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Dr. Brad’s Weekly Health Update: Can’t get enough coffee? Blame your DNA…

Coffee consumption linked to DNA

Coffee consumption linked to DNA

Your taste for coffee may be in your genes. An analysis of genetic data and coffee drinking habits on more than 1,200 Italians revealed that individuals with a gene variant called PDSS2 drank one less cup of coffee per day on average than those without the gene variation. Researchers say that PDSS2 reduces a cell’s ability to break down caffeine, which means caffeine stays in the body longer. The study adds to existing research that suggests our drive to drink coffee may be embedded in our genes. Scientific Reports, August 2016

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Fibromyalgia and Vitamin D Deficiency

Utilizing dietary approaches to help with fibromyalgia (FM) management has been our main topic these past two issues and serves as GREAT background information for this month’s topic: Vitamin D and its role in the management of pain associated with fibromyalgia. Let’s take a look!

Vitamin D is found in foods such as fish, eggs, fortified milk, cod liver oil, and more. The sun also helps the body produce vitamin D with as little as 10 minutes of exposure reported to be enough to prevent deficiency. There are several different forms of vitamin D, of which two are important in humans: vitamin D2 (made by plants), and D3 (made by human skin exposed to sunlight). Foods may be fortified with either type, and supplements are available in both forms (D3 is preferred). The main role of vitamin D is to maintain normal blood levels of calcium and phosphorus. Calcium and vitamin D are often taken together to improve bone health and reduce fractures. Research has also shown that vitamin D may protect against osteoporosis, high blood pressure, cancer, and other diseases. “Classic” vitamin D deficiency diseases include bone softening conditions such as rickets (in children) and osteomalacia (in adults). People at high risk include the elderly, individuals who are obese, and those with limited sun exposure. Individuals with conditions such as cystic fibrosis (mucous build-up in the lungs) or inflammatory bowel disease are also at risk for vitamin D deficiency. With that background information, can vitamin D help fibromyalgia patients with chronic pain?

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Fibromyalgia: It’s Hard to Explain!

stk62884corFibromyalgia (FM) is a condition that typically has a slow, gradual onset that starts out mild and gradually worsens. The symptoms associated with FM include generalized pain all over the body (above and below the waist including neck, shoulders, chest, upper back, arms, hips, buttocks, legs, and feet). The pain can be symmetrical or more intense on the left or right side AND it can vary from day to day. To top it all off, the pain is “chronic” and is usually present for three or more months, sometimes for years, before the FM patient might even mention it to their health care provider. The onset can be so gradual that other issues often become the center of focus until the intensity gets to the point where the patient FINALLY complains.

To better appreciate the complexity of FM, there are two types of FM: Primary and Secondary. Primary FM has no specific cause while secondary FM is linked to something such as trauma associated with a car accident or sports injury, a condition such as irritable bowel syndrome (IBS), chronic fatigue syndrome, restless leg syndrome (RLS), and others. Either way, it is often NOT the kind of thing many patients “bring up” during the discussion of history with their health care provider, especially if something else is bothering them that may be more pressing.

So, how does one explain the symptoms of FM? Words such as a deep ache, burning, tingling, shooting, tender, pins and needles, stiffness, and flu-like symptoms are often utilized when describing FM symptoms. Almost always, these complaints have been present for a long time – or for at least three months. Often, the patient is reluctant and almost embarrassed to mention it due to the difficulty in describing the symptoms and the fact that they often don’t know the cause. Equally, many doctors, “have an attitude” that is negative and/or non-supportive of the diagnosis of FM making it even more likely FM patients won’t pursue the condition with other health care providers. This polarization by physicians is a very common issue and often the reason FM sufferers continue to “put up” with their condition rather than consult with others.

The KEY to the diagnosis of FM includes the following: 1) Widespread pain NOT limited to one area of the body; 2) Greater than three months of symptom duration; 3) Symptoms including fatigue, sleep disturbance, depression/anxiety, as well as memory and/or concentration complaints; 4) Symptoms severe enough that they interfere with daily living activities/daily life; and 5) Difficulty finding an answer to the cause of the symptoms, USUALLY involving more than one health care provider. Even though awareness by both the general population and health care providers has improved in the last few years, research has shown that 92% of FM patients have talked to their doctor about their complaints, but this resulted in only 24% being diagnosed.

Another challenge confronting healthcare providers in making a diagnosis of fibromyalgia is because it can’t be seen on an x-ray or as an alteration on a blood test. Other diseases have to be “ruled out” before the diagnosis is even considered, but as was previously stated, secondary FM results from other conditions making it ALL the more challenging! It boils down to a very careful history and a physical exam has to be performed by the health care provider and the provider MUST believe in the diagnosis of FM. Tools such as the Fibromyalgia Pain Assessment can also be very helpful AND it’s available online for the FM patient to access. Bring those results with you to the provider for added help in making the diagnosis!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Fibromyalgia Dietary Considerations – Part 2

stk62884corFibromyalgia (FM) management must include dietary considerations, just ask ANY FM sufferer! Last month, we concentrated on the types of foods that reduce inflammation, but the question remains, what foods should we go out of our way to avoid? In other words, what should we NOT eat (and why)? Let’s take a look!

As we all know, it’s MUCH EASIER to simply grab a cookie, a chocolate bar, or go through the drive-through at McDonald’s and eat on the fly. This has become “the rule” for many of us as we trim down our meal times to fit in other tasks. We seem to have our priorities mixed up and have become preoccupied in our busy lives using the excuse that “…eating simply takes too long.”

The “avoid” list starts with stop eating junk food. It’s like pollution to our body as it clogs and clutters up our digestive system and the absorbed by-products include “bad” fat like trans-fats & saturated fats that can damage the heart. These fats are found in highly processed foods, red meats, and high-fat processed meats like bacon and sausage. Many of these meats are also high in salt, another “no-no” for heart health reasons, particularly for those with high blood pressure. Other sources of saturated fat include lamb, pork, lard, butter, cream, whole milk, and high-fat cheese. Some plant sources of saturated fat include coconut oil, cocoa butter, palm oil, and palm kernel oil. The U.S. Department of Agriculture’s 2005 Dietary Guidelines recommends that adults get 20-35% of their calories from fats. At a minimum, we need at least 10% of our calories from fat.

Other foods to avoid are white flour-based foods such as bread and pasta. This is primarily because white flour is derived from grains which are gluten rich (wheat, oats, barley, rye) and as we discussed last month, very inflammatory to our body! Simply avoiding gluten can be the nucleus of a great diet with benefits like increased energy, less mental fog, and weight loss without really trying! Sugar is also found in many products that we like eating. It’s found in juices, soda, pastries, candy, most desserts, as well as pre-sweetened cereals. Even ketchup has sugar in it! Another “bad guy” comes from the nightshade family of plants that includes tomatoes, eggplant, potatoes (but NOT sweet potatoes), sweet and hot peppers, ground cherries (a small orange fruit similar to a tomato), and Goji berries. These plants contain a chemical alkaloid called solanine that triggers pain in some people.

Weight reduction is another way to reduce pain and inflammation. If your Body Mass Index is over 25, (“Google” a BMI calculator and check yours) then you may need to lose weight! There are MANY diets one can follow, but to keep it simple embrace one approach first and see what kind of results you get. Try the “Paleo diet” as it is a gluten-free approach. The Mediterranean diet is similar and then there is the Aitkin’s Diet, the Zone Diet, etc., etc. Try eliminating the three most abused unhealthy foods in your diet (like soda, ice cream, chocolate, etc.) as that too can yield great results. Make sure your thyroid is working properly if you can’t lose weight with these approaches. Simply put, foods high in sugar, saturated fat, and white flour cause overactivity of our immune system which can lead to joint and muscle pain, fatigue, and damage to blood vessels.

Eliminating these foods and eating the foods discussed last month is good for all of us, not JUST those suffering from fibromyalgia!

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!

Fibromyalgia Dietary Considerations

stk62884corIn last month’s Health Update, we discussed fibromyalgia (FM) management from a multi-modal approach, which included dietary recommendations to reduce inflammation. We'll cover this topic in more detail this month…

Anti-inflammatory foods can be broken down into four categories: 1) Fruits and vegetables; 2) Protein Sources; 3) Fats and Oils; and 4) Beverages.

In the fruits and vegetables category, whole fruits, berries, and vegetables in general are rich in good things like vitamins, minerals, fiber, anti-oxidants, and phytochemicals. In particular, green and brightly colored vegetables and whole foods (such as broccoli, chard, strawberries, blueberries, spinach, carrots, and squash) are great choices.

Besides being low in calories, high in fiber, rich in vitamin/minerals and more, berries EVEN taste good! For example, one cup of strawberries contains >100mg of vitamin C (similar to a cup of orange juice), which helps our immune system function. One cup of blueberries includes a little less vitamin C but it has minerals, phytochemicals, and anti-oxidants at only 83 calories per cup. A cup of cranberries has only 44 calories (it can also help with bladder infections), and a cup of raspberries has 64 calories and has vitamin C and potassium. Less common, but equally nutritious, are loganberries, currants, gooseberries, lingonberries, and bilberries. Put these, or a mixture of these, on salads, yogurt, or a whole grain cereal and enjoy a VERY satisfying snack or meal! The health benefits of phytochemicals and flavonoids include cancer prevention, bladder infection treatment, and may even help your eyesight (such as from lutein in blueberries and raspberries).

Protein sources include fish/seafood, especially oily ocean fish like salmon and tuna, as these are rich in omega-3 fatty acids. Soy and soy foods like tofu and tempeh as well as legumes are great plant sources of protein, though some doctors may recommend staying away from soy. Nuts such as walnuts, almonds, pecans, and Brazil nuts are also great protein sources.

Fats and Oils: Omega-3 fatty acids can be found in flax seeds, canola oil, and pumpkin seeds, as well as cold-water oily fish. Other fats that are anti-inflammatory include monounsaturated fatty acids, which are found in olive oil, avocados, and nuts and have been found to be cardiovascular disease “friendly” as well. Other healthy oils include rice bran oil, grape seed oil, and walnut oil.

Beverages: Our bodies need water! Of course, tap, sparkling, or bottled water are great sources of water. So are 100% juices, herbal tea, low-sodium vegetable juice, and if tolerated, low or non-fat milk.

Meal suggestions include: Breakfast – oatmeal with fresh berries and walnuts; Snacks – whole fruits, nuts, seeds, and fresh vegetables; Lunch and Dinner – choose fish and less fatty red meats; cook with olive and canola oil; load up a salad with fresh vegetables and fruit, avoid deep fried foods – rather, bake, broil, poach, or stir-fry instead. Fill up HALF of your dinner plate with dark green or brightly colored vegetables. Avoid the following: junk food, high-fat meats, sugar (sodas, pastries, candy, rich desserts, and sweetened cereals), highly processed foods, trans-fats and saturated fats (i.e., bacon and sausage), and white flour products (get 100% whole grain instead). Some research suggests not eating “nightshade plants” like tomatoes and eggplant.

If you, a friend or family member requires care for Fibromyalgia, we sincerely appreciate the trust and confidence shown by choosing our services!