Diet and Inflammation

In Physical Therapy Articles by Jeff Gilliam, PT, PhD, OCS2 Comments

When my patients present with chronic joint pain, along with abdominal obesity and hypertension, I suspect underlying inflammation. While this may seem to be an easy determination, the treatment is more involved. Many patients will already be taking a regimen of anti-inflammatories, which present their own set of problems.

While it is important to ‘turn-off’ the inflammatory process, the patient is often exacerbating their condition with foods that actually increase the inflammation. Foods that have been shown to increase inflammation are foods high in saturated fats, transfats, in addition to high sugar foods and drinks and refined carbohydrates.

Circulating markers of inflammation are C – reactive protein (CRP), tumor necrosis factor alpha (TNF)-alpha and interleukin-6 (IL-6) to name a few. Omega-3 fatty acids have been shown to reduce markers of inflammation.  Substitution of saturated and trans-fats with polyunsaturated and monounsaturated fats through a long-term vegetarian diet demonstrated improved markers of inflammation, when comparing the highest intake of trans-fats and saturated fats to lowest intakes.

Intervention studies have shown an inverse relationship with fruits, vegetables, and nuts intake and biomarkers of inflammation. A reduction in refined grains and an increase in fiber intake decreased inflammatory markers and increases anti-inflammatory markers.  Additionally low to moderate sugar sweetened beverage consumption has been shown to increase markers of inflammation in a study of healthy subjects.

The message that needs to be communicated to your patient is to avoid all refined carbohydrates, increase your fruit, vegetable and nut intake, and avoid sugar-sweetened drinks and foods high in saturated fats and trans-fats, replacing these with foods high in polyunsaturated and monounsaturated fats. I provide my patients with a handout that nicely covers all of these areas; it is quick, easy to read and imparts critical information that can help your patient naturally reduce inflammation through lifestyle changes.

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Jeff Gilliam, PT, PhD, OCS
Jeff Gilliam PT PhD, OCS: is a weight loss specialist, who has studied extensively in the areas of health behavior, exercise physiology and nutritional biochemistry at the University of Florida. Jeff has taught a course at the University of Florida called ’Research Applications to Obesity and Weight Loss’. He has also taught courses for the DPT program at UF in Health Promotion and Wellness’ and ‘Evidence Based Practice III’. He has presented on a national level on topics related to diseases related to obesity and changing behavior to facilitate a healthy lifestyle. His PhD research was in the area of effective behavioral interventions for obesity and its associated diseases. He is founder of Physicians’ Choice for Weight Loss, a successful lifestyle/weight loss program, which can be found in over 50 clinics in the eastern US. He currently is clinical director of ReQuest Physical Therapy (Gainesville, Florida) and incorporates his lifestyle/weight loss program into his patients’ physical therapy to help them achieve their healthiest body weight. Jeff Gilliam is an Orthopedic Certified Specialist through the American Board of Physical Therapy Specialties

Comments

  1. With your patients, how well has the info about “no refined carbohydrates,” etc., translated from message into action? And does your handout say, “just stop eating them right now,” or provide an action plan to start replacing refined food with more whole food?

    I’d have to say I’m more a centrist with nutrition – no “always and never” statement, more “If you are eating snacks with protein 75% of the time or more, then you’re doing great.”

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