low in saturated fat, and tofu is an excellent meat substitute.

 

·    Sweet potatoes reduce C-reactive protein, the inflammation- causing cytokine.

 

·    Walnuts contain vitamin B₆ for healthy nerve/cell communication. 

 

 

  2. Exercise daily.

 

Exercise is a key component of any sound weight loss regimen. While restricting calories is invariably responsible for the weight loss, regular exercise and activity helps to maintain the weight loss and prevent weight gain. For those with pain, exercise is essential. Not only does daily exercise and movement help to build stronger muscles to support the joints, it also keeps you flexible, helping you to avoid falls or injury. Exercise also keeps bones strong and helps to prevent fractures, which are painful and debilitating.

“But I hate to exercise,” you say. Most of my patients balk when I explain the importance of exercise to reduce inflammation and pain. Maybe that’s because exercise has become complicated, confusing, and even inconvenient. That’s why the simple Functional Fitness Exercise regimen will let you select personalized activities you enjoy, as well as some key stretching movements that can help your joints move in full range of motion and your muscles stay toned.

           In Step 2, I will give you some easy functional fitness stretches and exercises you can start today to make sure you are doing all you can to build muscle and bone, decrease inflammation, maintain a normal weight, and, most important, end your pain.

 

3. Control your stress.

 

Stress increases inflammation in the body. A response of the body to any demand, stress is a biological phenomenon that affects the central and autonomic nervous systems, as well as the endocrine and immune systems. The body’s major stress hormones trigger the production of pro-inflammatory cytokines, influencing an increased pain response. Stress is linked with changes in our body at a cellular level; changes we don’t even feel or see occurring daily until we suddenly experience pain or illness.

Studies show that individuals who are prone to anger, hostility and depressive symptoms respond to stress with increased production of the stress hormones norepinephrine and cortisol, among others. Scientific evidence suggests that an increase in this stress hormone activates the inflammatory part of the immune system and triggers the expression of genes that cause low-grade inflammation, which is characterized by high levels of C-reactive protein and other pro-inflammatory markers.

 

4. Get quality sleep.

 

Pain is the leading cause of insomnia. Whether from difficulty getting to sleep or problems maintaining sleep, 65 percent of those individuals who suffer from pain claim they “never” get quality sleep. In fact, about 42 million people in the United States report that pain or physical discomfort disrupts their sleep a few nights a week or more. We know that people who have  pain experience less deep sleep, more arousals and disruptions with waking as well as less efficient sleep.

Sleep deprivation (even just an hour a night) results in markedly increased inflammatory cytokines, which increase systemic inflammation and results in pain. Most patients with fibromyalgia, a painful arthritis-like syndrome that causes deep muscle aches, fatigue, anxiety, and depression, have difficulty sleeping and feel unrefreshed in the morning. Research shows that many individuals with fibromyalgia have symptoms suggestive of pathologic sleep disturbances like sleep apnea (brief periods of cessation of breathing) and restless leg syndrome. In fact, some new studies link pro-inflammatory markers with obstructive sleep apnea.

Sleep disturbances in patients with back, hip, shoulder, neck or other type of pain can be triggered by the pain itself, by emotional trauma and stress, by a metabolic problem, and by low-grade inflammation. Poor sleep can lead to increased daytime fatigue with resultant diminished exercise causing worsened physical fitness and the establishment of a vicious cycle of inactivity and sleep disturbance with physical and mood-rated symptoms.

In Step 4 of this book, I will also elaborate on ways to increase quality sleep to help decrease inflammation, reduce pain and also to trigger human growth hormone in the body, which can decrease by as much as 75 percent by the time the person is thirty-five-years-old. Studies show that human growth deficiency leads to obesity, loss of muscle mass, and a reduced capacity to exercise—and getting quality sleep may reverse these problems in older adults.