<\/p>\n\n\n\n
He also, pertinently, said \u2018There are two things: science and opinion. The former begets knowledge; the latter ignorance.\u2019 So what does all this mean for you and your clients? Let\u2019s take a look at how nutrition can be used to help clients dealing with injury and inflammation, and how Hippocrates\u2019 advice is still useful, thousands of years later.<\/p>\n\n\n\n
\u2018The natural healing force within each of us is the greatest force in getting well.\u2019<\/h2>\n\n\n\n
Hippocrates didn\u2019t know about the biochemistry of immunity and inflammation in 400 BCE, but he did figure out that some system in the human body was responsible for healing and recovery \u2013 what we now know as the immune system. Inflammation is one of its jobs, but it has lots of others, such as:<\/p>\n\n\n\n
- \n
- recognising what is \u2018self\u2019 and what is \u2018foreign\u2019<\/li>\n\n\n\n
- keeping foreign material (such as viruses or unfriendly bacteria) out<\/li>\n\n\n\n
- kicking the butt of any foreign material that gets in<\/li>\n\n\n\n
- cleaning up the mess after aforementioned butt kicking.<\/li>\n<\/ul>\n\n\n\n
![\"\"](\"https:\/\/web.archive.org\/web\/20200319072905im_\/https:\/\/app-66b73b11c1ac1859509cd621.closte.com\/images2016\/autumn2017\/food-med.jpg\" "\\"\\"")
The immune system usually keeps things in careful balance, and even within our immune system itself there is ideally a balance between its various components.<\/p>\n\n\n\n<\/div>\n\n\n\nWhen our immune system detects something foreign in the system, such as a virus, or damage, such as an injury (which might also let pathogens in, if the first-line defences, such as the skin, are breached), it goes to work.<\/p>\n\n\n\n
The first stage of an immune response is inflammation, recognisable through symptoms such as swelling, warmth, redness and pain.<\/p>\n\n\n\n
These symptoms are caused by blood and other fluid flowing into the affected areas, as well as the work of chemical signalling molecules (such as eicosanoids and cytokines), which do things like:<\/p>\n\n\n\n
- \n
- elevate the local temperature to try to kill pathogens<\/li>\n\n\n\n
- dilate blood vessels to get more circulation to the injury<\/li>\n\n\n\n
- attract white blood cells to start attacking and eating any foreign material, and to eventually clear out waste products and dead cells.<\/li>\n<\/ul>\n\n\n\n<\/div>\n\n\n\n
\u2018Everything in excess is opposed by nature.\u2019<\/h2>\n\n\n\n
We need inflammation in the first stages of an injury. It\u2019s an important part of the process of healing. However, we have problems when:<\/p>\n\n\n\n
- \n
- inflammation becomes chronic<\/li>\n\n\n\n
- stuff gets into our system through unexpected routes, such as through our intestinal wall; and\/or<\/li>\n\n\n\n
- our immune system gets a little over-enthusiastic and starts labelling everything as \u2018foreign\u2019 (including, potentially, our own tissues).<\/li>\n<\/ul>\n\n\n\n
Many metabolic diseases and chronic pain conditions involve persistent inflammation, including:<\/p>\n\n\n\n
- \n
- cardiovascular disease<\/li>\n\n\n\n
- type 2 diabetes<\/li>\n\n\n\n
- cancer<\/li>\n\n\n\n
- Alzheimer\u2019s, multiple sclerosis, and other neurodegenerative diseases<\/li>\n\n\n\n
- arthritis and other joint problems.<\/li>\n<\/ul>\n\n\n\n
So where does nutrition fit in? When it comes to nutritional management of inflammation and injury, the aim is to help the immune system do its job, without encouraging it to go on a rampage. This is achieved through the following means:<\/p>\n\n\n\n
<\/div>\n\n\n\nEating fewer inflammatory foods<\/h3>\n\n\n\n
Our bodies use particular foods (or more accurately, components of those foods) to build things like hormones and chemical signals. So, for instance, it can use omega-6 fatty acids to synthesise some types of prostaglandins, chemicals that can stimulate inflammation.<\/p>\n\n\n\n
Other types of foods are linked to elevated inflammation, such as:<\/p>\n\n\n\n
- \n
- trans fatty acids (created during food processing)<\/li>\n\n\n\n
- excess sugar<\/li>\n\n\n\n
- excess alcohol<\/li>\n\n\n\n
- caffeine (in some people).<\/li>\n<\/ul>\n\n\n\n
For some, avoiding eating altogether, at least for brief periods, can also lower inflammation<\/a>. This is known as intermittent fasting (IF), and has shown some therapeutic potential for treating particular health problems.<\/p>\n\n\n\n
<\/div>\n\n\n\nRemoving other foods that cause an immune response<\/h3>\n\n\n\n
For some people, some normally innocuous food components may stimulate an inflammatory response through various pathways. For instance:<\/p>\n\n\n\n
- \n
- We may have a food allergy, which stimulates an immunoglobulin E (IgE) response and anaphylaxis, which can be life-threatening.<\/li>\n\n\n\n
- We may have a food sensitivity, which stimulates an immunoglobulin G (IgG) response that often has more systemic effects.<\/li>\n\n\n\n
- We may have gastrointestinal permeability (aka leaky gut), which allows normally benign particles (such as protein fragments) to sneak through and enter circulation. Our immune system will recognise these as \u2018foreign\u2019 and go on the attack.<\/li>\n<\/ul>\n\n\n\n<\/div>\n\n\n\n
Eating more anti-inflammatory foods<\/h3>\n\n\n\n
Fruits<\/a>, vegetables, and omega-3 fatty acids (found in marine foods such as fish) typically have anti-inflammatory effects through various pathways. For instance, many of the plant compounds (known as phytonutrients) in colourful fruits and vegetables may help control oxidative stress. Similarly, Omega-3 fatty acids (specifically EPA and DHA) have anti-inflammatory effects, and also improve insulin sensitivity, which can further dampen chronic inflammation.<\/p>\n\n\n\n
<\/div>\n\n\n\nProviding our bodies with raw materials<\/h3>\n\n\n\n
This is an often-overlooked component of food and healing. Our bodies need raw materials to repair and rebuild \u2013 in particular, they need protein. Most of our bodies\u2019 tissues, as well as most of our immune system, depend on protein. As dead cells get cleared out and new structures built, we see more protein turnover. This means that often, as we are recovering from an injury or chronic illness, we may need more protein. Depending on the health problem, we may also need a slightly higher energy intake to meet the metabolic demands of repair and reconstruction.<\/p>\n\n\n\n
<\/div>\n\n\n\nSupplementing wisely to assist the natural cycle of inflammation<\/h3>\n\n\n\n
Many food-derived supplements (particularly spices and aromatic herbs) have anti-inflammatory properties; ginger, curcumin (from turmeric), garlic, omega-3 fatty acid supplements, beet juice and bitter melon to name a few. Other types of supplements, such as probiotics, may help control inflammation indirectly.<\/p>\n\n\n\n
<\/p>\n\n\n\n
However, we can\u2019t just throw pills at things, or assume that any single nutrient or supplement will be a magic bullet. In addition, just because something has anti-inflammatory properties does not ensure that we can digest, absorb, and use it systemically to treat inflammation. Instead, we have to understand how immunity and inflammation work as a complex system within the human body, and what long-term effects any supplementation may have.<\/p>\n\n\n\n
<\/div>\n\n\n\n\u2018It is far more important to know what person the disease has than what disease the person has.\u2019<\/h2>\n\n\n\n
Eating to reduce inflammation is not a one-size-fits-all prescription. For instance, the relationship between alcohol consumption and inflammation seems to be gender-linked. In other words, men and women tend to have somewhat different inflammatory responses to drinking.<\/p>\n\n\n\n
Men and women also have different hormonal environments that can affect inflammation. Women <\/a>tend to have more auto-immune diseases than men, but oestrogen seems to help protect women against chronic inflammatory metabolic diseases (at least during their reproductive years).<\/p>\n\n\n\n
We also know there are genetic and ethnic differences in inflammation, and in our response to particular foods, which, again, can raise or lower our levels of inflammation. For example, data on whether coffee worsens inflammation has been mixed; in part, this may be due to genetic variations in caffeine processing, or perhaps varying responses to the dozens of other chemically active compounds in coffee.<\/p>\n\n\n\n
<\/div>\n\n\n\n\u2018Walking is the best medicine.\u2019<\/h2>\n\n\n\n
Inflammation is strongly affected by body fat. Adipose (fat) tissue<\/a> secretes inflammatory chemicals and can affect systemic inflammation through the actions of hormones such as leptin. So, helping clients lower their body fat to a healthy range, and improving proper nutrient partitioning through regular activity, may be a more important anti-inflammatory activity than any specific food or supplement.<\/p>\n\n\n\n
<\/div>\n\n\n\n\u2018Make a habit of two things \u2014 to help, or at least, to do no harm.\u2019<\/h2>\n\n\n\n
How can you put this into practice to help your clients? Here are some places to start.<\/p>\n\n\n\n
<\/div>\n\n\n\nThink systemically<\/h3>\n\n\n\n
There\u2019s almost never going to be a quick fix. Instead, look at the big picture of your clients\u2019 lives and behaviours.<\/p>\n\n\n\n
<\/div>\n\n\n\nPrioritise<\/h3>\n\n\n\n
If a client is eating poorly and sleeping four hours a night, all the supplements in the world probably won\u2019t help them. So try to control the most important factors first: basic nutrition<\/a>, regular activity, stress management, and above all \u2014 consistency.<\/p>\n\n\n\n
<\/div>\n\n\n\nFollow the evidence with your client<\/h3>\n\n\n\n
Base any decisions on data. Don\u2019t just randomly supplement or suggest sweeping dietary changes like \u2018You should stop eating all types of Food X\u2019 or \u2018You should do intermittent fasting\u2019. A food journal that also tracks inflammatory symptoms is a great place to start. Clients can improve their own self-awareness, and look for patterns in what they eat and how they feel.<\/p>\n\n\n\n
<\/div>\n\n\n\nHelp your client make small but important changes<\/h3>\n\n\n\n
These can include things like:<\/p>\n\n\n\n
- \n
- removing or reducing pro-inflammatory foods such as processed foods, refined sugars and excess alcohol<\/li>\n\n\n\n
- adding inflammation-controlling foods such as colourful fruits and vegetables and fatty fish<\/li>\n\n\n\n
- getting enough \u2018raw materials\u2019 and building blocks, such as protein and essential fatty acids<\/li>\n\n\n\n
- reducing body fat, if that\u2019s a concern for your client, because more body fat means more inflammation.<\/li>\n<\/ul>\n\n\n\n
Help your client identify possible food sensitivities<\/p>\n\n\n\n
Common sensitivities include wheat\/gluten and other grains (such as oats), soy, dairy, and eggs, but there are many others. Again, you can suggest the use of a food journal to help with identifying links between food and inflammation.<\/p>\n\n\n\n
<\/div>\n\n\n\nRefer out as needed<\/h3>\n\n\n\n
Know your scope of practice as a trainer or coach. You can help your client learn about inflammation and how foods relate to it, but unless you\u2019re specifically qualified to do so, don\u2019t make recommendations about treating any diseases with food or supplements. Establish relationships with other health care providers, and incorporate them into your referral network.<\/p>\n\n\n\n
<\/div>\n\n\n\n
\n\n\n\nReferences<\/h2>\n\n\n\n
Aksungar, Fehime B., Aynur E. Topkaya, and Mahmut Akyildiz. Interleukin-6, C-reactive protein and biochemical parameters during prolonged intermittent fasting. Annals of Nutrition and Metabolism<\/em> 51, no. 1 (2007): 88-95.
Allaire, Janie, et al. Randomized, crossover, head-to-head comparison of EPA and DHA supplementation to reduce inflammation markers in men and women: the Comparing EPA to DHA Study. The American Journal of Clinical Nutrition<\/em> (2016): ajcn131896.
Asgary, S., et al. Improvement of hypertension, endothelial function and systemic inflammation following short-term supplementation with red beet (Beta vulgaris L.) juice: a randomized crossover pilot study. Journal of Human Hypertension<\/em> (2016).
Dandawate, Prasad R., Dharmalingam Subramaniam, Subhash B. Padhye, and Shrikant Anant. Bitter melon: a panacea for inflammation and cancer. Chinese Journal of Natural Medicines<\/em> 14, no. 2 (2016): 81-100.
Epelman, Slava, Peter P. Liu, and Douglas L. Mann. Role of Innate and Adaptive Immunity in Cardiac Injury and Repair. Nature reviews. Immunology<\/em> 15 no.2 (2015): 117\u2013129.
Kim, Nancy D., and Andrew D. Luster. The role of tissue resident cells in neutrophil recruitment. Trends in immunology<\/em> 36 no.9 (2015): 547\u2013555.
Kuehl, Kerry S. “Cherry juice targets antioxidant potential and pain relief.” In Acute Topics in Sport Nutrition<\/em>, vol. 59, pp. 86-93. Karger Publishers, 2012.
Lorente-Cebri\u00e1n S, Costa AG, Navas-Carretero S, Zabala M, Laiglesia LM, Mart\u00ednez JA, Moreno-Aliaga MJ. An update on the role of omega-3 fatty acids on inflammatory and degenerative diseases. J Physiol Biochem. 2015 Jun;71(2):341-9. doi: 10.1007\/s13105-015-0395-y. Epub 2015 Mar 11.
Mashhadi, Nafiseh Shokri, et al. Influence of ginger and cinnamon intake on inflammation and muscle soreness endued by exercise in Iranian female athletes. International Journal of Preventive Medicine<\/em> 4 (2013).
Oliveira A, Rodr\u00edguez-Artalejo F, Lopes C. Alcohol intake and systemic markers of inflammation–shape of the association according to sex and body mass index. Alcohol & Alcoholism. 2010 Mar-Apr;45(2):119-25. doi: 10.1093\/alcalc\/agp092. Epub 2010 Jan 18.
Roberts-Thomson PJ, Roberts-Thomson RA, Nikoloutsopoulos T, Gillis D. Immune dysfunction in Australian Aborigines. Asian Pac J Allergy Immunol. 2005 Dec;23(4):235-44.
Russo, Matthew, and Dorian B. McGavern. \u201cImmune Surveillance of the CNS Following Infection and Injury.\u201d Trends in immunology<\/em> 36.10 (2015): 637\u2013650. PMC<\/em>. Web. 2 Jan. 2017.
Schumacher, H. R., S. Pullman-Mooar, S. R. Gupta, J. E. Dinnella, R. Kim, and M. P. McHugh. “Randomized double-blind crossover study of the efficacy of a tart cherry juice blend in treatment of osteoarthritis (OA) of the knee.” Osteoarthritis and Cartilage<\/em> 21, no. 8 (2013): 1035-1041.
Shin, In-Sik, et al. Diallyl-disulfide, an organosulfur compound of garlic, attenuates airway inflammation via activation of the Nrf-2\/HO-1 pathway and NF-kappaB suppression. Food and Chemical Toxicology<\/em> 62 (2013): 506-513.
Siervo, Mario, et al. “Inorganic nitrate and beetroot juice supplementation reduces blood pressure in adults: a systematic review and meta-analysis.” The Journal of nutrition<\/em> 143, no. 6 (2013): 818-826.
Vincent, F. B., Peter Bourke, E. F. Morand, F. Mackay, and David Bossingham. “Focus on systemic lupus erythematosus in Indigenous Australians: towards a better understanding of autoimmune diseases.” Internal medicine journal<\/em> 43, no. 3 (2013): 227-234.
Winkler, Christiana, Barbara Wirleitner, Katharina Schroecksnadel, Harald Schennach, and Dietmar Fuchs. “In vitro effects of beet root juice on stimulated and unstimulated peripheral blood mononuclear cells.” Am J Biochem Biotechnol<\/em> 1 (2005): 180-185.<\/p>\n\n\n\n
\n\n\n\nDr Krista Scott-Dixon<\/strong> is the Director of Curriculum for Precision Nutrition. Previously, she was a professor at York University in Toronto, Canada, as well as a researcher for a public health institute. She is the co-author of The Essentials of Sport and Exercise Nutrition. krista@precisionnutrition.com<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"
Taking a cue from ancient Greek doctor Hippocrates, we look at how nutrition can be used to help clients dealing with injury and inflammation. If you\u2019ve been working in the fitness or nutrition fields long enough, you\u2019ve probably seen this quote from the ancient Greek doctor Hippocrates: \u2018Let food be thy medicine, and medicine be […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[14,16],"tags":[17,15],"class_list":["post-6958","post","type-post","status-publish","format-standard","hentry","category-all","category-nutrition","tag-all","tag-nutrition"],"_links":{"self":[{"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/posts\/6958","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/comments?post=6958"}],"version-history":[{"count":0,"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/posts\/6958\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/media?parent=6958"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/categories?post=6958"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.fitnessnetwork.com.au\/wp-json\/wp\/v2\/tags?post=6958"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}