Diet and Supplements

The body makes digestive enzymes to help break down food carbohydrates, fats, and proteins. Healthy digestion and nutrient absorption depend on these enzymes, a protein that speeds up chemical reactions in the mouth, pancreas, and intestines. Certain health conditions like pancreatic insufficiency and lactose intolerance can cause low enzyme levels and insufficiency and may need replacement digestive enzymes to help prevent malabsorption. That's where digestive enzyme supplements come in.

Digestive Enzymes

Digestive enzymes are a vital part of digestion; without them, the body can't break foods down, and nutrients can't be fully absorbed. A lack of digestive enzymes can lead to gastrointestinal/GI symptoms and cause malnourishment, even with a nutritious diet. The result is unpleasant digestive symptoms that can include:

• Poor absorption of nutrients
• Bloating
• Stomach pain
• Nausea
• Vomiting

Digestive enzyme supplements have been used for treating common forms of gut irritation, heartburn, and other ailments.

Enzyme Types

The main digestive enzymes made in the pancreas include:

Amylase

• It is also made in the mouth.
• Breaks down carbohydrates, or starches, into sugar molecules.
• Low amylase can lead to diarrhea.

Lipase

• This works with liver bile to break down fats.
• Lipase insufficiency causes decreased levels of fat-soluble vitamins A, D, E, and K.

Protease

• This enzyme breaks down proteins into amino acids.
• It also helps keep bacteria, yeast, and protozoa out of the intestines.
• A shortage of protease can lead to allergies or toxicity in the intestines.

Enzymes made in the small intestine include:

Lactase

• Breaks down lactose, a sugar found in dairy products.

Sucrase

• Breaks down sucrose, a sugar found in fruits and vegetables.

Insufficiency

When the body does not produce enough digestive enzymes or doesn't release them correctly. A few types include:

Lactose Intolerance

• The body does not produce enough lactase, making digesting the natural sugar in milk and dairy products difficult.

Exocrine Pancreatic Insufficiency

• EPI is when the pancreas does not produce enough of the enzymes necessary to digest carbohydrates, proteins, and fats.

Congenital Sucrase-Isomaltase Deficiency

• The body does not have enough sucrase to digest certain sugars.

Symptoms

Common digestive enzyme insufficiency symptoms:

• Bloating
• Gas
• Stomach aches and pains.
• Cramps
• Diarrhea
• Oily bowel movement stools 
• Unexplained weight loss

Talking to a doctor if symptoms persist is recommended, as these could be signs of gut irritation or indicate a more serious condition.

Supplements

Prescription Enzymes

Individuals diagnosed with enzyme insufficiency may need to take prescription digestive enzymes, depending on the severity. These supplements assist in food breakdown and nutrient absorption. The most common enzyme replacement therapy is pancreatic enzyme replacement therapy or PERT. PERT is a prescribed medication that includes amylase, lipase, and protease. Individuals with cystic fibrosis often have pancreatic enzyme insufficiency, as the body can’t release the enzymes properly. And individuals with pancreatitis require PERT because their pancreas develops mucus and scar tissue over time.

Over-The-Counter Enzymes

Over-the-counter digestive enzyme supplements can contain amylase, lipase, and protease and can help with acid reflux, gas, bloating, and diarrhea. Some contain lactase and alpha-galactosidase. Alpha-galactosidase can help break down a non-absorbable fiber called galactooligosaccharides /GOS, mostly found in beans, root vegetables, and certain dairy products.

Certain foods contain digestive enzymes, including:

• Honey
• Avocados
• Bananas
• Pineapples
• Mangos
• Papayas
• Ginger
• Sauerkraut
• Kiwi
• Kefir

Supplementing the diet with some of these foods can help with digestion.

Functional Nutrition

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from various disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and directly or indirectly support our clinical scope of practice.* Our office has reasonably attempted to provide supportive citations and identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, don't hesitate to contact Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Beliveau, Peter J H, et al. “An Investigation of Chiropractor-Directed Weight-Loss Interventions: Secondary Analysis of O-COAST.” Journal of manipulative and physiological therapeutics vol. 42,5 (2019): 353-365. doi:10.1016/j.jmpt.2018.11.015

Brennan, Gregory T, and Muhammad Wasif Saif. “Pancreatic Enzyme Replacement Therapy: A Concise Review.” JOP: Journal of the pancreas vol. 20,5 (2019): 121-125.

Corring, T. “The adaptation of digestive enzymes to the diet: its physiological significance.” Reproduction, nutrition, developpement vol. 20,4B (1980): 1217-35. doi:10.1051/rnd:19800713

Goodman, Barbara E. “Insights into digestion and absorption of major nutrients in humans.” Advances in physiology education vol. 34,2 (2010): 44-53. doi:10.1152/advan.00094.2009

Vogt, Günter. “Synthesis of digestive enzymes, food processing, and nutrient absorption in decapod crustaceans: a comparison to the mammalian model of digestion.” Zoology (Jena, Germany) vol. 147 (2021): 125945. doi:10.1016/j.zool.2021.125945

Whitcomb, David C, and Mark E Lowe. “Human pancreatic digestive enzymes.” Digestive diseases and sciences vol. 52,1 (2007): 1-17. doi:10.1007/s10620-006-9589-z

Individuals and doctors have praised the anti-inflammatory, pain-relieving properties of drinking tea. Inflammation is the body’s natural immune response when injury and infection present. This is good. However, it’s meant to be a temporary response that deactivates when there is no longer any danger. When the body is exposed to various irritants like industrial chemicals, inflammatory foods like sugar, refined carbohydrates, and autoimmune disorders can cause the immune system to go into overdrive. Chronic inflammation can develop, circulating powerful hormones and chemicals through the body, causing damage to the cells. One consequence of chronic inflammation is back pain. Besides standard backaches, some chronic conditions are directly tied to inflammation. These include forms of arthritis:

• Ankylosing spondylitis
• Rheumatoid arthritis
• Transverse myelitis
• Multiple sclerosis
• These conditions involve inflammation of the central nervous system.
• Drinking tea can help with back pain and pain in general.

Teas With Anti-Inflammatory Properties

Certain teas contain anti-inflammatory compounds. These compounds are called polyphenols and work to decrease the chemicals in the body responsible for pain and inflammation. There are varieties of teas that contain anti-inflammatory properties.

Certain Teas Reduce Inflammation

Drinking specific teas with more polyphenols can better decrease inflammation. For example, green tea is higher in polyphenols than black tea. Recent studies centered on individuals with rheumatoid arthritis over six months found significant improvement in symptoms in those who drank green tea. Green tea works best when part of an anti-inflammatory and nutritional lifestyle adjustment. This supports combating inflammation. Other teas that are believed to reduce inflammation include:

• Turmeric
• Holy basil
• Ginger

Three Cups a Day

The amount of tea depends on the quality of the tea and how it is prepared. Doctors recommend around three cups a day for individuals with rheumatoid arthritis. However, these could contain caffeine. If this is an issue, there are decaffeinated versions with the same anti-inflammatory properties.

Drinking Tea Works Best When Combined with Other Treatments

If experiencing back pain or looking to combat a specific condition, it’s recommended to utilize various treatment approaches combined with drinking tea. This includes:

• Chiropractic care
• Physical therapy
• Acupuncture
• Mindfulness meditation
• Yoga
• Dietary supplements
• Anti-inflammatory diet

Tea Is Not For All Types Of Pain

Certain back conditions benefit from drinking tea regularly; however, spine structural issues or fractures will not benefit from tea's mild anti-inflammatory properties. It is vital for individuals with back pain that a spine specialist or chiropractor perform a proper and thorough examination, especially for Individuals that take medication that could directly interact with anti-inflammatory teas.

Drinking Tea for Back Pain

For most individuals, drinking tea is safe to help treat back pain conditions and added health benefits. For example, studies have found that green tea has mild anti-cancer, anti-diabetic properties and can help in maintaining a healthy weight. If tea helps reduce pain, it's worth trying. Remember, pain is the body’s way to alert the individual that something is wrong.

Body Composition

Alcohol and Heart Health

According to the Mayo Clinic, consuming more than three alcoholic drinks in one sitting causes a temporary blood pressure elevation. Foods often served with alcohol are usually high in salt, which can also raise blood pressure. A few alcoholic beverages on a night out is fine, but heavy or binge drinking can lead to short-term spikes in blood pressure that could cause cardiac health problems. These are the short-term effects of alcohol on blood pressure. Heavy alcohol consumption can lead to long term health risks like:

• Hypertension
• Heart disease
• Digestive issues
• Liver disease
• Stroke

It’s recommended that individuals incorporate regular exercise/physical activity and healthy diet changes and watch alcohol intake to improve heart health.

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified healthcare professional or licensed physician and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

The Clinical Journal of Pain. (October 2019) “Nonspecific Low Back Pain:

Inflammatory Profiles of Patients With Acute and Chronic Pain” https://journals.lww.com/clinicalpain/fulltext/2019/10000/nonspecific_low_back_pain__inflammatory_profiles.2.aspx

Certain Teas Bring Down Inflammation More Than Others: Journal of Physical Therapy Science. (October 2016) “Green tea and exercise interventions as nondrug remedies in geriatric patients with rheumatoid arthritis” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5088134/

The Bottom Line: Proceeding of the Japan Academy, Series B Physical and Biological Sciences. (March 2012) “Health-promoting effects of green tea” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365247/

Natural medicine for dealing with stress and taking initial steps can also help prevent and alleviate stress pain. With age, the body becomes more vulnerable to emotional and physical stress. The spine endures the effects of stress and can lead to back and/or neck pain. Chronic stress can also lead to chemical imbalances in the brain and overreaction/s. This produces a Hyperarousal or anxious state of mind. If frequent bouts of anxiety or stress are occurring the body is signaling that balance needs to be restored.

Steps to Control Stress

Take frequent physical and mental breaks

Throughout a day, there can be several and various stressful situations. Not letting the stress build-up is a skill that needs to be practiced. Every 50 minutes of work, take a 10-minute break to reduce any stress. This will increase productivity. In the middle or last break, practice deep breathing.

• Inhale slowly until the air reaches the bottom of the stomach.
• Exhale slowly like a balloon slowly releasing the air.
• To achieve the full potential of deep breathing, every exhalation should last twice as long as each inhalation.

Caffeine reduction

Caffeine can be medicinal in small doses. It increases bile flow. This stimulates the gall bladder and reduces cholesterol. However, too much can interfere with the body's systems that are responsible for stress response. Try to limit to one to two caffeinated drinks a week.

Regular physical activity

Physical activity is what helps remove waste products, specifically lactic and uric acids, from the muscles and nervous system. An excess of these acids makes the body edgy. Moderate activity prevents and reduces anxiety.
Try to get in at least 10 to 15 minutes of activity in the morning and afternoon. A quick walk combined with deep breathing is perfect.

Plenty of sleep

Hard work and playing hard help the body to sleep to the fullest. An irregular sleep pattern or poor-quality sleep confuses the body. The body reacts abnormally. Examples like confusion, tension, an adrenaline rush kicks in when it is not needed. Chronic poor sleep makes the body more vulnerable to disease and chronic conditions.

Natural Medicine Supplements

Natural medicine supplements have been shown to reduce mild to moderate stress and anxiety.

• Before trying any vitamins, minerals, or herbal therapies check with a doctor. This is to ensure safety with any medical conditions like pregnancy, that could prevent an individual from taking certain supplements.
• Also, make sure if taking any medications that could cause natural medicine supplements ineffective or create a dangerous situation.
• The reason for this is if an individual takes several supplements and develops side effects, it becomes a challenge to figure out which is responsible.
• Quality herbs and supplements can be purchased from a licensed naturopath physician, nutritionist, health coach, or from a health store.

Herbal supplements listed below can be taken for three months and then a two-week break should be implemented. This minimizes the potential for negative effects.

Vitamin B

The B vitamins, especially B6 and B12 help regulate the body's response to stress and keeps the nervous system healthy.

• Vitamin B complex formula that has at least 25 mg of B6 and also 1 mg of B12 can be taken twice a day.
• These vitamins are optimized when used in combination with other nutrients like a multivitamin-mineral supplement also twice a day.
• B12 in the form of hydroxocobalamin or methylcobalamin is better absorbed than the more common cyanocobalamin.

Kava

This is herbal supplement helps with anxiety and insomnia. It can help relieve acute and chronic anxiety without causing drowsiness or brain fog. Kava is effective for settling anxiety with no dependence potential.

Kava should be avoided if there is regular alcohol consumption or if taking Valium, Xanax, sleeping pills, like Seconal or Halcion, or anti-depressants, like Prozac or Zoloft.

Valerian

This is a natural sedative. It is used for relieving anxiety because it helps with sleep. The ingredients are similar to Valium. It is not addictive and does not cause grogginess the next day like sleeping pills. Recommended intake is one 150mg capsule twice a day. However, low doses can cause drowsiness. Therefore it is best used for sleep, one 300mg capsule one hour before sleeping is recommended. Do not use if taking sedatives, like phenobarbital or benzodiazepines.

The Body's Composition

Stress Can Throw Off Diet and Sleep

Achieving healthy body composition is more than just building muscle and losing fat. Proper diet and getting enough sleep are necessary to make meaningful progress. With chronic stress or poor sleep, this cannot be achieved. Depressive symptoms can be associated with obesity, and anxiety and depression can trigger emotional eating and weight gain. Proper stress management means making sure there are positive strategies, techniques that can be turned to in time of need. Without a plan, stress will cause health problems and will be a significant barrier when trying to achieve fitness and health goals.

Dr. Alex Jimenez’s Blog Post Disclaimer

The scope of our information is limited to chiropractic, musculoskeletal, physical medicines, wellness, and sensitive health issues and/or functional medicine articles, topics, and discussions. We use functional health & wellness protocols to treat and support care for injuries or disorders of the musculoskeletal system. Our posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate and support directly or indirectly our clinical scope of practice.*

Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We also make copies of supporting research studies available to the board and or the public upon request. We understand that we cover matters that require an additional explanation as to how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900. The provider(s) Licensed in Texas& New Mexico*

References

Boyle, Neil Bernard et al. “The Effects of Magnesium Supplementation on Subjective Anxiety and Stress-A Systematic Review.” Nutrients vol. 9,5 429. 26 Apr. 2017, doi:10.3390/nu9050429

If you are currently thinking about the ketogenic diet, then you might be asking yourself, is the keto diet right for you? While you may have already heard about the benefits of the ketogenic diet, you might still be wondering about whether if it is worth it to completely change your diet to take advantage of these benefits.

The keto diet has many benefits, from weight loss and improved physical health to mental clarity and enhanced physical performance. In the article, we will dive into the details of some of the ketogenic diet health benefits. These benefits can help with the particular health goal you may be attempting to attain.

Ketones serve as a source of energy for the mitochondria found inside the cells of the human body. These are an alternative fuel to sugar. Ketones are basic substances with a simple molecular structure. Ketones are natural, or carbon-based, chemicals made up of a central carbon atom double-bonded into an oxygen atom and two carbon-containing substituents, denoted by ”R”.

In humans, there are 3 distinct ketones created by the mitochondria. These are referred to as ketone bodies. The 3 ketones are:

• Acetone
• Acetoacetate, also known as Acetoacetic Acid
• Beta-Hydroxybutyric Acid, also known as Beta Hydroxybutyrate or BHB. Additional compound names include 3-hydroxybutyric acid or 3-hydroxybutyrate.

BHB isn’t particularly considered a ketone because it comprises a reactive OH-group rather than a double-bonded oxygen which would generally function as demonstrated in the diagram below. However, BHB continues to function much like a ketone because it transforms into energy, such as acetone and acetoacetate. The following is demonstrated in the diagram below.

The ketogenic diet seems to be one of the most popular topics to reach the current diet world. The ketogenic diet, or the keto diet, is characterized as a high fat, low carb dietary regimen. With claims that you can eat all the fat you want while not feeling hungry and considering its belief to reduce your blood sugar when you have type 2 diabetes as well as help improve overall performance, the ketogenic diet appears to be the ideal nutritional standard of the modern world. However, is the ketogenic diet right for everyone? Below, we will discuss what the ketogenic diet is and describe the modified ketogenic diet, their benefits and risks.

A majority of individuals today are aware about the gut-brain connection and how approximately 90 percent of their body’s serotonin is really generated in the gastrointestinal, or GI, tract as well as the way the gut-brain axis is associated with depression. Overall gut health involving a healthy population of gut microbiota can affect many facets of our well-being, therefore, it’s no mystery that the connection between the gut and chronic health issues, such as cardiovascular disease, diabetes and neurodegenerative diseases, are also significantly strong.

Berberine, an ancient mixture frequently utilized in a variety of medicinal herbs throughout several traditional treatments has been demonstrated to benefit as well as link the gut and the heart. Berberine is an isoquinoline derivative alkaloid found in numerous herbs. Although these berberine-containing herbs aren’t traditionally utilized in food preparations, the active ingredient has been identified and may be isolated from a variety of plant sources, such as Coptis chinensis, or Coptis or Goldthread, Hydrastis canadensis, or goldenseal, Berberis aquifolium, or Oregon grape, Berberis aristata, or Tree Turmeric, Berberis vulgaris, or Barberry, and Arcangelisia flava.

Berberine is most favorably known for its function in gut health, demonstrating activity which can help support gut microbial balance. In fact, scientists have shown a growing interest in many plant-derived compounds which affect bacterial direction and berberine is a pioneer in the group. Additionally, its a botanical proven to influence blood glucose, blood lipids and also the immune system. Researchers today have learned how berberine can provide these tremendous benefits.

CBD research currently being conducted is showing its medical potential. This has opened doors for antipsychotic, anticancer and anti-inflammatory treatment options among a variety of others. Scientists from all over are publishing studies that are proving CBD is one of the most effective and favorable cannabinoids that promotes proper function of the body's systems.

Five Properties Of CBD

CBD Medical Benefits 

1. Inhibits Cancer Cell Growth

Studies have supported this claim. By way of Proapoptotic action or apoptosis, Cannabidiol, Tetrahydrocannabinol, Cannabigerol and Cannabichromene in this order are extremely effective in tumor growth reduction in rats and cancerous human prostate cells. Research is still ongoing, but understanding that these cannabinoids stimulate the body’s process of killing cells that no longer function properly or at their optimal level. In traditional chemotherapy both healthy and cancerous cells are destroyed and only works when the cancer cells are replicating more frequently than healthy cells. CBD treatment promotes the body’s natural immune response to cells that are not functioning properly, which eradicates tumors.

2. Pain Reducer

The most common reason people start using marijuana despite its psychoactive affects, is that it also functions, as a pain reliever! People with chronic pain that are tired of taking pain killing opiates, rely on cannabinoid products to deal with pain and eliminate its source, commonly inflammation. Inflammation is the body’s natural response to injury, which floods the injured area with blood and nutrients to aid in rehabilitation. But inflammation creates secondary problems, among them pain and discomfort. Through stimulation of nutrients in the area that is injured, CBD creates negative feedback to inflammatory reactions, as the nutrients that came with the inflammation are already there.

3. Treats Anxiety

Anxiety along with PTSD affects over 40 million adults in the U.S. Valium and Xanax is what is normally used to treat these conditions. However, CBD products are becoming the preferred treatment, as they have none of the side effects or dependency issues. The effects of CBD have been observed thoroughly by experts and studies have proved its effectiveness, as a dependable alternative for mental disorders. Two receptors in the human brain responsible for sending out Adrenaline and Serotonin are the α2-adrenergic receptor agonist and 5-HT1A receptor antagonist. These receptors both are related to anxiety, depression, insomnia, and other mental disorders when imbalanced.

4. Strengthens The Immune System

Phytocannabinoids are able to balance, reinforce and strengthen the immune system. Cannabinoid products taken daily, work in regulating the immune system. This increases the body’s detection of foreign and potentially dangerous organisms, which include cancer cells.

5. Prevents Muscle Spasms

CBD contains chemically antispasmodic properties. Athletes from all sports love CBD and what it can do. It is a preferred supplement and these oils have proven to prevent muscle spasms and soreness. This is done through lubricating the potassium and calcium pumps within the muscle tissue.

CBD is finding its place, slowly, but surely. It is one of natures own medicines and it is our job to discover and figure how to utilize these properties. Consult a doctor before beginning any treatment of diagnosed or undiagnosed diseases with CBD. For the more severe diseases like diabetes, schizophrenia, epilepsy, which, CBD can treat, but only when used properly.

The therapeutic effects of Cannabidiol or CBD, is often the cannabinoid’s pain soothing effect that gets talked about. Headaches are the most common source of pain for the general population. Therefore, it makes sense that CBD use for migraines and headaches is an obvious.

Migraines and headaches can be a medical mystery, but usually their causes are brought on by problems with brain stem centers. The only treatments thus far, has been painkillers i.e. paracetamol or ibuprofen. Triptan medications, which constricts the blood vessels in order to block pain pathways in the brain are used as well. But is there a better more natural way to treat headaches and migraines? 

Cannabis Has Been Treating Headaches For Quite Awhile

CBD oil for headaches is not a new therapy. Cannabis is mentioned as treatment for headaches in ancient texts that go back thousands of years. However, its use didn't become familiar in the west until the 19th century when it would be prescribed by doctors as a tincture.

Today conclusive clinical evidence is incomplete, as far as, medical cannabis and hemp oil use for headaches. But scientists do know when it comes to CBD oil use for headaches and migraines, that the endocannabinoid system is working in conjunction with the compounds. 

The Endocannabinoid System & Migraines

A theory brought about a possible contributing cause of migraines is dysfunction in the endocannabinoid system or (ECS). This is the body's network of receptors and cannabis-like chemicals that respond and regulate:

• Pain
• Immune system
• Mood
• Sleep
• Appetite
• Memory

Researchers have noted ECS mechanisms that could have a connection to migraine attacks.

Anandamide (AEA) is one of the prime endocannabinoids in the body. It is both a painkiller and has been found to power the serotonin 5-HT1A receptors.

The clearest record of endocannabinoid dysfunction that contributes to migraines is from a study in 2007 at the University of Perugia and published in the Journal of Neuropsychopharmacology. Researchers measured endocannabinoid levels in the cerebrospinal fluid of patients with chronic migraines and found significantly lower amounts of Anandamide. These findings, could "reflect an impairment of the endocannabinoid system in these patients, which may contribute to chronic head pain.” 

Clinical Endocannabinoid Deficiency? Migraines Could Be A Sign

The link between lower levels of endocannabinoids in migraine patients has contributed to the formulation of what has been termed Clinical Endocannabinoid Deficiency. This theory was developed by Neurologist and Cannabinoid Researcher Dr. Ethan Russo. 

The theory comes from how many brain disorders are inadequate or missing neurotransmitters like acetylcholine. Russo has suggested “a comparable deficiency in endocannabinoid levels might manifest similarly in certain disorders that display predictable clinical features as sequelae of this deficiency.”

In an interview he describes how, “If you don’t have enough endocannabinoids you have pain where there shouldn’t be pain. You would be sick, meaning nauseated. You would have a lowered seizure threshold. And just a whole litany of other problems.”

Russo relates these deficiencies can be addressed through introduction to plant cannabinoids, which act almost like those found in the body, by stimulating the endocannabinoid receptors. There is CB1 agonists such as Marinol and Nabilone have been tested for migraines, Russo suggests that the ECS needs a “gentle nudge” rather than a “forceful shove” given by these synthetic alternatives. He suggests small doses of whole plant cannabis, which contain “additional synergistic and buffering components, such as CBD and cannabis terpenoids.” 

Cannabidiol CBD Oil: Migraines

Russo in particular singles out CBD (Cannabidiol) in that it brings balance to the endocannabinoid system. In his interview with Martin Lee from Project CBD he says, “cannabidiol is an endocannabinoid modulator, in other words, when given chronically it actually increases the gain of the system…. So, if there’s too much activity in a system, homeostasis requires that it be brought back down. If there’s too little, it’s got to come up. And that’s what cannabidiol can do as a promoter of endocannabinoid tone.”

Scientists still are not exactly sure of how CBD interacts with the endocannabinoid system. Unlike psychoactive THC, CBD does not bind with any of the endocannabinoid receptors. Instead it activates a host of other non-endocannabinoid receptors, which work in the development and treatment of migraines, i.e. the 5-HT1A serotonin and TRPV-1 receptors.

Another possible explanation is CBD’s role as a fatty acid amide hydrolase (FAAH) inhibitor, which breaks down anandamide in the body. By inhibiting its production the theory is that it might lead to higher levels of pain relieving endocannabinoid. This is something that would benefit migraine sufferers.

Lack Of Clinical Evidence

Currently there are no gold standard, double blind, placebo clinical studies published to back up any accounts that suggest CBD or cannabis is an effective treatment for headaches and migraines.

One placebo controlled study has been conducted, documenting the safety and efficacy of synthetic THC medication Dronabinol for migraines. However, the results are still pending.

The largest study to take place was done from a retrospective basis. It was published in 2016 and found that out of 121 participants that suffer from migraines and were prescribed medical cannabis by a doctor; 103 participants found their migraine frequency reduced by half.

Can Cannabidiol Cause A Headache?

There are those who tried CBD and noted persistent headaches and even migraines. Does CBD cause headaches, even though the research suggests the contrary.

Those who reported getting headaches after taking CBD oil noted that the oil they bought was low quality, and the ingredients used included ethanol, various alcohols, preservatives and harsh chemicals.

When purchasing CBD oil for migraines or other conditions, get the best quality, not the cheapest!

How To Use CBD For Head Pain

There are different ways to apply CBD oil for headaches. If taking CBD for tension headaches, migraines or general headaches, there are many way to administer. Probably the simplest and most effective ways of using CBD is the sublingual method.

With this method one places a few drops of oil underneath the tongue. There it permeates through the membrane and makes its way to where it needs to go.

This isn’t the only method and many others can be just as effective. Make sure to do research when looking for CBD products online and the methods of administering these products.

Just like the nature of migraines, CBD for headaches and migraines is still not completely and scientifically understood. But with continued research of CBD and Cannabinoid based medicine, the future of sufferers of headaches and migraines will get better.

Injury Medical Clinic: Migraine Treatment

Diets: The statistics are sobering. The typical American diet far exceeds the daily recommended intake levels in calories from sugars and solid fats, sodium, refined grains, and saturated fat. It is also lacking in the recommended amounts of fruits, vegetables, dairy, whole grains, and oils. The result is obesity and experts project that by 2030, in the United States alone, half of all adults will be obese.

That’s when people start dieting – and that is what gets them into trouble.

Diet vs. Lifestyle Change

Bottom line, diets are temporary. There are some serious consequences that can come from dieting, especially fad or crash diets. The effects of these types of diets can also seriously impact your chiropractic care, hindering your progress.

Also, because diets are temporary, once you return to your regular eating habits the weight usually comes back.

A lifestyle change is a far better choice. It involves making smart, healthy eating choices – choices that you maintain for the rest of your life. This also impacts your chiropractic care by strengthening your body and keeping it healthy so that it is in an optimal state for healing and responds well to treatment.

Types Of Diets

There are all sorts of diets out there. Some are blatantly unhealthy but others are sneaky. They come with claims of being healthy, of being created or endorsed by doctors, or include tons of vitamin supplements but very limited food intake. It is important to be able to spot these destructive fad diets so you don’t get suckered into their hype.

Some of the most common types of fad diets include high protein, low or no carb, liquid, cabbage, grapefruit, broth or juice, and food combining. Some of these can cause serious health problems including vital organ damage. Others can cause vitamin deficiencies and dehydration. None of them can (or should) be maintained over a long period of time, much less the rest of your life.

The Dangers Of Diets

Unhealthy dieting can come with some pretty scary dangers. Because they typically omit key foods or food groups your body can become imbalanced. Some of the dangers of dieting include dehydration, fatigue, weakness, vitamin and mineral deficiency, headaches, nausea, diarrhea, constipation, mental fogginess, loss of muscle mass, organ damage, and even heart attack and stroke.

One popular diet restricts carbs, often cutting them out completely. This includes all whole grains (which have vital minerals and fiber) as well as many fruits and vegetables. The result is a diet that is mostly protein and fat.

While the dieter may lose some weight on this plan, it is at a great cost. The extremely high intake of protein which exceeds the levels that the body should have can cause liver and kidney failure. The omission of vital grains, fruits, and vegetables can lead to serious vitamin deficiencies while the increased fat intake can lead to heart attack and stroke.

If a diet eliminates any of the key foods (lean meats, whole grains, fruits, and vegetables), it advocates losing more than 2 or 3 pounds a week, or it restricts caloric intake to less than 1,200 calories a day it is potentially unhealthy and should only be done 1) under a doctor’s close supervision, and 2) on a very temporary basis.

Healthy Eating Is A Lifestyle

When you make the life changing commitment to adopt a healthy eating lifestyle you open yourself up to a world of better health, more energy, and better focus. Your body will heal faster and you will feel better.

A diet of fresh fruits and vegetables, lean meats, fresh fish, and whole grains, along with lots of water should become a way of life. It is far healthier than the temporary diets that are out there and more effective too.

If you or a loved one need additional dietary guidance, give us a call. Our Doctor of Chiropractic is here to help!

Dietary Strategies:

Abstract: Metabolic syndrome (MetS) is established as the combination of central obesity and different metabolic disturbances, such as insulin resistance, hypertension and dyslipidemia. This cluster of factors affects approximately 10%–50% of adults worldwide and the prevalence has been increasing in epidemic proportions over the last years. Thus, dietary strategies to treat this heterogenic disease are under continuous study. In this sense, diets based on negative-energy-balance, the Mediterranean dietary pattern, n-3 fatty acids, total antioxidant capacity and meal frequency have been suggested as effective approaches to treat MetS. Furthermore, the type and percentage of carbohydrates, the glycemic index or glycemic load, and dietary fiber content are some of the most relevant aspects related to insulin resistance and impaired glucose tolerance, which are important co-morbidities of MetS. Finally, new studies focused on the molecular action of specific nutritional bioactive compounds with positive effects on the MetS are currently an objective of scientific research worldwide. The present review summarizes some of the most relevant dietary approaches and bioactive compounds employed in the treatment of the MetS to date.

Keywords: metabolic syndrome; dietary strategies; bioactive compounds

1. Metabolic Syndrome

It was during the period between 1910 and 1920 when it was suggested for the first time that a cluster of associated metabolic disturbances tended to coexist together [1]. Since then, different health organisms have suggested diverse definitions for metabolic syndrome (MetS) but there has not yet been a well-established consensus. The most common definitions are summarized in Table 1. What is clear for all of these is that the MetS is a clinical entity of substantial heterogeneity, commonly represented by the combination of obesity (especially abdominal obesity), hyperglycemia, dyslipidemia and/or hypertension [2–6].

 

Obesity consists of an abnormal or excessive fat accumulation, for which the main cause is a chronic imbalance between energy intake and energy expenditure [7,8]. The excess of energy consumed is primarily deposited in the adipose tissue as triglycerides (TG) [9].

 

Dyslipidemia encompasses elevated serum TG levels, increased low density lipoprotein- cholesterol (LDL-c) particles, and reduced levels of high density lipoprotein-cholesterol (HDL-c) [10]. It is associated with hepatic steatosis [11], dysfunction of pancreatic β-cells [12] and elevated risk of atherosclerosis [13], among others.

 

Another main modifiable MetS manifestation is hypertension, which is mainly defined as a resting systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg or drug prescription to lower hypertension [14]. It usually involves narrowed arteries and is identified as a major cardiovascular and renal risk factor, related to heart and vascular disease, stroke and myocardial infarction [13,15–17].

 

Hyperglycemia, related insulin resistance and type 2 diabetes mellitus are characterized by an impaired uptake of glucose by the cells, that lead to elevated plasma glucose levels, glycosuria and ketoacidosis [18]. It is responsible for different tissue damage that shortens the life expectancy of diabetics, involving cardiovascular diseases (CVD), atherosclerosis, hypertension [19], β-cell dysfunction [12], kidney disease [20] or blindness [21]. Currently, diabetes is considered the leading cause of death in developed countries [22].

 

Moreover, oxidative stress and low grade inflammation are two important mechanisms implicated in the etiology, pathogenesis, and development of MetS [23]. Oxidative stress is defined as an imbalance between the pro-oxidants and antioxidants in the body [24]. It plays a key role in the development of atherosclerosis by different mechanisms such as the oxidation of LDL-c particles [25] or impairment of HDL-c functions [26]. Inflammation is an immune system response to injury hypothesized to be a major mechanism in the pathogenesis and progression of obesity related disorders and the link between adiposity, insulin resistance, MetS and CVD [27].

 

Although the prevalence of the MetS varies broadly around the word and depends on the source used for its definition, it is clear that over the last 40–50 years the number of people presenting with this syndrome has risen in epidemic proportions [28]. Moreover, the frequency of this syndrome is increased in developed countries, sedentary people, smokers, low socioeconomic status population, as well as in individuals with unhealthy dietary habits [29,30].

 

For all of this, there is currently a wide concern to find effective strategies to detect, treat and control the comorbidities associated with MetS. This is a complex challenge as MetS is a clinical entity of substantial heterogeneity and therefore, the different cornerstones implicated in its development should be addressed. In this review we compiled and examined different dietary patterns and bioactive compounds that have pointed out to be effective in MetS treatment.

2. Dietary Patterns

Several dietary strategies and their potential positive effects on the prevention and treatment of the different metabolic complications associated to the MetS, are described below and summarized in Table 2.

2.1. Energy-Restricted Diet Strategies

Energy restricted diets are probably the most commonly used and studied dietary strategies for combating excess weight and related comorbidities. They consist in personalized regimes that supply less calories than the total energy expended by a specific individual [31].

 

A hypocaloric diet results in a negative energy balance and subsequently, in body weight reduction [31]. Weight loss is achieved via fat mobilization from different body compartments as a consequence of the lipolysis process necessary to provide energy substrate [32,33]. In people who are overweight or suffering from obesity, as is the case of most people with MetS, weight loss is important as it is associated with improvement of related disorders such as abdominal obesity (visceral adipose tissue), type 2 diabetes, CVD or inflammation [32–36].

 

Moreover, as described above, low grade inflammation is associated with MetS and obesity. Therefore, of particular importance is the fact that in obese individuals following a hypocaloric diet, a depletion of plasma inflammatory markers such as interleukin (IL)-6 has been observed [34]. Thus, caloric restriction in obese people suffering MetS may improve the whole-body pro-inflammatory state.

 

At the same time, body weight reduction is associated with improvements in cellular insulin signal transduction, increments in peripheral insulin sensitivity and higher robustness in insulin secretory responses [32,36]. People with excess body weight who are at risk of developing type 2 diabetes, may benefit from a hypocaloric regime by improving plasma glucose levels and insulin resistance.

 

In addition, different intervention trials have reported a relationship between energy restricted diets and lower risk of developing CVD. In this sense, in studies with obese people following a hypocaloric diet, improvements in lipid profile variables such as reductions of LDL-c and plasma TG levels, as well as improvements in hypertension via depletion of SBP and DBP levels have been observed [35,37].

 

Among the different nutritional intervention trials, a reduction of 500–600 kcal a day of the energy requirements is a well-established hypocaloric dietary strategy, which has demonstrated to be effective in weight reduction [38,39]. However, the challenge lies in maintaining the weight loss over time, as many subjects can follow a prescribed diet for a few months, but most people have difficulty in maintaining the acquired habits over the long term [40,41].

2.2. Diets Rich in Omega-3 Fatty Acids

The very long-chain eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are essential omega-3 polyunsaturated fatty acids (n-3 PUFAs) for human physiology. Their main dietary sources are fish and algal oils and fatty fish, but they can also be synthesized by humans from α-linolenic acid [40].

 

There is a moderate body of evidence suggesting that n-3 PUFAs, mainly EPA and DHA, have a positive role in the prevention and treatment of the pathologies associated to MetS [42].

 

In this context, it has been described that EPA and DHA have the ability to reduce the risk of developing CVD and cardiometabolic abnormalities as well as CVD-related mortality [42]. These beneficial effects are thought to be mainly due to the ability of these essential fatty acids to reduce plasma TG levels [43].

 

Moreover, different studies have shown that people following an increased n-3 PUFA diet have reduced plasma levels of the pro-inflammatory cytokines IL-6 and tumor necrosis factor-alpha (TNFα), as well as plasma C-reactive protein (CRP) [44]. These effects are probably mediated by resolvins, maresins and protectins, which are EPA and DHA metabolic products with anti-inflammatory properties [44].

 

There are some studies that have observed an association between n-3 ingestion and improvements or prevention of type 2 diabetes development. However, other studies found opposite results [44]. Thus, it cannot be made any specific affirmation in this respect.

 

The European Food Safety Authority recommends and intake of 250 mg EPA + DHA a day, in the general healthy population as a primary prevention of CVD [45]. These amounts can be achieved with an ingestion of 1–2 fatty fish meals per week [45].

2.3. Diets Based on Low Glycemic Index/Load

Over the last ten years, the concern about the quality of the carbohydrates (CHO) consumed has risen [46]. In this context, the glycemic index (GI) is used as a CHO quality measure. It consists in a ranking on a scale from 0 to 100 that classifies carbohydrate-containing foods according to the postprandial glucose response [47]. The higher the index, the more promptly the postprandial serum glucose rises and the more rapid the insulin response. A quick insulin response leads to rapid hypoglycemia, which is suggested to be associated with an increment of the feeling of hunger and to a subsequent higher caloric intake [47]. The glycemic load (GL) is equal to the GI multiplied by the number of grams of CHO in a serving [48].

 

There is a theory which states that MetS is a consequence of an elevated intake of high GI foods over time, among others unhealthy dietary habits [49]. In this sense, following a diet rich in high GI CHO has been associated with hyperglycemia, insulin resistance, type 2 diabetes, hypertriglyceridemia, CVD, and obesity [47,50,51], abnormalities directly related to MetS.

 

On the contrary, a low GI diet has been associated with slower absorption of the CHO and subsequently smaller blood glucose fluctuations, which indicate better glycemic control [46]. In patients with type 2 diabetes, diets based on low GI are associated with reductions in glycated hemoglobin (HbA1c) and fructosamine blood levels, two biomarkers used as key monitoring factors in diabetes management [52,53].

 

For all of this, it is common to find the limitation of CHO at high GI among the advice for MetS treatment [28], in particular with respect to “ready-to-eat processed foods” including sweetened beverages, soft drinks, cookies, cakes, candy, juice drinks, and other foods which contain high amounts of added sugars [54].

2.4. Diets with High Total Antioxidant Capacity

Dietary total antioxidant capacity (TAC) is an indicator of diet quality defined as the sum of antioxidant activities of the pool of antioxidants present in a food [55]. These antioxidants have the capacity to act as scavengers of free radicals and other reactive species produced in the organisms [56]. Taking into account that oxidative stress is one of the remarkable unfortunate physiological states of MetS, dietary antioxidants are of main interest in the prevention and treatment of this multifactorial disorder [57]. Accordingly, it is well-accepted that diets with a high content of spices, herbs, fruits, vegetables, nuts and chocolate, are associated with a decreased risk of oxidative stress-related diseases development [58–60]. Moreover, several studies have analyzed the effects of dietary TAC in individuals suffering from MetS or related diseases [61,62]. In the Tehran Lipid and Glucose Study it was demonstrated that a high TAC has beneficial effects on metabolic disorders and especially prevents weight and abdominal fat gain [61]. In the same line, research conducted in our institutions also evidenced that beneficial effects on body weight, oxidative stress biomarkers and other MetS features were positively related with higher TAC consumption in patients suffering from MetS [63–65].

 

In this sense, the World Health Organization (WHO) recommendation for fruit and vegetables consumption (high TAC foods) for the general population is a minimum of 400 g a day [66]. Moreover, cooking with spices is recommended in order to increase the TAC dietary intake and, at the same time, maintain flavor while reducing salt [67].

2.5. Moderate-High Protein Diets

The macronutrient distribution set in a weight loss dietary plan has commonly been 50%–55% total caloric value from CHO, 15% from proteins and 30% from lipids [57,68]. However, as most people have difficulty in maintaining weight loss achievements over time [69,70], research on increment of protein intake (>20%) at the expense of CHO was carried out [71–77].

 

Two mechanisms have been proposed to explain the potential beneficial effects of high-moderate protein diets: the increment of diet-induced thermogenesis [73] and the increase of satiety [78]. The increment of the thermogenesis is explained by the synthesis of peptide bonds, production of urea and gluconeogenesis, which are processes with a higher energy requirement than the metabolism of lipids or CHO [75]. An increment of different appetite-control hormones such as insulin, cholecystokinin or glucagon-like peptide 1, may clarify the satiety effect [79].

 

Other beneficial effects attributed to moderate-high protein diets in the literature are the improvement of glucose homeostasis [80], the possibility of lower blood lipids [81], the reduction of blood pressure [82], the preservation of lean body mass [83] or the lower of cardiometabolic disease risk [84,85]. However, there are other studies that have not found benefits associated to a moderate-high protein diet [76]. This fact may be explained by the different type of proteins and their amino acid composition [80], as well as by the different type of populations included in each study [85]. Therefore, more research in the field is needed in order to make these results consistent.

 

In any case, when a hypocaloric diet is implemented, it is necessary to slightly increase the amount of proteins. Otherwise it would be difficult to reach the protein energy requirements, established as 0.83 g/kg/day for isocaloric diets and which should probably be at least 1 g/kg/day for energy-restricted diets [86].

2.6. High Meal Frequency Pattern

The pattern of increasing meal frequency in weight loss and weight control interventions has currently become popular among professionals [87,88]. The idea is to distribute the total daily energy intake into more frequently and smaller meals. However, there is no strong evidence about the efficacy of this habit yet [89]. While some investigations have found an inverse association between the increment of meals per day and body weight, body mass index (BMI), fat mass percentage or metabolic diseases such as coronary heart disease or type 2 diabetes [71,88,90–92], others have found no association [93–95].

 

Different mechanisms by which high meal frequency can have a positive effect on weight and metabolism management have been proposed. An increment of energy expenditure was hypothesized; however, the studies carried out in this line have concluded that total energy expenditure does not differ among different meal frequencies [96,97]. Another postulated hypothesis is that the greater the number of meals a day, the higher the fat oxidation, but again no consensus has been achieved [89,98]. An additional suggested mechanism is that increasing meal frequency leads to plasma glucose levels with lower oscillations and reduced insulin secretion which is thought to contribute to a better appetite control. However, these associations have been found in population with overweight or high glucose levels but in normal-weight or normoglycaemic individuals the results are still inconsistent [93,99–101].

2.7. The Mediterranean Diet

The concept of the Mediterranean Diet (MedDiet) was for the first time defined by the scientific Ancel Keys who observed that those countries around the Mediterranean Sea, which had a characteristic diet, had less risk of suffering coronary heart diseases [102,103].

 

The traditional MedDiet is characterized by a high intake of extra-virgin olive oil and plant foods (fruits, vegetables, cereals, whole grains, legumes, tree nuts, seeds and olives), low intakes of sweets and red meat and moderate consumption of dairy products, fish and red wine [104].

 

There is a lot of literature supporting the general health benefits of the MedDiet. In this sense, it has been reported that a high adherence to this dietary pattern protects against mortality and morbidity from several causes [105]. Thus, different studies suggested the MedDiet as a successful tool for the prevention and treatment of MetS and related comorbidities [106–108]. Moreover, recent meta-analysis concluded that the MedDiet is associated with less risk of developing type 2 diabetes and with a better glycemic control in people with this metabolic disorder [107,109,110]. Other studies have found a positive correlation between the adherence to a MedDiet pattern and reduced risk of developing CVD [111–114]. In fact, many studies have found a positive association between following a MedDiet and improvements in lipid profile by reduction of total cholesterol, LDL-c and TG, and an increase in HDL-c [111–115]. Finally, different studies also suggest that the MedDiet pattern may be a good strategy for obesity treatment as it has been associated with significant reductions in body weight and waist circumference [108,116,117].

 

The high amount of fiber which, among other beneficial effects, helps to weight control providing satiety; and the high antioxidants and anti-inflammatory nutrients such as n-3 fatty acids, oleic acid or phenolic compounds, are thought to be the main contributors to the positive effects attributed to the MedDiet [118].

 

For all these reasons, efforts to maintain the MedDiet pattern in Mediterranean countries and to implement this dietary habits in westernized countries with unhealthy nutritional patterns should be made.

3. Dietary: Single Nutrients and Bioactive Compounds

New studies focused on the molecular action of nutritional bioactive compounds with positive effects on MetS are currently an objective of scientific research worldwide with the aim of designing more personalized strategies in the framework of molecular nutrition. Among them, flavonoids and antioxidant vitamins are some of the most studied compounds with different potential benefits such as antioxidant, vasodilatory, anti-atherogenic, antithrombotic, and anti-inflammatory effects [119]. Table 3 summarizes different nutritional bioactive compounds with potential positive effects on MetS, including the possible molecular mechanism of action involved.

 

3.1. Ascorbate

Vitamin C, ascorbic acid or ascorbate is an essential nutrient as human beings cannot synthesize it. It is a water-soluble antioxidant mainly found in fruits, especially citrus (lemon, orange), and vegetables (pepper, kale) [120]. Several beneficial effects have been associated to this vitamin such as antioxidant and anti-inflammatory properties and prevention or treatment of CVD and type 2 diabetes [121–123].

 

This dietary component produces its antioxidant effect primarily by quenching damaging free radicals and other reactive oxygen and nitrogen species and therefore preventing molecules such as LDL-c from oxidation [122]. It can also regenerate other oxidized antioxidants like tocopherol [124].

 

Moreover, it has been described that ascorbic acid may reduce inflammation as it is associated with depletion of CRP levels [125]. This is an important outcome to take in consideration in the treatment of MetS sufferers, as they usually present low grade inflammation [27].

 

Supplementation with vitamin C have also been associated with prevention of CVD by improving the endothelial function [126] and probably by lowering blood pressure [121]. These effects are thought to be exerted by the ability of vitamin C to enhance the endothelial nitric oxide synthase enzyme (eNOS) activity and to reduce HDL-c glycation [127].

 

Additionally, several studies have attributed to ascorbate supplementation an antidiabetic effect by improving whole body insulin sensitivity and glucose control in people with type 2 diabetes [123]. These antidiabetic properties are thought to be mediated by optimization of the insulin secretory function of the pancreatic islet cells by increasing muscle sodium-dependent vitamin C transporters (SVCTs) [128].

 

Despite all of this, it should be taken into account that most people reach ascorbic acid requirements (established at 95–110 mg/day in the general population) from diet and do not need supplementation [122,129]. Besides, it should be considered that an excess of vitamin C ingestion leads to the opposite effect and oxidative particles are formed [130,131].

3.2. Hydroxytyrosol

Hydroxytyrosol (3,4-dihydroxyphenylethanol) is a phenolic compound mainly found in olives [132].

 

It is considered the strongest antioxidant of olive oil and one of the main antioxidants in nature [133]. It acts as a powerful scavenger of free radicals, as a radical chain breaker and as metal chelator [134]. It has the ability of inhibiting LDL-c oxidation by macrophages [132]. In this sense, it is the only phenol recognized by the European Food Safety Authority (EFSA) as a protector of blood lipids from oxidative damage [135].

 

Hydroxytyrosol has also been reported to have anti-inflammatory effects, probably by suppressing cyclooxygenase activity and inducing eNOS expression [136]. Thus, enhancement of olives/olive oil intakes or hydroxytyroxol supplementation in people suffering from MetS may be a good strategy in order to improve inflammatory status.

 

Another beneficial effect attributed to this phenolic compound is its cardiovascular protective effect. It presents anti-atherogenic properties by decreasing the expression of vascular cell adhesion protein 1 (VCAM-1) and intercellular adhesion molecule 1 (ICAM-1) [132,137], which are probably the result of an inactivation of the nuclear factor kappa-light-chain-enhancer of activated B cells (NFκB), activator protein 1 (AP-1), GATA transcription factor and nicotinamide adenine dinucleotide phosphate (NAD(P)H) oxidase [138,139]. Hydroxytyrosol also provides antidyslipidemic effects by lowering plasma levels of LDL-c, total cholesterol and TG, and by rising HDL-c [138].

 

Despite the beneficial effects attributed to hydfroxytyrosol as an antioxidant, for its antiinflamatory properties and as cardiovascular protector, it should be taken into account that most studies focused on this compound have been performed with mixtures of olive phenols, thus a synergic effect cannot be excluded [140].

3.3. Quercetin

Quercetin is a predominant flavanol naturally present in vegetables, fruits, green tea or red wine. It is commonly found as glycoside forms, where rutin is the most common and important structure found in nature [141].

 

Many beneficial effects that can contribute to MetS improvement have been attributed to quercetin. Among them, its antioxidant capacity should be highlighted, as it has been reported to inhibit lipid peroxidation and increase antioxidant enzymes such as superoxide dismutase (SOD), catalase (CAT) or glutathione peroxidase (GPX) [142].

 

Moreover, an anti-inflammatory effect mediated via attenuation of tumor necrosis factor α (TNF-α), NFκB and mitogen-activated protein kinases (MAPK), as well as depletion of IL-6, IL-1β, IL-8 or monocyte chemoattractant protein-1 (MCP-1) gene expression has also been attributed to this polyphenol [143].

 

As most people with MetS are overweight or obese, the role of quercetin in body weight reduction and obesity prevention has been of special interest. In this sense, it stands out the capacity of quercetin to inhibit adipogenesis through inducing the activation of AMP-activated protein kinase (AMPK) and decreasing the expression of CCAAT-enhancer-binding protein-α (C/EBPα), peroxisome proliferator-activated receptor gamma (PPARγ), and sterol regulatory element-binding protein 1 (SREBP-1) [141,144].

 

According to the antidiabetic effects, it is proposed that quercetin may act as an agonist of peroxisome proliferator-activated receptor gamma (PPARγ), and thus improve insulin-stimulated glucose uptake in mature adipocytes [145]. Moreover, quercetin may ameliorate hyperglycemia by inhibiting glucose transporter 2 (GLUT2) and insulin dependent phosphatidylinositol-3-kinase (PI3K) and blocking tyrosine kinase (TK) [142].

 

Finally, different studies observed that quercetin has the ability to reduce blood pressure [146–148]. However, the mechanisms of action are not clear, since some authors have suggested that quercetin increases eNOS, contributing to inhibition of platelet aggregation and improvement of the endothelial function [146,147], but there are other studies that have not come across these results [148].

3.4. Resveratrol

Resveratrol (3,5,4′-trihidroxiestilben) is a phenolic compound mainly found in red grapes and derived products (red wine, grape juice) [149]. It has shown antioxidant and anti-inflammatory activities, and cardioprotective, anti-obesity and antidiabetic capacities [150–156].

 

The antioxidant effects of resveratrol have been reported to be carried out by scavenging of hydroxyl, superoxide, and metal-induced radicals as well as by antioxidant effects in cells producing reactive oxygen species (ROS) [150].

 

Moreover, it has been reported that the anti-inflammatory effects of resveratrol are mediated by inhibiting NFκB signaling [151]. Furthermore, this polyphenol reduces the expression of proinflammatory cytokines such as interleukin 6 (IL-6), interleukin 8 (IL-8), TNF-α, monocyte chemoattractant protein-1 (MCP-1) and eNOS [152]. In addition, resveratrol inhibits the cyclooxygenase (COX) expression and activity, a pathway involved in the synthesis of proinflammatory lipid mediators [152].

 

Concerning the effects of resveratrol against development of type 2 diabetes, it has been reported that treatment of diabetes patients with this polyphenol provides significant improvements in the status of multiple clinically relevant biomarkers such as fasting glucose levels, insulin concentrations or glycated hemoglobin and Homeostasis Model Assessment Insulin Resistance (HOMA-IR) [153,154].

 

Additionally, cardioprotective effects have been attributed to resveratrol. In this sense, it is suggested that resveratrol improves the endothelial function by producing nitric oxide (NO) through increasing the activity and expression of eNOS. This effect is thought to be conducted through activation of nicotinamide adenine dinucleotide-dependent deacetylase sirtuin-1 (Sirt 1) and 5′ AMP-activated protein kinase (AMPK) [155]. Besides, resveratrol exerts endothelial protection by stimulation of NF-E2-related factor 2 (Nrf2) [156] and decreasing the expression of adhesion proteins such as ICAM-1 and VCAM-1 [152].

 

Finally, it has been described that resveratrol may have a role in preventing obesity as it has been related with energy metabolism improvement, increasing lipolysis and reducing lipogenesis [157]. However, more studies are needed in order to corroborate these findings.

3.5. Tocopherol

Tocopherols, also known as vitamin E, are a family of eight fat-soluble phenolic compounds whose main dietary sources are vegetable oils, nuts and seeds [130,158].

 

For a long time, it has been suggested that vitamin E could prevent different metabolic diseases as a potent antioxidant, acting as scavenger of lipid peroxyl radicals by hydrogen donating [159]. In this sense, it was described that tocopherols inhibit peroxidation of membrane phospholipids and prevent generation of free radicals in cell membranes [160].

 

Moreover, it has been shown that supplementation with α-tocopherol or γ-tocopherol, two of the different isoforms of vitamin E, could have an effect on inflammation status by reducing CRP levels [161]. Additionally, inhibition of COX and protein kinase C (PKC) and reduction of cytokines such as IL-8 or plasminogen activator inhibitor-1 (PAI-1) are other mechanisms that may contribute to these anti-inflammatory effects [162,163].

 

However, the beneficial effects attributed to this vitamin previously have lately became controversial as different clinical trials have not come across such benefits, but ineffective or even harmful effects have been observed [164]. It has been recently suggested that this may be explained by the fact that vitamin E may lose most of the antioxidant capacity when ingested by human beings through different mechanisms [162].

3.6. Anthocyanins

Anthocyanins are water-soluble polyphenolic compounds responsible for the red, blue and purple colors of berries, black currants, black grapes, peaches, cherries, plums, pomegranate, eggplant, black beans, red radishes, red onions, red cabbage, purple corn or purple sweet potatoes [165–167]. Actually, they are the most abundant polyphenols in fruits and vegetables [167]. Moreover, they can also be found in teas, honey, nuts, olive oil, cocoa, and cereals [168].

 

These compounds have high antioxidant capacity inhibiting or decreasing free radicals by donating or transferring electrons from hydrogen atoms [167].

 

Regarding clinical studies, it has been shown that these bioactive compounds may prevent type 2 diabetes development by improving insulin sensitivity [169]. The exact mechanisms by which anthocyanins exert their antidiabetic effect are not yet clear, but an enhancement of the glucose uptake by muscle and adipocyte cells in an insulin-independent manner has been suggested [169].

 

Moreover, it has been shown that anthocyanins may have the capacity to prevent CVD development by improving endothelial function via increasing brachial artery flow-mediated dilation and HDL-c, and decreasing serum VCAM-1 and LDL-c concentrations [170–173].

 

Finally, these polyphenolic compounds may exert anti-inflamatory effects via reducing proinflamatory molecules such as IL-8, IL-1β or CRP [172,174].

 

However, most studies have used anthocyanin-rich extracts instead of purified anthocyanins; thus, a synergic effect with other polyphenols cannot be discarded.

3.7. Catechins

Catechins are polyphenols that can be found in a variety of foods including fruits, vegetables, chocolate, wine, and tea [175]. The epigallocatechin 3-gallate present in tea leaves is the catechin class most studied [176].

 

Anti-obesity effects have been attributed to these polyphenols in different studies [176]. The mechanisms of action suggested to explain these beneficial effects on body weight are: increasing energy expenditure and fat oxidation, and reducing fat absorption [177]. It is thought that energy expenditure is enhanced by catechol-O-methyltransferase and phosphodiesterase inhibition, which stimulates the sympathetic nervous system causing an activation of the brown adipose tissue [178]. Fat oxidation is mediated by upregulation of acyl-CoA dehydrogenase and peroxisomal b-oxidation enzymes [178,179].

 

Moreover, catechin intake has also been associated with lower risk of CVD development by improving lipid biomarkers. Thus, it has been reported that consumption of this kind of polyphenols may increase HDL-c and decrease LDL-c and total cholesterol [180].

 

Finally, and antidiabetic effect has also been related to catechin comsumption, lowering fasting glucose levels [175] and improving insulin sensitivity [178].

4. Conclusions

As the prevalence of MetS reaches epidemic rates, the finding of an effective and easy-to-follow dietary strategy to combat this heterogenic disease is still a pending subject. This work recompiled different dietary nutrients and nutritional patterns with potential benefits in the prevention and treatment of MetS and related comorbidities (Figure 1) with the aim of facilitating future clinical studies in this area. The challenge now is to introduce precision bioactive compounds in personalized nutritional patterns in order to gain the most benefits for prevention and treatment of this disease through nutrition.

 

Conflicts of Interest: The authors declare no conflict of interest.

 

1. Sarafidis, P.A.; Nilsson, P.M. The metabolic syndrome: A glance at its history. J. Hypertens. 2006, 24, 621–626.
[CrossRef] [PubMed]
2. Alberti, K.G.; Zimmet, P.Z. Definition, diagnosis and classification of diabetes mellitus and its complications.
Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation.
Diabet. Med. 1998, 15, 539–553. [CrossRef]
3. Balkau, B.; Charles, M.A. Comment on the provisional report from the WHO consultation. European Group
for the Study of Insulin Resistance (EGIR). Diabet. Med. 1999, 16, 442–423. [PubMed]
4. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive
Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on
Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA
2001, 285, 2486–2497.
5. Grundy, S.M.; Cleeman, J.I.; Daniels, S.R.; Donato, K.A.; Eckel, R.H.; Franklin, B.A.; Gordon, D.J.;
Krauss, R.M.; Savage, P.J.; Smith, S.C., Jr.; et al. Diagnosis and management of the metabolic syndrome:
An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation
2005, 112, 2735–2752. [CrossRef] [PubMed]
6. Alberti, K.G.; Zimmet, P.; Shaw, J. The metabolic syndrome—A new worldwide definition. Lancet 2005, 366,
1059–1062. [CrossRef]
7. Selassie, M.; Sinha, A.C. The epidemiology and aetiology of obesity: A global challenge. Best Pract. Res.
Clin. Anaesthesiol. 2011, 25, 1–9. [CrossRef] [PubMed]
8. WHO, W.H.O. Available online: http://www.who.int/mediacentre/factsheets/fs311/es/ (accessed on
4 June 2016).
9. Shimano, H. Novel qualitative aspects of tissue fatty acids related to metabolic regulation: Lessons from
Elovl6 knockout. Prog. Lipid Res. 2012, 51, 267–271. [CrossRef] [PubMed]
10. Bosomworth, N.J. Approach to identifying and managing atherogenic dyslipidemia: A metabolic
consequence of obesity and diabetes. Can. Fam. Phys. 2013, 59, 1169–1180.
11. Vidal-Puig, A. The Metabolic Syndrome and its Complex Pathophysiology. In A Systems Biology Approach to
Study Metabolic Syndrome; Oresic, M., Ed.; Springer: New York, NY, USA, 2014; pp. 3–16.
12. Poitout, V.; Robertson, R.P. Glucolipotoxicity: Fuel excess and beta-cell dysfunction. Endocr. Rev. 2008, 29,
351–366. [CrossRef] [PubMed]
13. Rizza, W.; Veronese, N.; Fontana, L. What are the roles of calorie restriction and diet quality in promoting
healthy longevity? Ageing Res. Rev. 2014, 13, 38–45. [CrossRef] [PubMed]
14. Lloyd-Jones, D.M.; Levy, D. Epidemiology of Hypertension. In Hypertension: A Companion to Braunwald’s
Heart Disease; Black, H.R., Elliott, W.J., Eds.; Elsevier: Philadephia, PA, USA, 2013; pp. 1–11.
15. Zanchetti, A. Challenges in hypertension: Prevalence, definition, mechanisms and management. J. Hypertens.
2014, 32, 451–453. [CrossRef] [PubMed]
16. Thomas, G.; Shishehbor, M.; Brill, D.; Nally, J.V., Jr. New hypertension guidelines: One size fits most?
Clevel. Clin. J. Med. 2014, 81, 178–188. [CrossRef] [PubMed]
17. James, P.A.; Oparil, S.; Carter, B.L.; Cushman, W.C.; Dennison-Himmelfarb, C.; Handler, J.; Lackland, D.T.;
LeFevre, M.L.; MacKenzie, T.D.; Ogedegbe, O.; et al. 2014 evidence-based guideline for the management
of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National
Committee (JNC 8). JAMA 2014, 311, 507–520. [CrossRef] [PubMed]
18. Klandorf, H.; Chirra, A.R.; DeGruccio, A.; Girman, D.J. Dimethyl sulfoxide modulation of diabetes onset in
NOD mice. Diabetes 1989, 38, 194–197. [CrossRef] [PubMed]
19. Ballard, K.D.; Mah, E.; Guo, Y.; Pei, R.; Volek, J.S.; Bruno, R.S. Low-fat milk ingestion prevents postprandial
hyperglycemia-mediated impairments in vascular endothelial function in obese individuals with metabolic
syndrome. J. Nutr. 2013, 143, 1602–1610. [CrossRef] [PubMed]
20. Pugliese, G.; Solini, A.; Bonora, E.; Orsi, E.; Zerbini, G.; Fondelli, C.; Gruden, G.; Cavalot, F.; Lamacchia, O.;
Trevisan, R.; et al. Distribution of cardiovascular disease and retinopathy in patients with type 2 diabetes
according to different classification systems for chronic kidney disease: A cross-sectional analysis of the
renal insufficiency and cardiovascular events (RIACE) Italian multicenter study. Cardiovasc. Diabetol. 2014,
13, 59. [PubMed]
21. Asif, M. The prevention and control the type-2 diabetes by changing lifestyle and dietary pattern. J. Educ.
Health Promot. 2014, 3, 1. [CrossRef] [PubMed]
22. Russell, W.R.; Baka, A.; Bjorck, I.; Delzenne, N.; Gao, D.; Griffiths, H.R.; Hadjilucas, E.; Juvonen, K.;
Lahtinen, S.; Lansink, M.; et al. Impact of Diet Composition on Blood Glucose Regulation. Crit. Rev. Food
Sci. Nutr. 2016, 56, 541–590. [CrossRef] [PubMed]
23. Soares, R.; Costa, C. Oxidative Stress, Inflammation and Angiogenesis in the Metabolic Syndrome; Springer:
Heidelberg, Germany, 2009.
24. Rahal, A.; Kumar, A.; Singh, V.; Yadav, B.; Tiwari, R.; Chakraborty, S.; Dhama, K. Oxidative Stress,
Prooxidants, and Antioxidants: The Interplay. BioMed Res. Int. 2014, 2014, 761264. [CrossRef] [PubMed]
25. Parthasarathy, S.; Litvinov, D.; Selvarajan, K.; Garelnabi, M. Lipid peroxidation and decomposition—Conflicting
roles in plaque vulnerability and stability. Biochim. Biophys. Acta 2008, 1781, 221–231. [CrossRef] [PubMed]
26. McGrowder, D.; Riley, C.; Morrison, E.Y.; Gordon, L. The role of high-density lipoproteins in reducing the
risk of vascular diseases, neurogenerative disorders, and cancer. Cholesterol 2011, 2011, 496925. [CrossRef]
[PubMed]
27. Ferri, N.; Ruscica, M. Proprotein convertase subtilisin/kexin type 9 (PCSK9) and metabolic syndrome:
Insights on insulin resistance, inflammation, and atherogenic dyslipidemia. Endocrine 2016. [CrossRef]
28. Oresic, M.; Vidal-Puig, A. A Systems Biology Approach to Study Metabolic Syndrome; Springer: Heidelberg,
Germany, 2014.
29. Lee, E.G.; Choi, J.H.; Kim, K.E.; Kim, J.H. Effects of a Walking Program on Self-management and Risk Factors
of Metabolic Syndrome in Older Korean Adults. J. Phys. Ther. Sci. 2014, 26, 105–109. [CrossRef] [PubMed]
30. Bernabe, G.J.; Zafrilla, R.P.; Mulero, C.J.; Gomez, J.P.; Leal, H.M.; Abellan, A.J. Biochemical and nutritional
markers and antioxidant activity in metabolic syndrome. Endocrinol. Nutr. 2013, 61, 302–308.
31. Bales, C.W.; Kraus, W.E. Caloric restriction: Implications for human cardiometabolic health. J. Cardiopulm.
Rehabil. Prev. 2013, 33, 201–208. [CrossRef] [PubMed]
32. Grams, J.; Garvey, W.T. Weight Loss and the Prevention and Treatment of Type 2 Diabetes Using Lifestyle
Therapy, Pharmacotherapy, and Bariatric Surgery: Mechanisms of Action. Curr. Obes. Rep. 2015, 4, 287–302.
[CrossRef] [PubMed]
33. Lazo, M.; Solga, S.F.; Horska, A.; Bonekamp, S.; Diehl, A.M.; Brancati, F.L.; Wagenknecht, L.E.; Pi-Sunyer, F.X.;
Kahn, S.E.; Clark, J.M. Effect of a 12-month intensive lifestyle intervention on hepatic steatosis in adults with
type 2 diabetes. Diabetes Care 2010, 33, 2156–2163. [CrossRef] [PubMed]
34. Rossmeislova, L.; Malisova, L.; Kracmerova, J.; Stich, V. Adaptation of human adipose tissue to hypocaloric
diet. Int. J. Obes. 2013, 37, 640–650. [CrossRef] [PubMed]
35. Wing, R.R.; Lang, W.; Wadden, T.A.; Safford, M.; Knowler, W.C.; Bertoni, A.G.; Hill, J.O.; Brancati, F.L.;
Peters, A.; Wagenknecht, L. Benefits of modest weight loss in improving cardiovascular risk factors in
overweight and obese individuals with type 2 diabetes. Diabetes Care 2011, 34, 1481–1486. [CrossRef]
[PubMed]
36. Golay, A.; Brock, E.; Gabriel, R.; Konrad, T.; Lalic, N.; Laville, M.; Mingrone, G.; Petrie, J.; Phan, T.M.;
Pietilainen, K.H.; et al. Taking small steps towards targets—Perspectives for clinical practice in diabetes,
cardiometabolic disorders and beyond. Int. J. Clin. Pract. 2013, 67, 322–332. [CrossRef] [PubMed]
37. Fock, K.M.; Khoo, J. Diet and exercise in management of obesity and overweight. J. Gastroenterol. Hepatol.
2013, 28, 59–63. [CrossRef] [PubMed]
38. Abete, I.; Parra, D.; Martinez, J.A. Energy-restricted diets based on a distinct food selection affecting the
glycemic index induce different weight loss and oxidative response. Clin. Nutr. 2008, 27, 545–551. [CrossRef]
[PubMed]
39. Alberti, K.G.; Eckel, R.H.; Grundy, S.M.; Zimmet, P.Z.; Cleeman, J.I.; Donato, K.A.; Fruchart, J.C.; James, W.P.;
Loria, C.M.; Smith, S.C., Jr. Harmonizing the metabolic syndrome: A joint interim statement of the
International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung,
and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis
Society; and International Association for the Study of Obesity. Circulation 2009, 120, 1640–1645. [PubMed]
40. Fleming, J.A.; Kris-Etherton, P.M. The evidence for alpha-linolenic acid and cardiovascular disease benefits:
Comparisons with eicosapentaenoic acid and docosahexaenoic acid. Adv. Nutr. 2014, 5, 863S–876S. [CrossRef]
[PubMed]
41. Gray, B.; Steyn, F.; Davies, P.S.; Vitetta, L. Omega-3 fatty acids: A review of the effects on adiponectin and
leptin and potential implications for obesity management. Eur. J. Clin. Nutr. 2013, 67, 1234–1242. [CrossRef]
[PubMed]
42. Wen, Y.T.; Dai, J.H.; Gao, Q. Effects of Omega-3 fatty acid on major cardiovascular events and mortality
in patients with coronary heart disease: A meta-analysis of randomized controlled trials. Nutr. Metab.
Cardiovasc. Dis. 2014, 24, 470–475. [CrossRef] [PubMed]
43. Lopez-Huertas, E. The effect of EPA and DHA on metabolic syndrome patients: A systematic review of
randomised controlled trials. Br. J. Nutr. 2012, 107, 185–194. [CrossRef] [PubMed]
44. Maiorino, M.I.; Chiodini, P.; Bellastella, G.; Giugliano, D.; Esposito, K. Sexual dysfunction in women with
cancer: A systematic review with meta-analysis of studies using the Female Sexual Function Index. Endocrine
2016, 54, 329–341. [CrossRef] [PubMed]
45. EFSA NDA Panel (EFSA Panel on Dietetic Products, Nutrition and Allergies). Scientific Opinion on Dietary
Reference Values for fats, including saturated fatty acids, polyunsaturated fatty acids, monounsaturated
fatty acids, trans fatty acids, and cholesterol1. EFSA J. 2010, 8, 1461–1566.
46. Bellastella, G.; Bizzarro, A.; Aitella, E.; Barrasso, M.; Cozzolino, D.; di Martino, S.; Esposito, K.; de Bellis, A.
Pregnancy may favour the development of severe autoimmune central diabetes insipidus in women with
vasopressin cell antibodies: Description of two cases. Eur. J. Endocrinol. 2015, 172, K11–K17. [CrossRef]
[PubMed]
47. Sun, F.H.; Li, C.; Zhang, Y.J.; Wong, S.H.; Wang, L. Effect of Glycemic Index of Breakfast on Energy Intake at
Subsequent Meal among Healthy People: A Meta-Analysis. Nutrients 2016, 8, 37. [CrossRef] [PubMed]
48. Barclay, A.W.; Brand-Miller, J.C.; Wolever, T.M. Glycemic index, glycemic load, and glycemic response are
not the same. Diabetes Care 2005, 28, 1839–1840. [CrossRef] [PubMed]
49. Nakagawa, T.; Hu, H.; Zharikov, S.; Tuttle, K.R.; Short, R.A.; Glushakova, O.; Ouyang, X.; Feig, D.I.;
Block, E.R.; Herrera-Acosta, J.; et al. A causal role for uric acid in fructose-induced metabolic syndrome.
Am. J. Physiol. Ren. Physiol. 2006, 290, F625–F631. [CrossRef] [PubMed]
50. Symons Downs, D.; Hausenblas, H.A. Women’s exercise beliefs and behaviors during their pregnancy and
postpartum. J. Midwifery Women Health 2004, 49, 138–144.
51. Brand-Miller, J.; McMillan-Price, J.; Steinbeck, K.; Caterson, I. Dietary glycemic index: Health implications.
J. Am. Coll. Nutr. 2009, 28, 446S–449S. [CrossRef] [PubMed]
52. Thomas, D.; Elliott, E.J. Low glycaemic index, or low glycaemic load, diets for diabetes mellitus.
Cochrane Database Syst. Rev. 2009. [CrossRef]
53. Barrea, L.; Balato, N.; di Somma, C.; Macchia, P.E.; Napolitano, M.; Savanelli, M.C.; Esposito, K.; Colao, A.;
Savastano, S. Nutrition and psoriasis: Is there any association between the severity of the disease and
adherence to the Mediterranean diet? J. Transl. Med. 2015, 13, 18. [CrossRef] [PubMed]
54. Mathias, K.C.; Ng, S.W.; Popkin, B. Monitoring changes in the nutritional content of ready-to-eat grain-based
dessert products manufactured and purchased between 2005 and 2012. J. Acad. Nutr. Diet. 2015, 115, 360–368.
[CrossRef] [PubMed]
55. Serafini, M.; del Rio, D. Understanding the association between dietary antioxidants, redox status and
disease: Is the Total Antioxidant Capacity the right tool? Redox Rep. 2004, 9, 145–152. [CrossRef] [PubMed]
56. Bellastella, G.; Maiorino, M.I.; Olita, L.; della Volpe, E.; Giugliano, D.; Esposito, K. Premature ejaculation is
associated with glycemic control in Type 1 diabetes. J. Sex. Med. 2015, 12, 93–99. [CrossRef] [PubMed]
57. Zulet, M.A.; Moreno-Aliaga, M.J.; Martinez, J.A. Dietary Determinants of Fat Mass and Body Composition.
In Adipose Tissue Biology; Symonds, M.E., Ed.; Springer: New York, NY, USA, 2012; pp. 271–315.
58. Carlsen, M.H.; Halvorsen, B.L.; Holte, K.; Bohn, S.K.; Dragland, S.; Sampson, L.; Willey, C.; Senoo, H.;
Umezono, Y.; Sanada, C.; et al. The total antioxidant content of more than 3100 foods, beverages, spices,
herbs and supplements used worldwide. Nutr. J. 2010, 9, 3. [CrossRef] [PubMed]
59. Harasym, J.; Oledzki, R. Effect of fruit and vegetable antioxidants on total antioxidant capacity of blood
plasma. Nutrition 2014, 30, 511–517. [CrossRef] [PubMed]
60. Maiorino, M.I.; Bellastella, G.; Petrizzo, M.; della Volpe, E.; Orlando, R.; Giugliano, D.; Esposito, K. Circulating
endothelial progenitor cells in type 1 diabetic patients with erectile dysfunction. Endocrine 2015, 49, 415–421.
[CrossRef] [PubMed]
61. Bahadoran, Z.; Golzarand, M.; Mirmiran, P.; Shiva, N.; Azizi, F. Dietary total antioxidant capacity and the
occurrence of metabolic syndrome and its components after a 3-year follow-up in adults: Tehran Lipid and
Glucose Study. Nutr. Metab. 2012, 9, 70. [CrossRef] [PubMed]
62. Chrysohoou, C.; Esposito, K.; Giugliano, D.; Panagiotakos, D.B. Peripheral Arterial Disease and
Cardiovascular Risk: The Role of Mediterranean Diet. Angiology 2015, 66, 708–710. [CrossRef] [PubMed]
63. De la Iglesia, R.; Lopez-Legarrea, P.; Celada, P.; Sanchez-Muniz, F.J.; Martinez, J.A.; Zulet, M.A. Beneficial
effects of the RESMENA dietary pattern on oxidative stress in patients suffering from metabolic syndrome
with hyperglycemia are associated to dietary TAC and fruit consumption. Int. J. Mol. Sci. 2013, 14, 6903–6919.
[CrossRef] [PubMed]
64. Lopez-Legarrea, P.; de la Iglesia, R.; Abete, I.; Bondia-Pons, I.; Navas-Carretero, S.; Forga, L.; Martinez, J.A.;
Zulet, M.A. Short-term role of the dietary total antioxidant capacity in two hypocaloric regimes on obese
with metabolic syndrome symptoms: The RESMENA randomized controlled trial. Nutr. Metab. 2013, 10, 22.
[CrossRef] [PubMed]
65. Puchau, B.; Zulet, M.A.; de Echavarri, A.G.; Hermsdorff, H.H.; Martinez, J.A. Dietary total antioxidant
capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition
2010, 26, 534–541. [CrossRef] [PubMed]
66. World Health Organization. Obesity: Preventing and Managing the Global Epidemic; Report of a WHO
Consultation; World Health Organization Technical Report Series; WHO: Geneva, Switzerland, 2000.
67. Tapsell, L.C.; Hemphill, I.; Cobiac, L.; Patch, C.S.; Sullivan, D.R.; Fenech, M.; Roodenrys, S.; Keogh, J.B.;
Clifton, P.M.; Williams, P.G.; et al. Health benefits of herbs and spices: The past, the present, the future.
Med. J. Aust. 2006, 185, S4–S24. [PubMed]
68. Abete, I.; Astrup, A.; Martinez, J.A.; Thorsdottir, I.; Zulet, M.A. Obesity and the metabolic syndrome: Role of
different dietary macronutrient distribution patterns and specific nutritional components on weight loss and
maintenance. Nutr. Rev. 2010, 68, 214–231. [CrossRef] [PubMed]
69. Ebbeling, C.B.; Swain, J.F.; Feldman, H.A.; Wong, W.W.; Hachey, D.L.; Garcia-Lago, E.; Ludwig, D.S. Effects
of dietary composition on energy expenditure during weight-loss maintenance. JAMA 2012, 307, 2627–2634.
[CrossRef] [PubMed]
70. Abete, I.; Goyenechea, E.; Zulet, M.A.; Martinez, J.A. Obesity and metabolic syndrome: Potential benefit
from specific nutritional components. Nutr. Metab. Cardiovasc. Dis. 2011, 21, B1–B15. [CrossRef] [PubMed]
71. Arciero, P.J.; Ormsbee, M.J.; Gentile, C.L.; Nindl, B.C.; Brestoff, J.R.; Ruby, M. Increased protein intake and
meal frequency reduces abdominal fat during energy balance and energy deficit. Obesity 2013, 21, 1357–1366.
[CrossRef] [PubMed]
72. Wikarek, T.; Chudek, J.; Owczarek, A.; Olszanecka-Glinianowicz, M. Effect of dietary macronutrients on
postprandial incretin hormone release and satiety in obese and normal-weight women. Br. J. Nutr. 2014, 111,
236–246. [CrossRef] [PubMed]
73. Bray, G.A.; Smith, S.R.; de Jonge, L.; Xie, H.; Rood, J.; Martin, C.K.; Most, M.; Brock, C.; Mancuso, S.;
Redman, L.M. Effect of dietary protein content on weight gain, energy expenditure, and body composition
during overeating: A randomized controlled trial. JAMA 2012, 307, 47–55. [CrossRef] [PubMed]
74. Westerterp-Plantenga, M.S.; Nieuwenhuizen, A.; Tome, D.; Soenen, S.; Westerterp, K.R. Dietary protein,
weight loss, and weight maintenance. Annu. Rev. Nutr. 2009, 29, 21–41. [CrossRef] [PubMed]
75. Koppes, L.L.; Boon, N.; Nooyens, A.C.; van Mechelen, W.; Saris, W.H. Macronutrient distribution over
a period of 23 years in relation to energy intake and body fatness. Br. J. Nutr. 2009, 101, 108–115. [CrossRef]
[PubMed]
76. De Jonge, L.; Bray, G.A.; Smith, S.R.; Ryan, D.H.; de Souza, R.J.; Loria, C.M.; Champagne, C.M.;
Williamson, D.A.; Sacks, F.M. Effect of diet composition and weight loss on resting energy expenditure in
the POUNDS LOST study. Obesity 2012, 20, 2384–2389. [CrossRef] [PubMed]
77. Stocks, T.; Angquist, L.; Hager, J.; Charon, C.; Holst, C.; Martinez, J.A.; Saris, W.H.; Astrup, A.; Sorensen, T.I.;
Larsen, L.H. TFAP2B-dietary protein and glycemic index interactions and weight maintenance after weight
loss in the DiOGenes trial. Hum. Hered. 2013, 75, 213–219. [CrossRef] [PubMed]
78. Giugliano, D.; Maiorino, M.I.; Esposito, K. Linking prediabetes and cancer: A complex issue. Diabetologia
2015, 58, 201–202. [CrossRef] [PubMed]
79. Bendtsen, L.Q.; Lorenzen, J.K.; Bendsen, N.T.; Rasmussen, C.; Astrup, A. Effect of dairy proteins on appetite,
energy expenditure, body weight, and composition: A review of the evidence from controlled clinical trials.
Adv. Nutr. 2013, 4, 418–438. [CrossRef] [PubMed]
80. Heer, M.; Egert, S. Nutrients other than carbohydrates: Their effects on glucose homeostasis in humans.
Diabetes Metab. Res. Rev. 2015, 31, 14–35. [CrossRef] [PubMed]
81. Layman, D.K.; Evans, E.M.; Erickson, D.; Seyler, J.; Weber, J.; Bagshaw, D.; Griel, A.; Psota, T.; Kris-Etherton, P.
A moderate-protein diet produces sustained weight loss and long-term changes in body composition and
blood lipids in obese adults. J. Nutr. 2009, 139, 514–521. [CrossRef] [PubMed]
82. Pedersen, A.N.; Kondrup, J.; Borsheim, E. Health effects of protein intake in healthy adults: A systematic
literature review. Food Nutr. Res. 2013, 57, 21245. [CrossRef] [PubMed]
83. Daly, R.M.; O’Connell, S.L.; Mundell, N.L.; Grimes, C.A.; Dunstan, D.W.; Nowson, C.A. Protein-enriched
diet, with the use of lean red meat, combined with progressive resistance training enhances lean tissue mass
and muscle strength and reduces circulating IL-6 concentrations in elderly women: A cluster randomized
controlled trial. Am. J. Clin. Nutr. 2014, 99, 899–910. [CrossRef] [PubMed]
84. Arciero, P.J.; Gentile, C.L.; Pressman, R.; Everett, M.; Ormsbee, M.J.; Martin, J.; Santamore, J.; Gorman, L.;
Fehling, P.C.; Vukovich, M.D.; et al. Moderate protein intake improves total and regional body composition
and insulin sensitivity in overweight adults. Metab. Clin. Exp. 2008, 57, 757–765. [CrossRef] [PubMed]
85. Gregory, S.M.; Headley, S.A.; Wood, R.J. Effects of dietary macronutrient distribution on vascular integrity in
obesity and metabolic syndrome. Nutr. Rev. 2011, 69, 509–519. [CrossRef] [PubMed]
86. Consenso FESNAD-SEEDO. Recomendaciones nutricionales basadas en la evidencia para la prevención y el
tratamiento del sobrepeso y la obesidad en adultos (Consenso FESNAD-SEEDO). Rev. Esp. Obes. 2011, 10, 36.
87. Jakubowicz, D.; Froy, O.; Wainstein, J.; Boaz, M. Meal timing and composition influence ghrelin levels,
appetite scores and weight loss maintenance in overweight and obese adults. Steroids 2012, 77, 323–331.
[CrossRef] [PubMed]
88. Schwarz, N.A.; Rigby, B.R.; La Bounty, P.; Shelmadine, B.; Bowden, R.G. A review of weight control strategies
and their effects on the regulation of hormonal balance. J. Nutr. Metab. 2011, 2011, 237932. [CrossRef]
[PubMed]
89. Ohkawara, K.; Cornier, M.A.; Kohrt, W.M.; Melanson, E.L. Effects of increased meal frequency on fat
oxidation and perceived hunger. Obesity 2013, 21, 336–343. [CrossRef] [PubMed]
90. Ekmekcioglu, C.; Touitou, Y. Chronobiological aspects of food intake and metabolism and their relevance on
energy balance and weight regulation. Obes. Rev. 2011, 12, 14–25. [CrossRef] [PubMed]
91. Lioret, S.; Touvier, M.; Lafay, L.; Volatier, J.L.; Maire, B. Are eating occasions and their energy content related
to child overweight and socioeconomic status? Obesity 2008, 16, 2518–2523. [CrossRef] [PubMed]
92. Bhutani, S.; Varady, K.A. Nibbling versus feasting: Which meal pattern is better for heart disease prevention?
Nutr. Rev. 2009, 67, 591–598. [CrossRef] [PubMed]
93. Leidy, H.J.; Tang, M.; Armstrong, C.L.; Martin, C.B.; Campbell, W.W. The effects of consuming frequent,
higher protein meals on appetite and satiety during weight loss in overweight/obese men. Obesity 2011, 19,
818–824. [CrossRef] [PubMed]
94. Mills, J.P.; Perry, C.D.; Reicks, M. Eating frequency is associated with energy intake but not obesity in midlife
women. Obesity 2011, 19, 552–559. [CrossRef] [PubMed]
95. Cameron, J.D.; Cyr, M.J.; Doucet, E. Increased meal frequency does not promote greater weight loss in subjects
who were prescribed an 8-week equi-energetic energy-restricted diet. Br. J. Nutr. 2010, 103, 1098–1101.
[CrossRef] [PubMed]
96. Smeets, A.J.; Lejeune, M.P.; Westerterp-Plantenga, M.S. Effects of oral fat perception by modified sham
feeding on energy expenditure, hormones and appetite profile in the postprandial state. Br. J. Nutr. 2009,
101, 1360–1368. [CrossRef] [PubMed]
97. Taylor, M.A.; Garrow, J.S. Compared with nibbling, neither gorging nor a morning fast affect short-term
energy balance in obese patients in a chamber calorimeter. Int. J. Obes. Relat. Metab. Disord. 2001, 25, 519–528.
[CrossRef] [PubMed]
98. Smeets, A.J.; Westerterp-Plantenga, M.S. Acute effects on metabolism and appetite profile of one

Dr. Alex Jimenez's insight:

Some of the most dietary-strategies-treatment-metabolic dietary strategies and bioactive compounds employed in the treatment of MetS to date. For Answers to any questions you may have please call Dr. Jimenez at 915-850-0900

Partager

more...

No comment yet.

Sign up to comment

Nutrition is how the body utilizes consumed food. Nutrition plays a role in chronic pain; lifestyle behaviors can influence how food contributes to illness/diseases. A common cause of chronic pain is chronic systemic inflammation. Inflammation plays a role in many chronic disease conditions, including diabetes, heart disease, and cancer. Reducing inflammation can be achieved by adjusting diet to get individuals back to feeling better quickly and to aid them in maintaining and improving their overall health. Injury Medical Chiropractic and Functional Medicine Clinic offer diet and nutritional supplements guidance as part of a personalized treatment plan.

Inflammation

The purpose of the inflammatory response includes:

• Isolate the dangerous bacteria, viruses, or damaged cells.
• Flush out the dead cells and other damaging substances.
• Initiate the repair/healing process.

Types of inflammation

• Localized inflammation occurs at the site of an injury or infection.
• A sprained ankle that becomes swollen and painful or a cut that gets infected and becomes red and swollen are examples of localized inflammation.
• Systemic inflammation occurs throughout the body. External factors can trigger this type of inflammation.
• Viral and Bacterial infections.
• Allergens or toxins in food and the environment.
• Smoking
• Alcohol consumption
• It can also be triggered by internal factors, including:
• Stress
• Obesity
• Autoimmune conditions
• Genetic variations

Optimizing Diet and Nutritional Supplements Effect on Chronic Pain

The body needs protein, carbohydrates, fat, fiber, vitamins, and minerals for the health and the prevention of chronic disease.

• Dietary intake can enhance the function of the nervous system, immune system, and endocrine system that directly affects pain symptoms and episodes.
• Losing weight decreases the added pressure on joints and reduces inflammation.
• Dietary intake and weight status impact the risk and/or severity of other chronic diseases that include:
• Cardiovascular disease
• Diabetes
• Anxiety
• Depression
• Often occur simultaneously with chronic pain.

Prescribed diet modification, also known as diet therapy includes:

• Modifying the entire diet.
• Supplementing the diet with specific nutrients.
• Changing dietary patterns to induce a fasting state.

Benefits include:

• Calorie reduction
• Increased antioxidants
• Prebiotic supplementation for gastrointestinal health.

These approaches positively impact comorbidities of chronic pain and promote secondary gains, including:

• Pain alleviation and management.
• A positive promotion of health and well-being.
• Reductions of comorbidities like obesity and cardiovascular disease.
• Reducing healthcare costs.

Vitamin and Mineral Supplements

Diet and nutritional supplements provide added essential nutrients to a damaged, inflamed, or injured body. Dietary supplements improve overall health and wellness.

• Vitamin D and calcium tablets help maintain optimal bone health, as low vitamin D levels can lead to back pain.
• Omega-3 fatty acids help reduce inflammation.
• Vitamins E and C, combined with copper, help with blood production, tissue repair, and brain and skin health.
• Folic acid can help with joint pain and myofascial pain.
• B Vitamins can help with pain and prevent liver dysfunction.

Nutritional supplements support the body until the body and/or organs have correctly healed. Recovery from an injury could cause body stress that can interfere with the healing process. Diet and nutritional supplements expedite the healing and recovery process by:

• Helping overcome dietary deficiencies.
• Improving immune system function.
• Detoxifying toxins.
• Contain antioxidants that help the body stay toxin-free.

Chiropractic restores and realigns the body by incorporating supplements to nourish the body tissues and recover optimally from injury.

InBody Nutrition

General Disclaimer *

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, or licensed physician, and is not medical advice. We encourage you to make your own healthcare decisions based on your research and partnership with a qualified healthcare professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the injuries or disorders of the musculoskeletal system. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.* Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request.

We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, ATN*

email: coach@elpasofunctionalmedicine.com

Licensed in: Texas & New Mexico*

References

Dragan, Simona, et al. “Dietary Patterns and Interventions to Alleviate Chronic Pain.” Nutrients vol. 12,9 2510. 19 Aug. 2020, doi:10.3390/nu12092510

Lee, Mi Kyung, et al. “The use of nutritional guidance within chiropractic patient management: a survey of 333 chiropractors from the ACORN practice-based research network.” Chiropractic & manual therapies vol. 26 7. 20 Feb. 2018, doi:10.1186/s12998-018-0175-1

Li, Chuan, et al. “Macrophage polarization and meta-inflammation.” Translational research: the journal of laboratory and clinical medicine vol. 191 (2018): 29-44. doi:10.1016/j.trsl.2017.10.004

Nutrition and Chronic Pain https://www.iasp-pain.org/resources/fact-sheets/nutrition-and-chronic-pain/

Pahwa R, Goyal A, Jialal I. Chronic Inflammation. [Updated 2021 Sep 28]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493173/

Chiropractors do far more than provide musculoskeletal adjustments for proper alignment and function of the spine.  They help bring the body back into balance, achieve and maintain optimal health. Every individual receives a personalized/customized treatment plan that covers aspects more than chiropractic adjusting. This includes:

• Home pain relief
• Stretches
• Physical therapy
• Lifestyle adjustments

When treatment only focuses on symptoms and not the whole body, the plan is incomplete and may not be successful. At Injury Medical Chiropractic and Functional Medicine Clinic, we recommend incorporating a variety of treatment approaches for the best results. One area that is often overlooked in treatment is individual diet. The food that individuals consume could cause or be contributing to inflammatory responses that cause or worsen pain symptoms. Adding anti-inflammatory foods to an individual's diet can help reduce inflammation and enhance the treatment plan.

Chronic inflammation pain

Inflammation is a normal body response that helps fight infections and heal damaged tissues. Too much inflammation can become chronic and harmful to the body. Chronic inflammation has been linked to various health problems, that affect both long-term and short-term health issues like reduced mobility and pain. A chiropractic treatment plan can help alleviate the inflammation and improve the symptoms associated with inflammation. However, chronic inflammation can be worsened by lifestyle factors that include:

• Lack of physical activity
• Unhealthy stress management
• Not properly sleeping
• Unhealthy Diet

Making healthy diet adjustments from inflammatory foods to anti-inflammatory will reduce chronic inflammation throughout the body. Combined with a complete chiropractic treatment plan, nutritional changes can help in alleviating pain, reducing the need for anti-inflammatory medications.

Top anti-inflammatory foods

There are foods that are known for their anti-inflammatory properties. Increasing consumption of anti-inflammatory foods and reducing foods that generate inflammatory responses will help reduce inflammation and pain. These include:

Fatty fish

Fatty fish is one of the best anti-inflammatory foods because they are full of omega-3 fatty acids. These acids help fight and neutralize other acids in the body that increase inflammation. They include:

• Salmon
• Sardines
• Mackerel
• Herring are a few examples of anti-inflammatory-rich fish.

Green tea

Green tea is filled with antioxidant compounds known as epigallocatechin-3-gallate/EGCG. EGCG is known to strengthen and reinforce the immune system, which reduces inflammation.

Dark, leafy greens:

Dark, leafy vegetables contain anti-inflammatory flavonoids and antioxidants both help reduce inflammatory responses. These include:

• Spinach
• Bok Choy
• Collards
• Kale

Turmeric

This spice has been shown to contain a variety of healing compounds, antioxidants, and anti-inflammatory agents. The active ingredient curcumin is believed to be the main source.

Nuts

Most nuts and seeds contain omega-3 fatty acids along with other anti-inflammatory compounds. A handful of nuts and seeds as a quick snack every day can reduce inflammation and along with other health benefits. These include:

• Almonds
• Cashews
• Hazelnuts
• Peanuts
• Pecans
• Pistachios
• Walnuts

Reduction of Inflammatory foods

Pro-inflammatory foods should also be reduced. These include:

• Red meat
• Sugar
• Sodas
• Margarine
• Refined carbohydrates

At Injury Medical Chiropractic and Functional Medicine Clinic, we educate individuals on their diet, exercise, lifestyle, and help them achieve optimal health. Contact us today to learn more.

Body Composition

Personalized Lifestyle Medicine

Personalized lifestyle medicine is a model of medicine that looks at every individual's case when making health recommendations. It looks at how the body works as an integrated system and combines new technology approaches that include gene expression, life, behavioral sciences, and nutrigenomics. Nutrigenomics involves the science of analyzing and understanding gene and nutrient interactions. It is defined as the relationship between nutrients and gene expression. Nutrigenomic testing can help individuals understand the influence of dietary components on their genes. This could help prevent the development of chronic diseases. Essentially, it can tell individuals how well the body is absorbing certain nutrients from specific foods. If there are issues being able to make adjustments.

Disclaimer

The information herein is not intended to replace a one-on-one relationship with a qualified health care professional, licensed physician, and is not medical advice. We encourage you to make your own health care decisions based on your research and partnership with a qualified health care professional. Our information scope is limited to chiropractic, musculoskeletal, physical medicines, wellness, sensitive health issues, functional medicine articles, topics, and discussions. We provide and present clinical collaboration with specialists from a wide array of disciplines. Each specialist is governed by their professional scope of practice and their jurisdiction of licensure. We use functional health & wellness protocols to treat and support care for the musculoskeletal system’s injuries or disorders. Our videos, posts, topics, subjects, and insights cover clinical matters, issues, and topics that relate to and support, directly or indirectly, our clinical scope of practice.*Our office has made a reasonable attempt to provide supportive citations and has identified the relevant research study or studies supporting our posts. We provide copies of supporting research studies available to regulatory boards and the public upon request. We understand that we cover matters that require an additional explanation of how it may assist in a particular care plan or treatment protocol; therefore, to further discuss the subject matter above, please feel free to ask Dr. Alex Jimenez or contact us at 915-850-0900.

Dr. Alex Jimenez DC, MSACP, CCST, IFMCP*, CIFM*, CTG*
email: coach@elpasofunctionalmedicine.com
phone: 915-850-0900
Licensed in Texas & New Mexico

References

Adam O, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M et al. Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis [abstract]. Rheumatol Int. 2003;23(1):27-36. doi: 10.1007/s00296-002-0234-7.

Dr. Weil's anti-inflammatory food pyramid. Dr. Weil Web site.  http://www.drweil.com/drw/ecs/pyramid/press-foodpyramid.html. Accessed April 22, 2011.

Chronic pain is a common health issue which affects many people in the United States. While several medical conditions, such as fibromyalgia and myofascial pain syndrome, can cause chronic pain, it may also develop due to a variety of other health issues.

Research studies have found that widespread inflammation is the leading cause of chronic pain. Inflammation is a natural defense mechanism to injury, illness, or infection. But, if the inflammatory process continues for too long, it can become problematic.

Inflammation signals the immune system to heal and repair damaged tissue as well as to protect itself against bacteria and viruses. As mentioned above, however, chronic inflammation can cause a variety of health issues, including chronic pain symptoms. Healthy lifestyle modifications can help manage chronic pain, but first, let’s understand the common causes of chronic pain.

Fats are an essential part of the ketogenic diet since they constitute approximately 70 percent of your dietary calories. The type of fat you eat on the ketogenic diet is also important and there may be some confusion regarding good fats and bad fats. The following article discusses exactly what fats you need to include and what fats you must avoid while on the keto diet.

Good Fats on the Ketogenic Diet

The type of “good” fats included while on the ketogenic diet are divided into four groups: saturated fats, monounsaturated fats (MUFAs), polyunsaturated fats (PUFAs), and naturally-occurring trans fats. All fats can be classified into more than one group, however, we classify them according to the most dominant of these mixtures. It’s essential to be able to recognize what type of fat you are eating on the ketogenic diet. Below, we will describe each group of good fat so you can properly implement them into your own food choices.

Cancer is the second leading cause of death in the United States. Research studies have estimated that approximately 595,690 Americans die from cancer every year, that’s about 1,600 deaths every day, on average. Cancer is frequently treated utilizing a combination of surgery, chemotherapy, and radiation. Recent research studies have analyzed a variety of nutritional strategies for cancer treatment. Early research studies suggest that the ketogenic diet may help treat cancer.

What is the Ketogenic Diet?

The ketogenic diet is a very low-carb, high-fat diet which is often compared with the Atkins diet and other low carb diets. Also commonly known as the keto diet, this nutritional strategy entails drastically reducing your consumption of carbohydrates and instead substituting them with fat. This dietary shift is what causes the human body to enter a state of ketosis, the well-known metabolic state associated with the keto diet. Ketosis utilizes fat as the cell’s main source of energy, rather than sugar or glucose.

Ketosis causes a considerable increase in the levels of ketones. In general, a ketogenic diet used for weight loss consists of about 60 to 75 percent of calories from fat, with 15 to 30 percent of calories from protein and 5 to 10 percent of calories from carbohydrates. However, when a ketogenic diet is used therapeutically to treat cancer, the fat content might be significantly higher, up to 90 percent of calories from fat, and the protein content will also be considerably lower, up to 5 percent of calories from protein.

How important is nutrition for our brain health? In the current work force, we are continuously stressed, often forced to finish tasks faster in order to meet ever so demanding deadlines. In addition, we are expected to maintain our optimal mental health, as this can be an essential part towards delivering quality work. When our mental health is being affected by our hectic lifestyles, however, several practices which can help you start thinking more clearly can include sleeping properly, controlling stress, and even taking nutritional supplements for your brain health.

One nutritional supplement which has been widely recognized for its ability to boost brain health is curcumin, the active ingredient found in turmeric. Well-known for its antioxidant properties and its capacity to control inflammation in the human body, this powerful herb can also promote good mood and cognition. Another specific group which has reported significant benefits with the increased use of curcumin, is the elderly population. Below, we will discuss how curcumin can help boost brain health as well as demonstrate additional benefits this golden gem can have on our overall health and wellness.

Envision yourself waking up entirely rested, prepared to deal with any obstacle and adopt all the joys of the world with gratitude. The majority of us know what a good night’s sleep resembles, but are we really getting the proper rest we should be getting? Within this stressful universe, it’s tough to achieve the sleep schedule that our brains and bodies require to operate to its fullest potential.

Proper sleep hygiene and the application of organic herbs and botanicals can help promote a healthy amount of sleep. The outcome could result in a wide array of benefits, including an improvement in problem solving and work performance, weight management, and even promote the prevention of chronic health issues, such as diabetes, cardiovascular disease and mood disorders like depression. You may find numerous products and information regarding how to manage proper sleep. A research study from 2016 indicated that individuals in the United States alone spent over $41 billion on sleeping treatments, where it is expected to rise up to $52 billion by the year 2020.

Hemp, is one of the oldest cultivated crops, which was grown thousands of years ago in Asia as a food source. Ancient civilizations wove the strong and durable fibers into clothing and rope.1

It helped Christopher Columbus with the ships he sailed, both the sails and ropes were made of hemp and it was also placed between the planks to help the ships remain watertight.2

Two Plants With Completely Different Uses 

Hemp (Cannabis Sativa)

In this form is cultivated outside the United States (however, the U.S. Government has allowed it to be grown for research purposes) for clothing, paper, dietary supplements, cosmetics, foods, biofuels, and bioplastics. European hemp has less than 0.3% of the psychoactive compound tetrahydrocannabinol (THC), as measured in dried flower tops.3

Marijuana (Cannabis Sativa)

This cannabis sativa is cultivated to maximize the THC content, which is focused in the United States, and used exclusively for recreational and medicinal purposes.

How Hemp Helps The Body

Foods made from the plant are processed from the plant's seeds and are quite common. Common foods include granola, roasted seeds, milk, and butter. These foods do not appear on drug tests when consumed.

The European strain offers a variety of health benefits without the side effects of the THC.

Protein

Powder is made from the oil the of the seeds and then processed into powder. The result is a complete protein that contains all nine essential amino acids plus omega fatty acids and fiber4. When compared to whey or animal protein, hemp powder is low in lysine and leucine.

Can't Stand Fish?

For essential fatty acids, seeds are rich in healthy fats, which include omega-3,6, and 9 fatty acids. It also contains linoleic acid, and gamma-linolenic acid (GLA).5

Health Benefits Of Phytocannabinoids

The stalk of the plant contains natural compounds called phytocannabinoids. When eaten, they interact with the body's endocannabinoid system (ECS) and help with stress, as well as, relieve aches, pains, and discomfort. Phytocannabinoids also support brain, bone, digestive health, and promote immune and metabolic function.

The plant contains over 80 different phytocannabinoids that help supplement the cannabinoids in your body makes naturally and support the ECS.6 Legally stalk extracts that are imported from outside of the United States must have less than 0.3% THC. 

Legality

Since 1970, cultivation of cannabis sativa from both the hemp and marijuana plants have been illegal in the U.S. under the federal Controlled Substances Act. Even though some States have legalized marijuana and the federal Farm Bill of 2014 allows States to issue licenses for limited and experimental growth, federal law still prohibits the domestic cultivation, sale, and distribution.8

Hemp products such as, paper, rope, clothing, and bioplastics, have always been available in the United States. Federal law never banned the importation of these products, as long as, the THC content is less than or equal to 0.3 percent.8

Now with people interested in plant nutrition there is a larger availability of hemp-derived foods. These foods are made from sources outside of the U.S. These sources only contain a minimal amount of THC, and are completely legal.

When Buying Hemp Products

When buying a hemp products, make sure that it is made from imported industrial hemp. Buy brands that manufacture with Good Manufacturing Practice (GMP) standards and test their products purity and quality.

• Food purchases should be from major brands and reputable sources. It's best to go with organic products, which do not contain pesticides.
• Hemp oil products should be organic and cold processed. These oils should be refrigerated to avoid rancidity.
• When buying hemp protein, find brands, which list amino acid content. There should be no additives, i.e. a lot of sugar.

Cannabidiol (CBD) & Phytocannabinoids

References

1. http://www.ancient-origins.net/history/cannabis-journey-through-ages-003084. [Accessed March 19, 2018]
2. http://hashmuseum.com/en/collection/columbus-and-cannabis. [Accessed March 19, 2018]
3. Johnson R. Hemp as an agricultural commodity. Washington, D.C. Library of Congress Congressional Research Service, 2014.
4. Callaway J. Hempseed as a nutritional resource: An overview. Euphytica 2004;140(1-2):65-72.
5. Leizer C, Ribnicky D, Poulev A, et al. The composition of hemp seed oil and its potential as an important source of nutrition. J Nutraceut Func Med Foods 2002;2(4):35-53.
6. Borgelt L, Franson K, Nussbaum A, Wang G. The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy 2013;33(2):195-209.
7. Cherney J, Small E. Industrial hemp in North America: production, politics and potential. Agronomy 2016;6(4):58.
8. Mead A. The legal status of cannabis (marijuana) and cannabidiol (CBD) under U.S. law. Epilepsy Behav 2017;70(Pt B):149-153.

Cannabinoids: Plants and medicine have come around like never before. With more research taking place and more information coming to the medical field, there are now more options for ailments, conditions, diseases and disorders. Chiropractor, Dr. Alex Jimenez analyzes the data and brings insight to these developing medicines and treatments. How they can help patients, what can they do and what can't they do?

Most associate cannabinoids with the marijuana plant. This is the most recognized cannabinoid compound - tetrahydrocannabinol (THC), which is what causes feelings of euphoria.

However, scientists have identified cannabinoids in many plants, which include black pepper, broccoli, carrots, clove, echinacea, and ginseng. None of these will get you high. But with an understanding of how the cannabinoids in these various plants affect the human body can create a path to important health discoveries.

Plants Are Medicine

Many modern drugs were developed through plant research. Researching compounds in these plants led to discovering life saving drugs and furthered the knowledge of how the human body functions. An example is the foxglove plant, which gave us digoxin and digitoxin. Two very important heart medications.1

Humans have been especially resourceful when finding plants for pleasure or to decrease pain.

Caffeine provides energy, while nicotine from tobacco stimulates and relaxes. This explains why tobacco is still popular even though we know the health risks of smoking.2

Pain-Relieving Drugs & Their Origin

Aspirin

In ancient times, medical practitioners drank tea made from willow tree, in order to reduce fever and pain. It took hundreds of years for scientists to find and isolate the active compound, which is salicylic acid. This led to the discovery of aspirin and from there, it evolved into inflammation reduction.4

Anesthetics

Coca plant leaves were used by the Incan's in South America. It was used to treat headaches, wounds, and fractures. However, the coca plant also brought about cocaine. But is an effective anesthetic. To have an understanding of how cocaine blocks pain has created common anesthetics like lidocaine, which is used in dental procedures.5

Opiates

Scientists studying opium from the poppy plant, have discovered opiate receptors in the human body and how they manage pain. This led to morphine, codeine, and other opiate based medications.3

Human Health & Cannabis

Cannabis has been used for centuries. Chinese text from the year A.D. 1 has recorded the use of hemp in treating over 100 ailments, which date back to 2737 B.C.6 After this, the tops of the cannabis plant were cultivated for their psychoactive attributes. While this was happening a different strain of the plant was grown for industrial hemp use, in making clothing, paper, biofuels, foods, and other products. 

Based on the controversy surrounding marijuana, it has not been easy for researchers to study the effects of the non-THC components in cannabis. THC was identified in the 1940's, but it was not until 50 years later that research revealed humans (and almost all animals) have a system of cannabinoid receptors.

Humans make cannabinoids (endocannabinoids) and they act on these receptors.7

This system is called the endocannabinoid system (ECS). The ECS is involved in multiple processes, which include:

• Pain Sensation
• Appetite
• Memory
• Mood

Ever hit your toe, digest a piece of fruit or forget a password? Then the ECS was involved.

Discovery of the ECS along with the natural compounds identified in cannabis helped science and medicine. Researchers called these compounds phytocannabinoids, from the prefix “phyto" for plant. Over 80 phytocannabinoids have now been discovered in marijuana and hemp. THC is just one of the many compounds being studied for their health benefits.8

Cannabis & THC Moving Forward

Now that many plants are known to contain these compounds, phytocannabinoids are no longer just associated with cannabis.9 Chances are you have some source of phytocannabinoids in your diet right now.

Remember it could be just a small amount, and not all phytocannabinoids interact strongly with the ECS.

How Far Has This Research Developed?

Current research shows that some of the phytocannabinoids in hemp, clove, and black pepper can support the ECS to promote relaxation, decrease nerve discomfort, and improve digestive health. And as these compounds do not contain THC there is no mind-altering effects. Therefore, the option of using phytocannabinoids for health benefits, without feeling the psychoactive effects is definitely something to look forward to.10

References

1. Gurib-Fakim A. Medicinal plants: traditions of yesterday and drugs of tomorrow. Mol Aspects Med 2006;27(1):1-93.
2. Singh Y, Blumenthal M. Kava: an overview. Distribution, mythology, botany, culture, chemistry and pharmacology of the South Pacific’s most revered herb. Herbalgram 1997;39(suppl):34-56.
3. Brownstein M. A brief history of opiates, opioid peptides, and opioid receptors. Proc Natl Acad Sci U S A 1993;90(12):5391-5393.
4. Vainio H, Gareth M. Aspirin for the second hundred years: new uses for an old drug. Pharmacol Toxicol 1997;81(4):151-152.
5. Ruetsch Y, Thomas B, Alain B. From cocaine to ropivacaine: the history of local anesthetic drugs. Curr Top Med Chem 2001;1(3):175-182.
6. http://www.thenorthwestleaf.com/pages/articles/post/traditional-chinese-medicine-how-marijuana-has-been-used-for-centuries [Accessed April 16, 2018].
7. Pertwee R. Cannabinoid pharmacology: the first 66 years. Br J Pharmacol 2006;147(Supp 1):163-171.
8. Borgelt L, Franson K, Nussbaum A, Wang G. The pharmacologic and clinical effects of medical cannabis. Pharmacotherapy 2013;33(2):195-209.
9. Gertsch J, Roger G, Vincenzo D. Phytocannabinoids beyond the Cannabis plant – do they exist? Br J Pharmacol 2010;160(3):523-529.
10. Russo E. Taming THC: potential cannabis synergy and phytocannabinoid?terpenoid entourage effects. Br J Pharmacol 2011;163(7):1344-1364.

Gluten Free: During a visit to my orthopedist I made a confession: “I stopped eating gluten and—this might sound a little crazy, but—a lot of my joint pain disappeared.

She smiled broadly and said, “You’re not the first person to say that.”

See How Gluten Can Cause Joint Pain

Giving up gluten may be difficult, but it could lead to less joint pain.  Learn more: What Are Anti-Inflammatory Foods?[

I stopped eating gluten because couple of friends suggested it might relieve some unexplained symptoms I was experiencing, like fatigue and mild joint pain. I had strong doubts, but my primary care doctor and I had run out of ideas (I was waiting to see a specialist), so I figured I had nothing to lose.

See Rheumatoid Arthritis and Fatigue

Within a week of going on a gluten-free diet, my fatigue, joint pain, and many other symptoms disappeared.

The Connection Between Gluten & Joint Pain

It turns out, researchers have long known that people with autoimmune forms of arthritis, such as rheumatoid 

arthritis and psoriatic arthritis, are at higher risk for celiac disease,1, 2 an autoimmune disorder triggered by gluten.

See Inflammatory Arthritis

More recently, medical experts have begun to acknowledge the connection between gluten and joint pain described as non-pathologic (unrelated to disease).

Both my orthopedist and primary care provider agree that my gluten-free diet is probably keeping my joint pain and other symptoms of inflammation in check.

See An Anti-Inflammatory Diet for Arthritis 

Wait, Don’t Go Gluten Free Yet…

Before you throw away your pasta and cereal in search of joint pain relief, consider these factors:

• Going gluten free isn’t for everyone. 
  Whole grains are a recommended part of a healthy diet. No research suggests everyone should start eating a gluten free diet. But for people experiencing painful joint inflammation, eliminating gluten and other “pro-inflammatory” foods may be one treatment approach to consider.

See The Ins and Outs of an Anti-Inflammatory Diet

• Food products labeled “gluten free” aren’t necessarily healthy. 
  It’s almost always better to eat whole foods as opposed to processed foods that are gluten-free, but still full of sugar or saturated fats. For example, skip the gluten-free sugar cereal and make yourself a bowl of gluten-free oatmeal or a fruit smoothie for breakfast.
• Eating a gluten-free diet isn’t a magic bullet. 
  Adopting other healthy habits, such as making time for exercise, is essential to eliminating joint pain.

See Managing RA Fatigue Through Diet and Exercise

• A health professional can help.It’s always a good idea to tell yourdoctor about lifestyle changes, including achange in diet. A doctor may refer you to a registered dietician who can recommend certain foods, helping ensure you get enough nutrients and fiber in your gluten-free diet.

See Arthritis Treatment Specialists

• You might experience gluten withdrawal.Many people report that their inflammatory symptoms initially got worse after starting their gluten free diet. This withdrawal stage can last days or even weeks, so you may not want to go gluten free right before a big event, like a vacation, holiday, or the start of a newjob.

No single treatment or lifestyle habit can eliminate the symptoms of arthritis, but going gluten-free may be an option worth trying as part of your overall treatment plan.

By Jennifer Flynn

Learn More

Turmeric and Curcumin for Arthritis

Dietary Supplements for Treating Arthritis

References

Turmeric: Let us ease your mind a bit. As with any dietary supplement, there are right ways to take turmeric root that could best benefit your health. We review things to keep in mind to limit any potential side effects. 

Potential Benefits Of Turmeric Root 

The compound that gives turmeric root its signature bright yellow hue is also the compound that packs the potential health benefits punch: curcumin. Curcumin – and therefore turmeric root – is believed to provide some pretty attractive health benefits, including support of joint and muscle comfort, promotion of healthy aging of the brain, support of a healthy digestive tract, and maintenance of healthy cholesterol levels already in the normal range.

But that doesn’t mean that taking 10 turmeric root supplement capsules at once would give you 10 times the potential benefit. Quite the opposite. There are right – and wrong – ways to consume the supplement in an effort to reduce possible side effects.

Avoiding Turmeric Root Side Effects

According to MentalHealthDaily.com, if you’re supplementing with turmeric root, especially at high doses, it is possible that you may encounter some unwanted side effects at one point or another. The two most common side effects associated are diarrhea and nausea. High on the list of possible side effects are also:

• Thinning of the blood. Some research shows that curcumin may have anticoagulant effects which can slow blood clotting. If you’re already taking a blood thinner, speak to your doctor about your desire to add a turmeric root supplement, and discontinue use at least two weeks before any surgery.
• Some estimates indicate that one in four turmeric root users will notice an increase in bloating and passing gas. To reduce the likelihood of experiencing this particular side effect, consider a dose less than 6 grams per day, and avoid taking your supplement on an empty stomach.
• Low blood sugar. Especially in those with health concerns related to blood glucose, turmeric root supplements may yield this unwanted effect. Some experts believe that the curcumin may even act to amplify pre-existing blood sugar issues.

Less common side effects may also include facial flushing, fever, headaches, skin rash and even low testosterone.

But as with any supplement or medication, remember that the severity and number of side effects you experience is likely subject to a variety of causes and factors. Keep in mind that some individuals may not experience any side effects at all.

Recommendations And Dosages

As with all medications and supplements, we encourage you to consult with your healthcare professional before adding a turmeric root supplement to your regimen. He or she can personalize dosing recommendations for you based on your desired outcomes and other factors – like other medications and supplements you are taking. That said, WebMD.com offers a few general guidelines for using turmeric and avoiding possible side effects:

• This root is likely safe when applied to the skin appropriately for up to eight months.
• It should only be considered as a mouthwash for short-term use.
• For high cholesterol levels: 1.4 grams of turmeric extract in two divided doses each day for three months has been used for those 15 years or older.

Let’s Get Technical

While there are still many studies to be done and results to be reported, BCM-95 – a highly-absorbent form of curcumin, which is the active ingredient in turmeric root – has been clinically proven to help temporarily relieve minor pain. When used at a dosage of 2 grams per day, volunteers participated in the study without any mild adverse reactions. To try BCM-95 out for yourself, we recommend CuraMed and other daily supplements from Terry Naturally. And as always, we’re proud to provide you with free shipping anywhere in the U.S.

by Theresa Groskopp, CN in Health Challenges, Health Tips, Nutrition Supplements