Diet & Diets
This section offers and overview of diet and how it relates to health and pain as well as specific, goal-directed diets including general wellness diets, anti-inflammatory diets and diets directed at reducing blood pressure, constipation, pain, depression, gout and addiction relapse risk.
Integrative, Complimentary and Alternative Medicine
Elimination Diets (coming soon)
Wellness Diets (coming soon)
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There are always many opinions as to what constitutes the healthiest diet and what people should eat. The Paleo Diet appears to be a front runner currenty but how one defines a Paleo Diet is open to a wide range of interpretation and the reader is referred to other sites for more information at this time. The Mediterranean Diet is highly recommended particularly as an anti-inflammatory diet to reduce oxidative stress and minimize dietary contribution to chronic pain (see handouts below).
What is less controversial is what one should not eat: low fiber, calorie-dense, high fat, highly-processed foods. It has been well established that a diet rich in these products contributes to oxidative stress, obesity, cardiovascular disease and possibly some cancers as well as other diseases. For more information, please see:
See: Wellness (Anti-inflammatory) Diet: Overview
See: Wellness Diet: Menu Examples
Diet for High Blood Pressure
Conventional recommendations focus on the Dash Diet (see below) for high blood pressure. This generally does not conflict with the Paleo or Mediterranean diets but also includes the focus on salt restriction.
See: Dash Diet for High Blood Pressure
Diet for Managing Gout
Gout occurs when high levels of uric acid in the blood cause crystals to form and accumulate in and around a joint. Your body produces uric acid when it breaks down purines. Purines occur naturally in your body, but also come from eating certain foods, such as organ meats, anchovies, herring, asparagus and mushrooms. Dietary recommendations for managing gout are therefore focused on restricting purines in the diet as their metabolism contributes to symptomatic gout.
See: Diet & Gout
Diet for Managing Constipation
While the dietary approach to constipation depends of course on the reason for constipation, for the usual initial approach to constipation includes maintaining an abundant intake of fiber particularly from vegetables (preferably raw) and fruits and should amount to 30 gms of dietary fiber/day. Plenty of water and exercise are also important in the prevention and management of constipation. Consult your physician for any symptomatic constipation that persists despite dietary treatment, especially if associated with a smaller caliber of stool. For more information, see the handout below.
Opioid Induced Constipation (OIC)
For patients taking opioids, constipation is a common problem. In general, the initial approach to opioid induced constipation (OIC) is the same as noted above. When this fails and rotating to an alternative opioid is not advised, there are new prescription medications on the market specifically for OIC that are generally very effective and well tolerated, such as Movantik. Consult your physician for further information
Diet for Managing Depression
Studies indicate that those people with depression or at risk for depression are likely to experience a mood benefit from a short term tryptophan-rich diet with high Trp:LNAA (tryptophan:other amino acids) ratios based on selected foods or tryptophan supplements. However, if taken to extremes excessive tryptophan intake can have the reverse effect of impairing mood.
Similarly, cognitive improvement in terms of memory and learning may be expected from a short term tryptophan-rich diet with high Trp:LNAA ratios based on selected foods or tryptophan supplements. However, if taken to extremes excessive tryptophan intake can have the reverse effect of impairing memory and learning.
See: Diet & Depression
Diet for Managing Reward Deficiency Syndrome and Addiction
Similar to the suggestions related to diet in depression related above, there are dietary modificatons that may support dopamine levels in the brain. Reduced dopamine levels are implicated as playing a central role in susceptibility to, and manifestations of, a number of conditions related to Reward Deficiency Syndrome (RDS). RDS is believed to be a core component underlying conditions such as binge eating, obsessive compulsive disorder (OCD), PTSD as well as chemical and behavioral addictions including gambling and computer gaming.
There may be a benefit from a short term tyrosine-rich diet coupled with low carbohydrate/low glycemic index foods to support dopamine levels, particularly in times of stress or relapse into addictive behaviors. A recent pre-clinical animal study provides support for the benefit of a diet rich in omega-3 fatty acids in reducing the consequences of chronic opioid use related to neuroinflammation secondary glial activation.
See: Diet & Dopamine
Resources for Nutritional Information
This is my favorite online resource for nutritional information. It provides excellent breakdowns of the nutrional value of natural foods, raw and cooked, as well as commercial food products. It offers a web-based app that allows you to track and analyze your diet and monitor your exercise. It has a wealth of educational information on topics from food additives, glycemic index, food processing, individual nutrients and pretty much anything of interest to the person motivated to learn more about diet and nutrition. There are even recipes!
Nutrition.gov provides easy access to vetted food and nutrition information from across the federal government. It serves as a gateway to reliable information on nutrition, healthy eating, physical activity, and food safety for consumers.
Providing science-based dietary guidance is critical to enhance the public’s ability to make healthy choices in the effort to reduce obesity and other food related diseases. Since dietary needs change throughout the lifespan, specialized nutrition information is provided about infants, children, teens, adult women and men, and seniors.
Users can find practical information on healthy eating, dietary supplements, fitness and how to keep food safe. The site is kept fresh with the latest news and features links to interesting sites.
National Association to Advance Fat Acceptance
Founded in 1969, the National Association to Advance Fat Acceptance (NAAFA) is a non-profit, all volunteer, civil rights organization dedicated to protecting the rights and improving the quality of life for fat people. NAAFA works to eliminate discrimination based on body size and provide fat people with the tools for self-empowerment through advocacy, public education, and support.
“Dopamine for Dinner”
by Joan Borsten, 2014
Avaliable online at Amazon.com: Kindle subscriber: free; Kindle book: $9.95 Paperback: $149.00
“Dopamine for Dinner,” is the first Malibu Beach Recovery Diet Cookbook, based on their famous low-glycemic diet. The recipes developed by four accomplished chefs are both pleasant eating as well as healthy. Based on the use of low glycemic index foods, the recipes emphasize nutritious eating in a manner that promotes maintaining high brain levels of dopamine and serotonin as a means of supporting healthy brain chemistry.
Dietary Supplement Testing and Safety:
Information on Herbal and Dietary Supplements:
Diet – Overviews
- Diet and cognition – Data, theory, and some solutions from the playbook of psychology – 2016
- Cannabimimetic phytochemicals in the diet – an evolutionary link to food selection and metabolic stress adaptation? – 2016
- Combining pain therapy with lifestyle – the role of personalized nutrition and nutritional supplements according to the SIMPAR Feed Your Destiny approach – 2016
- Second edition of SIMPAR’s “Feed Your Destiny” workshop – the role of lifestyle in improving pain management – 2018
Genetics and Nutrition
Emphasis on Education
Accurate Clinic promotes patient education as the foundation of it’s medical care. In Dr. Ehlenberger’s integrative approach to patient care, including conventional and complementary and alternative medical (CAM) treatments, he may encourage or provide advice about the use of supplements. However, the specifics of choice of supplement, dosing and duration of treatment should be individualized through discussion with Dr. Ehlenberger. The following information and reference articles are presented to provide the reader with some of the latest research to facilitate evidence-based, informed decisions regarding the use of conventional as well as CAM treatments.
For medical-legal reasons, access to these links is limited to patients enrolled in an Accurate Clinic medical program.
Should you wish more information regarding any of the subjects listed – or not listed – here, please contact Dr. Ehlenberger. He has literally thousands of published articles to share on hundreds of topics associated with pain management, weight loss, nutrition, addiction recovery and emergency medicine. It would take years for you to read them, as it did him.
For more information, please contact Accurate Clinic.
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