Come and see me talk about ‘Real Food for Real Nutrition’ at the inagrual Kitchen Table Wisdom event.
Come and see me talk about ‘Real Food for Real Nutrition’ at the inagrual Kitchen Table Wisdom event.
In this podcast with Audra Starkey aka The Healthy Shift Worker I talk about how chronic pain is essentially an oversensitive nervous system response. I also discuss how sleep and pain are bio-directional, meaning pain can disturb our sleep and vice versa, along with the correlation between lower back and low vitamin D levels. Thanks to Audra for having me on The Healthy Shift Worker – it was heaps of fun.
Is two weeks soon enough to start feeling better? Yes according to a recent paper of which the title is in part “Let them eat fruit!” reported that increasing fruit and vegetable consumption for just 2 weeks is enough to start seeing and feeling positive benefits. Young adults taking part in the reported trial experienced motivation, positive mood and increased vitality.
Before taking part, participants ate 3 or less servings of combined fruit and vegetables a day, a similar average daily consumption of many Australian adults. Groups within the trial were either provided with fresh seasonal fruit and vegetables or sent twice-daily texts encouraging them to consume more fresh produce.
Interestingly, text messaging didn’t work but by contrast, ready availability of produce did, with consumption increasing along with blood levels of vitamin C and carotenoids (a plant nutrient found in orange and red vegetables).
While this trial was conducted on young adults, I think the take home message is the same regardless – if there is a ready supply of fresh seasonal produce in the home, it is more likely to be consumed. I can say from personal experience that this approach works for me, and not just at home. Recently during ‘O-week’ at the college I teach, there were bowls of Granny Smith apples supplied in ready abundance for students. I admit, in passing, I poached at least one every day, as did many students and staff members I saw munching on apples over that week. Providing access to fresh seasonal fruit and vegetables could also be applied to the work place environment, schools and universities alike. A few ideas I have seen work or strategies I have used myself to increase easy access to fruit and vegetables include:
Conner TS, et al. Let them eat fruit! The effect of fruit and vegetable consumption on psychological well-being in young adults: A randomized controlled trial. PLoS One. 2017 Feb 3;12(2):e0171206.
Loneliness hurts. You feel it in your body like a physical pain. Why? Because that sensation of pain we experience when we feel socially isolated or all alone in the world has the similar underlying processes as physical pain. Our body has an amazing detection system, one which alerts us to both the possibility or physical or social damage and brings our attention to the situation until we fix it. Essentially social pain and physical pain are one and the same.
The roots of this convergence are the necessity of human closeness between mother and child for human survival, particularly in the early stages of development. Pain is attention grabbing and as such experiencing pain due to social separation is potentially an adaptive response, preventing this occurrence.
The interesting thing is that social isolation and loneliness have chronic health implications and in essence loneliness can turn into a physical disease state. Risk of heart disease, cancer and Alzheimer’s all increase in the chronically lonely. Social isolation is a risk, one that our body views as a threat and drives immune system changes that lead to inflammation.
Loneliness happens to all of us in various ways at various times. Human connection not only gives us a way not to feel lonely, it also allows a sense of belonging, and based on above, helps maintain both physical and emotional health. In this TED talk Brene Brown discusses human connection, our ability to empathize, belong, love and how the power of vulnerability can help us connect more significantly and strongly.
Go outside and play! As a child I heard this refrain a lot and luckily ‘outside’ was a mountainside of bushland and green space. Spending time in nature has long been promoted as healthy but recently the concept of forest bathing has hit social media. In Japan, forest bathing, or as it is known ‘shinrin yoku’ is a recognised and promoted as therapy. Specifically it is defined as: ‘making contact with and taking in the atmosphere of the forest: a process intended to improve an individual’s state of mental and physical relaxation’ (Park et al., 2010).
While it is not surprising there is a ‘backlash’ to the rise of environmental stress from built environments, technology, artificial light exposure etc, one of the reasons we respond so positively to nature and natural environments is explained by the concept of biophilia, which proposes that we all have an innate connection and the desire to seek out nature and other forms of life (animals, plants). Children in particular are seen to be connected with and supported by nature. Lack of access to natural environments, caused largely by increasing urbanisation potentially contributes to childhood health disorders such as hyperactivity, attention deficit disorders, obesity and depression…disorders that have also been termed ‘nature-deficit disorder’.
Looking at the research, it is not just children that benefit from time in nature; there are some significant health benefits for all ages. Forest bathing has been shown to help with mood disorders, improved self-esteem and physical fitness, and a wide array of other health benefits including (references available upon request):
As you can see from point 5, time spend in nature is beneficial for all ages. Science bit – the positive effects of forest bathing are currently seen to be the result of the interplay between the nervous, endocrine and immune systems, whereby a less stressful environment encourages the parasympathetic nervous system reducing blood pressure and heart rate and reduces stress hormones to induce a relaxed state. Stress hormones inhibit immune function so the relaxed state brought indirectly acts on the immune system to improve immune resilience.
Tips for forest bathing or spending relaxing time in nature (Li, 2012):
I did a quick search of green spaces and local walks within 30km of Brisbane (my local area) and there are some great options both within Brisbane and the immediate surrounds:
So in the spirit and practice of ‘shinrin yoku’ I am off to bathe in the healing greenness of my local nature reserve.
Li, Q., 2012. Forest medicine. New York, NY: Nova Science Publishers.
Park, B.J., Tsunetsugu, Y., Kasetani, T., Kagawa, T. and Miyazaki, Y., 2010. The physiological effects of Shinrin-yoku (taking in the forest atmosphere or forest bathing): evidence from field experiments in 24 forests across Japan. Environmental health and preventive medicine, 15(1), pp.18-26.
When it comes to the management of chronic pain one of the nutrients I consider in many cases is vitamin D. The idea that there was a link between chronic pain and vitamin D levels came from a paper I read a decade ago (Faraj, 2003) outlining the relationship between non-specific low back pain and vitamin D deficiency. Since then numerous research papers have look at the association between vitamin D levels and various types of chronic pain. I have also in that time, used vitamin D in many cases as part of chronic pain treatment to help improve pain outcomes.
I am really happy to report that a recent systematic review of 19 different randomised controlled trials has been published in the journal Pain Physician supporting the use of vitamin D supplementation to reduce pain scores in those with pain conditions and further suggesting it could have a role in the overall management of chronic pain. Woohoo!
A limitation noted by the researchers of this review is that currently there isn’t enough data to identify the different doses required for pain management, and indeed I have found this to be quite individual in clinic, with some clients requiring significantly more than others. Another important consideration with treatment is establishing a baseline level before treatment because as is often the case, both too much and too little can impact on outcomes.
Supplementation of vitamin D is often necessary where pain is chronic, however, vitamin D is also known as the sunshine nutrient and time spent outside is well spent for topping up or maintaining levels. Exposure to UVB rays is required for the production of vitamin D within the skin. The length of exposure depends on skin colour, the amount of skin exposed, where you live and the time of year. To establish how long you need to spend in the sun for vitamin D production, check out this basic guide.
Due to the variation in the sun’s intensity summer is a perfect time to top up your vitamin D levels. You don’t need to get burnt to achieve this effect and in Australia we need to balance the risk of sun cancer with maintaining good levels of vitamin D. Five (fair skin) to ten minutes (darker skin) is usually enough between 10am and 3pm.
You can also get some of the vitamin D you need from food. Food sources of vitamin D include fatty fish, dairy products, liver, cheese and egg yolks.
For more information about pain management please contact me here or read about my pain management program.
Al Faraj, S. and Al Mutairi, K., 2003. Vitamin D deficiency and chronic low back pain in Saudi Arabia. Spine, 28(2), pp.177-179.
Wu, Z., Malihi, Z., Stewart, A.W., Lawes, C.M. and Scragg, R., 2016. Effect of Vitamin D Supplementation on Pain: A Systematic Review and Meta-analysis. Pain physician, 19(7), p.415.
The causes of chronic pain are many and varied but a condition I see with increasing frequently is chronic pain associated with diabetic neuropathy. This isn’t particularly surprising given the significant rise in Type 2 diabetes in Australia. Treatment usually focuses on improved blood-sugar control and nerve support with the aim of slowing progression and reducing pain however, like treating any chronic condition, improvement usually results from numerous small changes made over time. As such I was heartened to read about recent research from the University of Otago in New Zealand has shown that a short walk after meals can help lower blood sugar levels.
The study compared the blood sugar lowering effects of a 30-minute daily walk to a shorter 10-minute walk after each main meal. The effect was significant with an average blood sugar drop of 12% post meals, more so after the evening meal when most carbohydrates are consumed and people tend to be sedentary.
The potential health benefits of a post meal walk go beyond lowered blood sugar levels and may also reduce the need for total or additional meal time insulin, which in turn may lead to less insulin-associated weight gain. So the out-take of this research is take 10 minutes to go for a walk after main meals. Take family, friends or your furry loved one with you or use the time for quiet contemplation, or even time out from the work place. This is a habit worth creating and I just know my dog Ed will love an after dinner stroll each evening.
Reynolds, A.N., Mann, J.I., Williams, S. and Venn, B.J., 2016. Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study. Diabetologia, 59(12), pp.2572-2578.