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Patient Home  >  Nutritional Foundation Program  >  Dietary Information
Dietary Information

What diet is best for back pain, headaches, osteoarthritis, diabetes, etc.? This is a common question that doctors hear from their patients.

We have all been somewhat conditioned to view our “health worlds” from the window of medication use. We took different medications for different conditions as we grew up, such as for sour throats, colds, coughs, fevers, etc., and this continued as we aged. There are medications for high blood pressure, high cholesterol, blood sugar problems, depression, anxiety, pain, osteoarthritis, rheumatoid arthritis, ulcers, and numerous other conditions. So it is natural to embrace the false notion that there must be special diets for different conditions. Barring the rare condition, there is only one basic diet for all of us.

An interesting paper was published in 2004 that described foods that best protected us against heart disease. The combination of recommended foods was called the Polymeal (5), which is an excellent word because it does not lend itself to various dietary mental constructs or preconceived notions when we hear the names of various diets, such as South Beach Diet, Weight Watchers, Atkins, Paleodiet, and the Zone. Instead the Polymeal is about choosing the most healthy food.

The genesis of the Polymeal involved a response to an article that discussed a Polypill approach to preventing heart attacks and stroke. The authors suggested that everyone, over the age of 55 and everyone with existing cardiovascular disease, should take a polypill [or multiple medications] that included a statin; three blood pressure lowering drugs (for example, a thiazide diuretic, a beta-blocker, and an angiotensin converting enzyme inhibitor), each at half standard dose; folic acid (800 mcg); and aspirin (75 mg). They estimated that the Polypill will reduce ischemic heart disease events by 88% and stroke by 80% (20).

In response, another group of scientists, proposed a Polymeal strategy as a nutritional/dietary option to combat cardiovascular disease and increase life expectancy (5). Table 1 outlines the components in the published Polymeal and then a modified/expanded version based on additional research that looked at foods that calm the inflammation-driving disease process (1,2,14,15,21).

Table 1. Polymeal

Polymeal Foods

Modified Polymeal Foods

Wine

Red wine & stout beer

Fish

Fish, lean protein & wild game

Dark chocolate

Dark Chocolate

Fruits & vegetables

Fruits and vegetables & modest potato intake

Garlic

Garlic, ginger, turmeric, rosemary, and most other spices

Almonds

All nuts [best if raw]


Notice the foods that are NOT present as Polymeal choices: there is no sugar, flour, and refined oils, which makes up over 50% of calories in the average American’s diet (2). Dairy is also not listed; however, the average diet contains about 10% of calories from dairy (2), and this is not a problem for most people.

If you decide to adhere to the Polymeal, this does not mean you can never have birthday cake, pizza, or fast food ever again. The key is to refocus our dietary choices and make sure the majority of consumed calories come from healthy anti-inflammatory Polymeal foods. Most Americans currently consume very few calories from anti-inflammatory vegetables, fruit, and healthy animal proteins.

If we avoid the anti-inflammatory Polymeal food components, we place ourselves at risk for developing chronic inflammatory conditions that cannot be cured by drugs or supplements. Table 2 lists the various diseases that are known to be promoted by chronic inflammation (1,2,5,6,11-15,17-19,21).

Table 2 – Examples of diseases promoted by a chronic pro-inflammatory state

Alzheimer’s disease

Cardiovascular disease

Hypertension

Pain

Unhealthy aging

Cognitive decline

Kidney stones

Parkinson’s disease

Acne

Crohn’s disease

Macular degeneration

Psoriasis

Allergies

Depression & anxiety

Malaise/fatigue

Renal insufficiency

Arthritis

Dry eye syndrome

Migraine headaches

Skin cancer

Asthma

Eczema

Multiple sclerosis

Stroke

Cancer

Dysmenorrhea

Osteoporosis

Ulcerative colitis


Additional components viewed as Polymeal add-ons include olive oil, teas, whole grains and legumes (5). A word to the wise:

        Whole grains are considered to be an add-on to the Polymeal, which means that dietary change should NOT focus on eating whole grains. On a caloric basis, compared with refined and whole grains, vegetables and fruit have substantially more fiber and the important mineral potassium as outlined in Table 3.

Table 3. Fiber and potassium in common foods (8)

Food

Calories

Fiber (g)

K (mg)

1 cup millet

280

3.2

150

2 cups oatmeal

290

8.0

262

3 pc white bread

240

2.1

108

4 pc whole wheat

280

7.6

284

1.5 cups corn

250

6.3

600

Bkd sweet potato

206

6.0

700

4 Gold delic apples

240

10.0

400

3 navel oranges

240

12.0

900

6 cups broccoli

264

27.6

3036

35 cups romaine

280

35.0

5670



Americans currently consume about 2500 mg of potassium per day and the best evidence suggests we need approximately 7000-10,000 mg per day (2,3,9). As Table 3 demonstrates, vegetables and fruit are the best sources of potassium, which must come from diet and should NOT be supplemented.

An important point to embrace regarding grains:

        Whole grains are a healthier choice compared with refined grains; however, green vegetables followed by fruit are the most important sources of fiber, micronutrients, phytonutrients, and potassium. Whole grains do not compare to vegetables and fruit. Our dietary focus needs to be on vegetables and fruit, to which we can add sweet potatoes and fresh corn.

It should be clear that grains are a weak food compared to vegetation. An additional issue is that a component of wheat, rye and barley, called gluten can create diverse symptoms. Wheat is the primary grain we consume in America, so it is important focus on the diverse symptoms created by gluten. Traditionally, gluten has been linked to digestive condition called celiac disease or celiac sprue; however we now know that many other conditions can manifest in those who are gluten intolerant. And for many individuals with gluten intolerance, there are no digestive symptoms; rather these individuals suffer with diverse symptoms and conditions (see Table 4).

Table 4. Non-gastrointestinal symptoms caused by gluten intolerance (4,7,10,16)

Anemia

Dyspepsia

Infertility

 

Neurological symptoms

Autoimmune symptoms

Esophageal reflux

 

Irritable bowel syndrome

Peripheral neuropathies

Arthralgia

 

Fatigue

 

Learning disabilities

Central neuropathies (ataxia)

Arthritis

 

Guillain-Barre-like syndrome

Malaise

 

Psychological symptoms

Depression

 

Headaches

 

Myalgia

Reduced bone density

Dermatitis herpetiformis

Hypothyroidism

 

Myopathy

Thyroiditis


Summary

It should be clear that the same dietary imbalances can, over time, lead to multiple conditions. Research suggests that we are genetically disposed to develop various diseases and pro-inflammatory dietary choices function as disease-promoters. For this reason, we suggest that all patients focus on the anti-inflammatory Polymeal foods.

If you would like more details, you can read the Diet page in the Clinician section of our website. You are also welcome to download the Nutritional Foundation Booklet and listen to the Nutritional Foundation MP3.


References

1. Aggarwal BB, Shishodia S. Suppression of the nuclear factor-kB activation pathway by spice-derived phytochemicals. Reasoning for the seasoning. Ann NY Acad Sci. 2004;1030:434-41.
2. Cordain L, Eaton SB, Sebastian A et al. Origins and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005;81:341-54.
3. Demigne C, Sabboh H, Remesy C, Meneton P. Protective effects of high dietary potassium: nutritional and metabolic aspects. J Nutr. 2004;134:2903-06.
4. Dohan FC et al. Antibodies to wheat gliadin in blood of psychiatric patients: possible role of emotional factors. Biol Psych. 1972; 5(7):127-37.
5. Franco OH, Bonneux L, de Laet C, Peeters A, Steyerberg EW, Mackenbach JP. The Polymeal: a more natural, safer, and probably tastier (than the Polypill) strategy to reduce cardiovascular disease by more than 75%. Brit Med J. 2004; 329:1447-50.
6. Giugliano D, Ceriello A, Esposito K. The effects of diet on inflammation: emphasis on the metabolic syndrome. J Am Coll Cardiol. 2006;48(4):677-85.
7. Green PH, Jabri B. Coeliac disease. Lancet. 2003; 362:383-91.
8. Hands ES. Nutrients in food. Philadelphia: Lippincott Williams & Wilkins; 2000.
9. He FJ, MacGregor GA. Beneficial effects of potassium. Brit Med J. 2001;323:497-501.
10. Hopper AD, Hadjivassiliou M, Butt S, Sanders DS. Adult coeliac disease. BMJ 2007; 335:558-62.
11. Joseph J, Cole G, Head E, Ingram D. Nutrition, brain aging, and neurodegeneration. J Neurosci. 2009;29(41):12795-12801.
12. Lekander M, Elofsson S, Neve IM, Hansson LO, Unden AL. Self-rated health is related to levels of circulating cytokines. Psychosom Med. 2004;66(4):559-63.
13. Lopez-Garcia E, Schulze MB, Fung TT et al. Major dietary patterns are related to plasma concentrations of markers of inflammation and endothelial dysfunction. Am J Clin Nutr. 2004;80:1029-35.
14. Nicklas BJ, You T, Pahor M. Behavioural treatments for chronic system inflammation: effects of dietary weight loss and exercise training. Can Med Assoc J. 2005;172(9):1199-209.
15. O’Keefe JH, Gheewala NM, O’Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol. 2008;51:249-55.
16. Satengna-Guidetti C, Volta U, Ciacci C et al. Prevalence of thyroid disorders in untreated adult celiac disease patients and effect of gluten withdrawal: an Italian multicenter study. Am J Gastroenterol. 2001; 96(3):751-57.
17. Seaman DR. The diet-induced pro-inflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002;25:168-79.
18. Shapira N. Nutritional approach to sun protection: a suggested complement to external strategies. Nutr Rev. 2009;68(2):75-86.
19. Simopoulos AP. The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases. Exp Biol Med. 2008;233:674-88.
20. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. Brit Med J. 2003;326:1419.
21. Warnberg J, Gomez-Martinez S, Romeo J, Diaz LE, Marcos A. Nutrition, inflammation, and cognitive decline. Ann NY Acad Sci. 2009;1153:164-75.




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