Episode 12 - The Recommended Diet to Reduce Inflammation
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Episode Summary
Did you know that nutrition plays an important role in contributing to your better quality of health and overall well-being? According to research, about 700,000 deaths and 15% disability cases have a correlation to poor nutrition. It’s not just diseases, but the pain that you’re feeling right now in your back and other parts of the body may be because of high levels of inflammation. And as clinics are not operating at full-capacity with the COVID-19 pandemic still underway, you can make a difference in managing your pain with the food that you eat.
In this episode of Back Talk Doc, Dr. Sanjiv Lakhia dives deep into the anti-inflammatory diet and how it can help with pain. He debunks certain misconceptions about inflammation and the role food plays in exacerbating this condition, and affecting our body. One type of diet he highly recommends is the Mediterranean diet, which is more of a pattern and way of eating rather than specific recipes. It’s one that’s backed up by studies that have shown positive results to
Dr. Lakhia further breaks down the Mediterranean diet, and the different food groups that you can consume while following it. He further specifies the type of food you can and cannot eat, such as nuts, the type of protein, fats and carbohydrates, to name a few. You can also tweak the Mediterranean diet and make adjustments to your meal plans, for as long as you follow the basic principles it espouses.
Improving your nutrition is a great way to supplement pain management, especially if you’re already taking medicine to lower inflammation levels. If you start providing your body with good nutrition and being consistent with it, then you’re going to see the results and benefits in the long run.
Key moments in the episode
Links mentioned in the episode
Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.
Did you know that nutrition plays an important role in contributing to your better quality of health and overall well-being? According to research, about 700,000 deaths and 15% disability cases have a correlation to poor nutrition. It’s not just diseases, but the pain that you’re feeling right now in your back and other parts of the body may be because of high levels of inflammation. And as clinics are not operating at full-capacity with the COVID-19 pandemic still underway, you can make a difference in managing your pain with the food that you eat.
In this episode of Back Talk Doc, Dr. Sanjiv Lakhia dives deep into the anti-inflammatory diet and how it can help with pain. He debunks certain misconceptions about inflammation and the role food plays in exacerbating this condition, and affecting our body. One type of diet he highly recommends is the Mediterranean diet, which is more of a pattern and way of eating rather than specific recipes. It’s one that’s backed up by studies that have shown positive results to
Dr. Lakhia further breaks down the Mediterranean diet, and the different food groups that you can consume while following it. He further specifies the type of food you can and cannot eat, such as nuts, the type of protein, fats and carbohydrates, to name a few. You can also tweak the Mediterranean diet and make adjustments to your meal plans, for as long as you follow the basic principles it espouses.
Improving your nutrition is a great way to supplement pain management, especially if you’re already taking medicine to lower inflammation levels. If you start providing your body with good nutrition and being consistent with it, then you’re going to see the results and benefits in the long run.
Key moments in the episode
- Important statistics - 03:56
- The truth behind inflammation - 04:49
- How food contributes to inflammation - 05:54
- Determine existence of high levels of inflammation in your body - 06:53
- The Mediterranean diet - 08:05
- The Mediterranean diet as a pattern of eating - 09:44
- PREDIMED trial on the Mediterranean diet and cardiovascular disease - 11:07
- Debunking fats - 12:13
- On nuts - 14:09
- On carbohydrates - 15:09
- On fruits and vegetables - 16:57
- The importance of spices - 19:40
- Consumption of alcoholic beverages - 20:39
- 16 top food sources for the anti-inflammatory diet - 22:12
Links mentioned in the episode
- Back Talk education booklet
- Integrative Medicine by Dr. David Rakel
- PREDIMED trial
- What Is The Anti-Inflammatory Diet And Food Pyramid? by Dr. Andrew Weil
- 16 Top Sources for the Anti-Inflammatory Diet by Dr. Andrew Weil
Back Talk Doc is brought to you by Carolina Neurosurgery & Spine Associates, with offices in North and South Carolina. To learn more about Dr. Lakhia and treatment options for back and spine issues, go to backtalkdoc.com. To schedule an appointment with Carolina Neurosurgery & Spine Associates, you can call us at 1-800-344-6716 or visit our website at carolinaneurosurgery.com.
Intro: 00:01
Welcome. You are listening to Back Talk Doc where you'll find answers to some of the most common questions about back pain and spine health, brought to you by Carolina Neurosurgery & Spine Associates where providing personalized, highly skilled and compassionate spine care has been our specialty for over 75 years. And now it's time to understand the cause of back pain and learn about options to get you back on track. Here's your Back Talk Doc, Dr. Sanjiv Lakhia.
Dr. Sanjiv Lakhia: 00:32
Good afternoon, listeners. This is Dr. Sanjiv Lakhia here today, bring me the 12th episode of Back Talk Doc, the podcast. If you're new to the podcast, I just want to let you know that we're all about educating individuals on the best way to take care of their spine health and overall health in general, so I appreciate you taking the time today to listen to what I have to say. This is our second episode that we've recorded in the midst of the COVID-19 pandemic where the world has significantly changed and we are looking for more creative solutions on how to help take care of patients. Obviously, the clinics are operating not near capacity and if you're at home, if you're one of my patients or a patient of our group at Carolina Neurosurgery & Spine, or across the country dealing with any sort of spine pain or pain in general, I know you're scrambling a bit to figure out what to do to get you through this period of time.
Dr. Sanjiv Lakhia: 01:37
On my last episode I outlined eight of my favorite apps that you can download to your Android or iPhone that may be useful to help you manage or cope with your pain. And we went through things such as acupressure, exercise and meditation. So if you haven't had a moment to download that episode, I encourage you to do that and share it with your friends. In fact, if you've enjoyed these episodes, I'd really appreciate it if you'd go onto iTunes and leave us a positive review. And more than that though, I just want you to share with friends and family because my mission here is to help educate individuals and give them tools to alleviate some of their pain and improve their function and quality of life.
Dr. Sanjiv Lakhia: 02:22
Having said that, today I wanted to talk about a topic that I've spoken briefly on before and I have some information on this in my patient education booklet, Back Talk, which you could pick up a copy if you like, like you can get it online at backtalkdoc.com. But I always recommend to my patients the anti-inflammatory diet, it's something that I've been preaching for years and I think it'd be worthwhile taking a bit of time today to review what that exactly is. It's another tool in your tool box that everyone right now, even if you're at home and can't get out much, you still have control over what you eat to a large degree. And just making some simple choices can lead to some very, very positive results, not just for your pain but your overall health and longevity.
Dr. Sanjiv Lakhia: 03:10
So the numbers are staggering, and I want to go through some information from Dr. David Rakel, and his, textbook Integrative Medicine. He wrote a chapter on the anti-inflammatory diet. And so I'm a board certified physiatrist, I specialize in non-operative spine care, but I also have a holistic health hat that I wear. I've spent a fair amount of my career as an osteopath studying and learning about acupuncture, nutritionals, herbals, and just more holistic ways to take care of yourself. So I'm currently a fellow at the University of Arizona, Andrew Weil Center for Integrative Medicine fellowship program, and we just want to through a module on the anti-inflammatory diet, and I'm excited to share and pass along some information.
Dr. Sanjiv Lakhia: 03:56
But the numbers are staggering really based upon recent meta analysis, which is a very large analysis of groups of populations of patients, at least 700,000 deaths and almost 15% of disability is accounted for due to nutritional and dietary factors. So there's a lot of room here to make improvement in your personal health and help our society as a whole. And there's evidence, there's literature linking dietary interventions and poor nutrition to conditions such as cardiovascular disease, diabetes, asthma, depression, you name it, there's a correlation. And what I find interesting in our society is that I think most of you out there who are listening understand inflammation is somewhat of an enemy.
Dr. Sanjiv Lakhia: 04:49
Now, inflammation is a natural response to any sort of injury, but it's when it gets out of control or is sustained for too long of a time period, it can become detrimental. And I find it interesting that we understand that and we will take medications such as nonsteroidal anti-inflammatory drugs, or NSAIDs, these are ibuprofen and Aleve products, statin drugs which are typically prescribed to lower cholesterol but they also have an antiinflammatory effect. And then really on the broad end of the spectrum, biologic agents for conditions such as rheumatoid arthritis, which significantly modulate or control your inflammation by altering your immune system. We're fairly quick to utilize these medications to lower inflammation, but many don't have an understanding that the foods you eat increases inflammation. So it's like trying to put out a fire while you're still putting gasoline on it. And I think a little bit of education is going to go a long way.
Dr. Sanjiv Lakhia: 05:45
So take out your pen and paper, go ahead and take some notes, go along today. And of course, we'll detail all of this in the show notes for you to review at a later time.
Dr. Sanjiv Lakhia: 05:54
It's fairly interesting, we consume about five pounds of food per day, so if you don't think food can change how you feel, you're mistaken. There's plenty of opportunity, at least five pounds of opportunity there, with our choices. You may wonder, how does food contribute to inflammation? It has their menace amount of effect on multiple biochemical pathways in the body. You might hear terms like eicosanoids or prostoglandins or cytokines, these are all different molecules in our immune system that play a role with expressing inflammation in the body. Food also certainly affects your insulin and glucose levels, which can have a direct impact on inflammation. And of course there's genetic issues that food can affect, so it can flip the switch on and off with your genes, which then can cause some downstream effects which aren't advantageous. The good news is that with the proper food choices, you can tip the scale in your favor.
Dr. Sanjiv Lakhia: 06:53
Now, one question to ask is, do you have a situation where you have inflammation in your body that's somewhat out of control or causing you problems? Up till now, clinically, it's a bit of a guesswork in terms of using more history and physical examination. There are inflammatory blood markers that you can ask your physician to check. One of them is a hsCRP, or high sensitive CRP level, and this is sometimes checked when you're evaluating cardiovascular disease. And an hsCRP level greater than two may signal a higher cardiovascular risk.
Dr. Sanjiv Lakhia: 07:24
Now, there are other immune molecules that go up and down with our levels of inflammation such as tumor necrosis factor-alpha, interleukin six, interleukin one and some of these are more used on a research environment and not on typical blood panels. But in general I think if you have pain of any type, you can be fairly certain that there's inflammation playing a role and that is enough for me to recommend the anti-inflammatory diet. So let's talk about that.
Dr. Sanjiv Lakhia: 07:55
The anti-inflammatory diet is one that has been shown through research to lower levels of inflammation in the body. And really the staple diet is a Mediterranean diet, which is a branch of this. And it's not necessarily single recipes, but more of a philosophy on how to eat. In general, the Mediterranean diet is rich in vegetables and fruits and whole grains. A bit emphasizes nuts and olive oil as a primary source of fat. And there's also strong recommendations for legumes, lean poultry and fish rather than as much red meat. If you look at the Mediterranean diet pyramid, and we'll put a link to that on drweil.com, Andrew Weil, and he's put together a lot of information, and it's really - some have praised this style of eating for several decades now. But he has a good graphic, a good pyramid we can link to.
Dr. Sanjiv Lakhia: 08:51
But first of all, the base of the pyramid involves physical activity and good social activities, eating with others too and taking your time. And those factors really are important to improving your digestion and health. But as you go up the pyramid, the main base of the pyramid is made up of fresh fruits and vegetables with whole grains, beans, nuts, legumes, seeds, herbs and spices. And then moving up the pyramid, the next category is your meats and that's largely made up of fish and seafood, with some poultry or chicken and minimal red meat. Above that then to a lesser amount, eggs, cheese, yogurt. And you can have that daily to weekly. And at the tip of the pyramid is your red meat and a little bit of sweet such as dark chocolate. And of course, you can have red wine in moderation and plenty and plenty of water. That's very, very important.
Dr. Sanjiv Lakhia: 09:44
Now the Mediterranean diet, as I said, is a pattern of eating. It's not really a collection of specific recipes. Now, there are dozens and dozens of recipe cookbooks on the market now, but if you understand the basic principles, you can design your own meal plan and food plans rather effectively.
Dr. Sanjiv Lakhia: 10:01
Now this whole concept of how you eat with the Mediterranean diet can be adopted to other cultures such as Indian or Japanese for example. Instead of having quinoa, as you would in the Mediterranean diet, you might substitute that for brown rice if you're on more of an Asian food plan and Saki instead of red wine. So there are definite ways to modify it for your culture.
Dr. Sanjiv Lakhia: 10:26
The original Mediterranean diet recommends four or more servings of vegetables a day, one or more serving of legumes, three or more servings of fruit, one or more servings of nut and seed per week, one or more servings of whole grains per day, about four servings of fish a week. And then more unsaturated fats such as all of oiled and saturated fats like butter. And then alcohol in moderation about a glass a day for men, half a glass or one drink a day for women. And typically, that's red wine. In terms of red meat and processed meat, you should keep that under one or two servings a week if you want to stay true to the Mediterranean anti-inflammatory food plan.
Dr. Sanjiv Lakhia: 11:07
There's a lot of research supporting this style of eating. The hallmark trial was a PREDIMED trial, that's P-R-E-D-I-M-E-D, and we can link to that as well in the show notes, is a very large randomized controlled trial that assessed the impact of the Mediterranean diet on cardiovascular disease. And it really showed that patients who are more adherent to that type of food plan significantly reduced their rate of cardiovascular disease and mortality. So it's well-researched. That's why I like it.
Dr. Sanjiv Lakhia: 11:37
There are many options on how to eat. I myself did vegan for almost two years, I've tried keto for a little bit, and I just found the Mediterranean diet to have the best combination of scientific research and health benefits, along with practicality from cooking at home to socialization. So I think it hits the sweet spot for me personally and that's why I recommend it to patients because a food plan is no good if you can't comply with it or adhere to it. And I think the Mediterranean diet checks most of the boxes.
Dr. Sanjiv Lakhia: 12:13
If you look at the traditional Mediterranean diet, there's a fairly large component of fat that is obtained from fatty fish and olive oil. So as you get into the whole debate about how much fat you should eat, I think you should understand a little bit about fats. Fats can be broken down in saturated fats, mono and saturated fats and polyunsaturated fats. And not to get too much into the weeds of the biochemistry, it just deals with the degree of double bonds on the carbon chain. But examples of saturated fat include animal fats like meat, butter and cheese, along with tropical oils like coconut and palm oil. Now, coconut oil is more of a shorter chain saturated fat and your body can metabolize it more on a carbohydrate type manner, so there is some potential benefit. Mono and saturated fats are dominantly in this diet, come from olive oil, nuts and avocados. And there's really terrific research, particularly on olive oil. It has a high level of polyphenols like linoleic acid and oleo canthal, which is an anti-inflammatory type of polyphenol. Polyphenols are molecules within foods that really help promote health regulation and are important for lowering cancer risk and lowering inflammation. They're just fantastic ingredients in your food that you want to have in your diet.
Dr. Sanjiv Lakhia: 13:33
Polyunsaturated fats, so particularly the omega-6 fatty acids are somewhat questionable for your health. This comes from things like corn oil, vegetable oils, canola oil. You have to be careful. In this country, there's much more predominance of omega-6 fatty acids versus omega-3 fatty acids in the standard American diet, so you want to flip the ratio a little bit. And you can do that in this food plan by eating freshwater fish, using olive oil and really staying away from fried foods which have a lot of trans fats in them and high levels of saturated fat.
Dr. Sanjiv Lakhia: 14:09
As we go through the Mediterranean food plan, I want to speak a little bit about nuts. Nuts, I've heard for years, people are told eat nuts, but be careful, it's going to cause weight gain too many calories. And I have never seen anyone become obese eating nuts. In fact, if you switch out all the processed food in your diet and eat nuts to your heart's content, I think you're going to come out doing really well in the end. So nuts are a rich source of monounsaturated and polyunsaturated fats. They provide fiber and minerals and other nutrients. And there's really good research, again, demonstrating their positive health benefits, research demonstrating that they can reduce CRP, interleukin six and other inflammatory chemicals. Again, in the PREDIMED study, the finding suggests that consuming just three servings of nuts per week can reduce all-cause mortality by 39%. Think about that. Three servings of nuts per week reduces your risk of death by almost 40%. Talk about a safe and healthy and cheap intervention, I just gave it to you.
Dr. Sanjiv Lakhia: 15:09
Carbohydrates have a lot of controversy around them, and in the Mediterranean diet you do eat carbs. This is not a necessarily a low carb diet, but it's the type of carbs that really matter when you're making your food choices. So in the Mediterranean diet you want to look at whole grain carbohydrates. And whole wheat bread is not a form of a whole grain. Whole wheat bread is basically processed grains, processed flour, and it rapidly spikes your blood sugar and insulin almost equivalent to the response your sugar would have if you drink a can of Coke. But you want to get whole fiber where the bran is intact and the bran has a coating around the seed and it contains the fiber and the B vitamins and minerals. Within it is the germ and then you have endosperm. So these are all nutritional powerhouses. And because you have the coding on the whole grain, when you have a whole grain, your blood sugar spike will be much less. It will be much slower and more spread out over time.
Dr. Sanjiv Lakhia: 16:11
So foods that can offer you this would be quinoa, steel-cut oats, buckwheat. And if you haven't tried any of these, I encourage you to go ahead and get some from your local grocery store that ... These steel-cut oats, it's very simple to make. I make mine for my kids in our instant pot and they love it. It's delicious. You can really doctor it up with plenty of nuts and seeds and low-glycemic berries and it's a terrific way to start your day. So I encourage you to research yourself more about whole grains, it's a big part of the anti-inflammatory diet. And again with carbohydrates it's more of the type than carbs themselves. You also get a tremendous amount of carbohydrates on this food plan from your fruits and vegetables.
Dr. Sanjiv Lakhia: 16:57
In terms of fruits and vegetables, on a Mediterranean food plan, it's encouraged to eat almost a rainbow pattern on your plates, so colorful, vibrant looking vegetables, very healthy for you. They contain a lot of what we call phytochemicals or phytonutrients, which lower cancer risk, lower inflammation, reduce cholesterol, improve your energy, improve your gut microbiome, which is the balance of good and bad bugs within your digestive tract and over all, they just make you healthier. So in particular, I recommend the green leafy vegetables like kale, Swiss chard. So these are ones that you would find in the produce section. Typically, I'd recommend organic. If you go back to one of our original episodes, we went over the dirty dozen of fruits and vegetables, which is a list that describes their toxicity from pesticide and chemical exposures. So you want to try and get organic when you can or even from your farmer's market.
Dr. Sanjiv Lakhia: 17:57
But there are certainly numerous vegetables ... I mean, you can make so many recipes, radishes, bell peppers. Now, peppers can be a part of this diet. And orange, yellow and red and green peppers, they're very rich in vitamin C and really provide flavor to your salads. I myself, I'm not a chef. I don't claim to be one, but I really have failed to find a group of vegetables that I can't make taste decent when I saw sauté it with a little bit of olive oil, add in some garlic and ginger, and maybe a little bit of low sodium soy sauce or Bragg's Liquid Aminos. You can even use some miso, miso paste in your sauté. So for example, this weekend in my Instapot I did a half a cup of quinoa, chopped up some leftover cilantro with kale, I also had some orange and yellow peppers that were about to go bad and I put those in, and then sprinkled in some mushrooms.
Dr. Sanjiv Lakhia: 18:52
Now mushrooms, we could do a whole episode on mushrooms, but mushrooms such as shiitake mushrooms, maitake mushrooms, they have tremendous immune benefits, so feel free to buy some of those and throw those into your stir fry. So I put that in, cook it for a couple of minutes in the Instapot, take it out, sprinkle some olive oil and some Bragg's Liquid Aminos, add in some pickled ginger and garlic, and there you go. If you want to increase the protein level, you can chop up some tempeh. Tempeh is a very, very healthy nutritional form of whole soy and it provides increased protein levels, particularly if you're on a plant based diet. Tempeh can be a lifesaver for you. So just get creative. There are certainly numerous recipes, YouTube channels, cookbooks out there that you should explore and figure out what works for you.
Dr. Sanjiv Lakhia: 19:40
The other part of the anti-inflammatory diet which I think is sometimes neglected is spices. We all have a rack of spices in our pantry and I would guess that many people don't really use those very much. Turmeric is a staple in the anti-inflammatory diet. It's the yellow, orangey spice that you'll see in traditional Indian dishes like chicken curry. The main ingredient is curcumin, although there's multiple other phytochemicals in turmeric that provide a variety of inflammatory benefit. Clinical trials have been done on curcumin showing an equivalent pain relief to ibuprofen and diclofenac for knee arthritis, it's been studied on rheumatoid arthritis as well, and it has a long track record of culinary use with excellent side effect profile. When I'm asked by my patients, I always encourage them to try and use it in their food versus supplement form. Turmeric though does have a bit of a problem with absorption, so you want to add it with some degree of fat. And black pepper can enhance the absorption systemically.
Dr. Sanjiv Lakhia: 20:39
One question that comes up on this food plan is alcohol usage. Excessive alcohol consumption is never recommended, but I think it's fine to consume red wine. Red wine is rich in polyphenols. That's basically what gives it the color. It's the red coloring or the coloring on the grape that is processed into wine. And again, polyphenols have antiinflammatory effects and health benefits. I think largely the research shows a positive effect of a small amount of daily wine intake or a periodic red wine intake on this food plan, probably more so than white wine.
Dr. Sanjiv Lakhia: 21:15
But again, other things, again, getting back to the spices, ginger, oregano, basil, thyme, rosemary, they all have antiinflammatory properties. You can grow these in your own garden, you can get them dried and bottled as something to add in your spice rack. But use those when you're thinking of reaching for salt, reach for some spices instead. You'll likely find the dish tastes even better without the negative effects.
Dr. Sanjiv Lakhia: 21:42
So that's a pretty good breakdown of the Mediterranean diet or the antiinflammatory diet. Again, there's research showing its benefit with so many conditions ranging from arthritis, to Alzheimer's, psoriasis, depression, inflammatory bowel disease. So do your own research, but this is a really good fundamental food plan. And then for your specific conditions, you can certainly adopt and customize for your own specific needs.
Dr. Sanjiv Lakhia: 22:12
What I'd like to do now for you is really go through an article that was on drweil.com where he went through the 16 top sources for the anti-inflammatory diet. This is going to give you a list of how much of each category to eat and what are some healthy choices. We touched on some of this before but let's give you some more details.
Dr. Sanjiv Lakhia: 22:33
The first category was the healthy sweets. Again, this is something you're going to do sparingly, maybe a couple times a week, predominantly from dark chocolate, unsweetened dried fruit and fruit sorbet. Dark chocolate provides polyphenols and antioxidant activity and you want to choose at least 70% pure cacao. And you can have that a few times a week, let's say a few ounces. And I would look at fruit sorbet over ice cream.
Dr. Sanjiv Lakhia: 22:59
Alcohol is the next category, and the primary choice here would be red wine. If you're really following the Mediterranean diet, no more than one or two glasses per day for men and half to one glass a day for women. Red wine is preferential because the red color is rich in polyphenols, resveratrol and antioxidant activity, so it's the color that gives it the power and the health benefit. Therefore, red wine would be slightly more beneficial for you than white wine. If you don't drink alcohol, I don't recommend you start, but if you do, then I would look at wine as a good option on this food plan.
Dr. Sanjiv Lakhia: 23:38
Other beverage sources, tea, I really am a big fan of tea, particular green tea, white tea, oolong teas, teas are rich in antioxidant compounds that lower your inflammation. You want to look for some high quality teas and sample and see what you like. Now, don't over sweeten the tea with too much honey or artificial sweeteners, you'll ruin the benefit. Tea does have a degree of caffeine in it, less than coffee.
Dr. Sanjiv Lakhia: 24:04
Now, if you're wondering about coffee, I'm not against coffee, I think there's good literature on the health benefits of coffee, but what I am against is what goes in most people's coffee. If you're out there and you love Starbucks, if my parents are listening, that's them and they have to have their Starbucks and that's okay, but you have to understand that when you order coffee and then you put in the coffee a large amount of cream and sugar with high fructose corn syrup-based sweeteners followed by some whipped cream, you're no longer drinking coffee. You're essentially drinking a dessert and you should treat it as such. It's going to have pretty significant effect on inflammation levels in your body. So I myself prefer a little bit of green tea throughout the day.
Dr. Sanjiv Lakhia: 24:50
We touched a bit on protein sources. Again, part of this also may include eggs on the anti-inflammatory diet. Eggs are recommended. Now, they need to be high quality, omega-3 enriched eggs. If you can get them from an organic source, free range, chickens, it's preferable. And then the other sources of proteins is going to be your beans or legumes, which you can wash or gently cook, meats, your fish and a little bit of chicken with minimal red meat. So you want to have one to two servings a week of cheese, egg or dairy, and then diversify from your legumes and your meats.
Dr. Sanjiv Lakhia: 25:33
Whole soy foods can be on this food plan, one to two servings per day. One serving is equal to about half a cup of tofu or tempeh, one cup of soy milk or half a cup of cooked edamame, or one ounce of soy nuts. Edamame is a really nice snack to have on. And you can cook that, sprinkle some sea salt on it and it's very healthy for you. Soy foods contain isoflavones and they have antioxidant activity and are protective against most cancers, so make sure that you choose whole soy foods over fractionated foods like isolated soy protein powders and imitation meats, maybe with soy isolate. I am not a fan of the imitation meat products on the market. Most of them are loaded with a high amounts of coconut oil, which is a big source of saturated fat, which could be a problem for you. And the rest of the ingredients, if I can't pronounce what's on the label, I just don't want to put it in my body.
Dr. Sanjiv Lakhia: 26:29
Moving on again to fats. You want to have about five to seven servings per day, so one serving is equal to about one teaspoon of olive oil, two walnuts, a tablespoon of flax seed or one ounce of avocado. My primary cooking oil is extra virgin olive oil. I also use avocado oil as well. We try and cook on a low temperature so you don't oxidize the oils. Again, you want to choose healthy fats that are rich in either mono and saturated or omega-3 fats.
Dr. Sanjiv Lakhia: 26:58
In terms of your whole grains, your options there are going to be your brown rice, your basmati rice or wild rice, buckwheat groats, quinoa, Barley's steel-cut oats, about three servings per day. And a serving is equal to about half a cup of cooked grains. The whole grains, again, as we said before, digest slowly so you reduce the spike in your blood sugar that, for example, you would get from white rice. Remember, whole grain means the grain is intact, so it should have some texture to it. More specifically with beans and legumes, there's multiple choices. Beans like not anasazi, adzuki and black, as well as chickpeas, black-eyed peas and lentils. If that sounds very complicated, you can just eat some hummus and you will do just fine. You can have some black bean soup or some lentil soup. Beans are rich in folic acid, magnesium, potassium and soluble fiber, which is really good for your gastrointestinal track and your gut microbiome.
Dr. Sanjiv Lakhia: 27:56
And then rounding it out, I would say the vegetables I think we've covered before, look for dark leafy greens like spinach, collard, kale and Swiss chard, cruciferous vegetables are excellent, broccoli, cauliflower, Brussels sprouts, bok choy. And I've been cooking a lot of bok choy lately, it has a really nice taste to it.
Dr. Sanjiv Lakhia: 28:16
And then the fruits. The one comment I would make on the fruit, try and pick low-glycemic index fruits such as raspberries, blueberries, strawberries, apples, cherries, pears. And fruits are rich in flavonoids and carotinoids, which again, antioxidant, anti-inflammatory powerhouses.
Dr. Sanjiv Lakhia: 28:34
And don't forget, lastly, plenty of water throughout the day. You want to drink pure water, filtered water if you can, and make sure you're drinking throughout the day. Stay well hydrated.
Dr. Sanjiv Lakhia: 28:45
So there you have it. That's a really good rundown of the anti-inflammatory food plan, Mediterranean food plan. It's something that has been researched for quite some time now. It's used at multiple hospitals across the country as a primary food plan through their cardiovascular programs. I think it's practical for most of you listeners, it's going to reduce inflammation in your body and it will help with your pain. And what I like to say is that eating well, eating high quality food, it's like putting down good fertilizer on your lawn. If you put an application of fertilizer, you don't expect a green grass the next day, but if you continue to put the fertilizer down, over the course of seasons, I promise you that lawn will turn green and look healthy. It's the same way with eating well. If you're in pain and you're listening to this podcast, if you start eating broccoli tomorrow and olive oil in your diet, well it's possible you could feel immediate results, chances are it's going to take some time to notice the benefits, but I encourage you to stick with it. It's well worth the long-term benefits and it will pay dividends in the long run.
Dr. Sanjiv Lakhia: 29:51
So take care of yourself, try need healthy and take care of your back. And I look forward to speaking with you on further episodes.
Outro: 29:59
Thank you for listening to this episode of Back Talk Doc brought to you by Carolina neurosurgery and spine associates with offices in North and South Carolina. If you'd like to learn more about Dr Lakhia and treatment options for back issues, go to backtalkdoc.com we look forward to having you join us for more insights about back pain and spine health on the next episode of Back Talk Doc. Additional information is also available at carolinaneurosurgery.com.
Welcome. You are listening to Back Talk Doc where you'll find answers to some of the most common questions about back pain and spine health, brought to you by Carolina Neurosurgery & Spine Associates where providing personalized, highly skilled and compassionate spine care has been our specialty for over 75 years. And now it's time to understand the cause of back pain and learn about options to get you back on track. Here's your Back Talk Doc, Dr. Sanjiv Lakhia.
Dr. Sanjiv Lakhia: 00:32
Good afternoon, listeners. This is Dr. Sanjiv Lakhia here today, bring me the 12th episode of Back Talk Doc, the podcast. If you're new to the podcast, I just want to let you know that we're all about educating individuals on the best way to take care of their spine health and overall health in general, so I appreciate you taking the time today to listen to what I have to say. This is our second episode that we've recorded in the midst of the COVID-19 pandemic where the world has significantly changed and we are looking for more creative solutions on how to help take care of patients. Obviously, the clinics are operating not near capacity and if you're at home, if you're one of my patients or a patient of our group at Carolina Neurosurgery & Spine, or across the country dealing with any sort of spine pain or pain in general, I know you're scrambling a bit to figure out what to do to get you through this period of time.
Dr. Sanjiv Lakhia: 01:37
On my last episode I outlined eight of my favorite apps that you can download to your Android or iPhone that may be useful to help you manage or cope with your pain. And we went through things such as acupressure, exercise and meditation. So if you haven't had a moment to download that episode, I encourage you to do that and share it with your friends. In fact, if you've enjoyed these episodes, I'd really appreciate it if you'd go onto iTunes and leave us a positive review. And more than that though, I just want you to share with friends and family because my mission here is to help educate individuals and give them tools to alleviate some of their pain and improve their function and quality of life.
Dr. Sanjiv Lakhia: 02:22
Having said that, today I wanted to talk about a topic that I've spoken briefly on before and I have some information on this in my patient education booklet, Back Talk, which you could pick up a copy if you like, like you can get it online at backtalkdoc.com. But I always recommend to my patients the anti-inflammatory diet, it's something that I've been preaching for years and I think it'd be worthwhile taking a bit of time today to review what that exactly is. It's another tool in your tool box that everyone right now, even if you're at home and can't get out much, you still have control over what you eat to a large degree. And just making some simple choices can lead to some very, very positive results, not just for your pain but your overall health and longevity.
Dr. Sanjiv Lakhia: 03:10
So the numbers are staggering, and I want to go through some information from Dr. David Rakel, and his, textbook Integrative Medicine. He wrote a chapter on the anti-inflammatory diet. And so I'm a board certified physiatrist, I specialize in non-operative spine care, but I also have a holistic health hat that I wear. I've spent a fair amount of my career as an osteopath studying and learning about acupuncture, nutritionals, herbals, and just more holistic ways to take care of yourself. So I'm currently a fellow at the University of Arizona, Andrew Weil Center for Integrative Medicine fellowship program, and we just want to through a module on the anti-inflammatory diet, and I'm excited to share and pass along some information.
Dr. Sanjiv Lakhia: 03:56
But the numbers are staggering really based upon recent meta analysis, which is a very large analysis of groups of populations of patients, at least 700,000 deaths and almost 15% of disability is accounted for due to nutritional and dietary factors. So there's a lot of room here to make improvement in your personal health and help our society as a whole. And there's evidence, there's literature linking dietary interventions and poor nutrition to conditions such as cardiovascular disease, diabetes, asthma, depression, you name it, there's a correlation. And what I find interesting in our society is that I think most of you out there who are listening understand inflammation is somewhat of an enemy.
Dr. Sanjiv Lakhia: 04:49
Now, inflammation is a natural response to any sort of injury, but it's when it gets out of control or is sustained for too long of a time period, it can become detrimental. And I find it interesting that we understand that and we will take medications such as nonsteroidal anti-inflammatory drugs, or NSAIDs, these are ibuprofen and Aleve products, statin drugs which are typically prescribed to lower cholesterol but they also have an antiinflammatory effect. And then really on the broad end of the spectrum, biologic agents for conditions such as rheumatoid arthritis, which significantly modulate or control your inflammation by altering your immune system. We're fairly quick to utilize these medications to lower inflammation, but many don't have an understanding that the foods you eat increases inflammation. So it's like trying to put out a fire while you're still putting gasoline on it. And I think a little bit of education is going to go a long way.
Dr. Sanjiv Lakhia: 05:45
So take out your pen and paper, go ahead and take some notes, go along today. And of course, we'll detail all of this in the show notes for you to review at a later time.
Dr. Sanjiv Lakhia: 05:54
It's fairly interesting, we consume about five pounds of food per day, so if you don't think food can change how you feel, you're mistaken. There's plenty of opportunity, at least five pounds of opportunity there, with our choices. You may wonder, how does food contribute to inflammation? It has their menace amount of effect on multiple biochemical pathways in the body. You might hear terms like eicosanoids or prostoglandins or cytokines, these are all different molecules in our immune system that play a role with expressing inflammation in the body. Food also certainly affects your insulin and glucose levels, which can have a direct impact on inflammation. And of course there's genetic issues that food can affect, so it can flip the switch on and off with your genes, which then can cause some downstream effects which aren't advantageous. The good news is that with the proper food choices, you can tip the scale in your favor.
Dr. Sanjiv Lakhia: 06:53
Now, one question to ask is, do you have a situation where you have inflammation in your body that's somewhat out of control or causing you problems? Up till now, clinically, it's a bit of a guesswork in terms of using more history and physical examination. There are inflammatory blood markers that you can ask your physician to check. One of them is a hsCRP, or high sensitive CRP level, and this is sometimes checked when you're evaluating cardiovascular disease. And an hsCRP level greater than two may signal a higher cardiovascular risk.
Dr. Sanjiv Lakhia: 07:24
Now, there are other immune molecules that go up and down with our levels of inflammation such as tumor necrosis factor-alpha, interleukin six, interleukin one and some of these are more used on a research environment and not on typical blood panels. But in general I think if you have pain of any type, you can be fairly certain that there's inflammation playing a role and that is enough for me to recommend the anti-inflammatory diet. So let's talk about that.
Dr. Sanjiv Lakhia: 07:55
The anti-inflammatory diet is one that has been shown through research to lower levels of inflammation in the body. And really the staple diet is a Mediterranean diet, which is a branch of this. And it's not necessarily single recipes, but more of a philosophy on how to eat. In general, the Mediterranean diet is rich in vegetables and fruits and whole grains. A bit emphasizes nuts and olive oil as a primary source of fat. And there's also strong recommendations for legumes, lean poultry and fish rather than as much red meat. If you look at the Mediterranean diet pyramid, and we'll put a link to that on drweil.com, Andrew Weil, and he's put together a lot of information, and it's really - some have praised this style of eating for several decades now. But he has a good graphic, a good pyramid we can link to.
Dr. Sanjiv Lakhia: 08:51
But first of all, the base of the pyramid involves physical activity and good social activities, eating with others too and taking your time. And those factors really are important to improving your digestion and health. But as you go up the pyramid, the main base of the pyramid is made up of fresh fruits and vegetables with whole grains, beans, nuts, legumes, seeds, herbs and spices. And then moving up the pyramid, the next category is your meats and that's largely made up of fish and seafood, with some poultry or chicken and minimal red meat. Above that then to a lesser amount, eggs, cheese, yogurt. And you can have that daily to weekly. And at the tip of the pyramid is your red meat and a little bit of sweet such as dark chocolate. And of course, you can have red wine in moderation and plenty and plenty of water. That's very, very important.
Dr. Sanjiv Lakhia: 09:44
Now the Mediterranean diet, as I said, is a pattern of eating. It's not really a collection of specific recipes. Now, there are dozens and dozens of recipe cookbooks on the market now, but if you understand the basic principles, you can design your own meal plan and food plans rather effectively.
Dr. Sanjiv Lakhia: 10:01
Now this whole concept of how you eat with the Mediterranean diet can be adopted to other cultures such as Indian or Japanese for example. Instead of having quinoa, as you would in the Mediterranean diet, you might substitute that for brown rice if you're on more of an Asian food plan and Saki instead of red wine. So there are definite ways to modify it for your culture.
Dr. Sanjiv Lakhia: 10:26
The original Mediterranean diet recommends four or more servings of vegetables a day, one or more serving of legumes, three or more servings of fruit, one or more servings of nut and seed per week, one or more servings of whole grains per day, about four servings of fish a week. And then more unsaturated fats such as all of oiled and saturated fats like butter. And then alcohol in moderation about a glass a day for men, half a glass or one drink a day for women. And typically, that's red wine. In terms of red meat and processed meat, you should keep that under one or two servings a week if you want to stay true to the Mediterranean anti-inflammatory food plan.
Dr. Sanjiv Lakhia: 11:07
There's a lot of research supporting this style of eating. The hallmark trial was a PREDIMED trial, that's P-R-E-D-I-M-E-D, and we can link to that as well in the show notes, is a very large randomized controlled trial that assessed the impact of the Mediterranean diet on cardiovascular disease. And it really showed that patients who are more adherent to that type of food plan significantly reduced their rate of cardiovascular disease and mortality. So it's well-researched. That's why I like it.
Dr. Sanjiv Lakhia: 11:37
There are many options on how to eat. I myself did vegan for almost two years, I've tried keto for a little bit, and I just found the Mediterranean diet to have the best combination of scientific research and health benefits, along with practicality from cooking at home to socialization. So I think it hits the sweet spot for me personally and that's why I recommend it to patients because a food plan is no good if you can't comply with it or adhere to it. And I think the Mediterranean diet checks most of the boxes.
Dr. Sanjiv Lakhia: 12:13
If you look at the traditional Mediterranean diet, there's a fairly large component of fat that is obtained from fatty fish and olive oil. So as you get into the whole debate about how much fat you should eat, I think you should understand a little bit about fats. Fats can be broken down in saturated fats, mono and saturated fats and polyunsaturated fats. And not to get too much into the weeds of the biochemistry, it just deals with the degree of double bonds on the carbon chain. But examples of saturated fat include animal fats like meat, butter and cheese, along with tropical oils like coconut and palm oil. Now, coconut oil is more of a shorter chain saturated fat and your body can metabolize it more on a carbohydrate type manner, so there is some potential benefit. Mono and saturated fats are dominantly in this diet, come from olive oil, nuts and avocados. And there's really terrific research, particularly on olive oil. It has a high level of polyphenols like linoleic acid and oleo canthal, which is an anti-inflammatory type of polyphenol. Polyphenols are molecules within foods that really help promote health regulation and are important for lowering cancer risk and lowering inflammation. They're just fantastic ingredients in your food that you want to have in your diet.
Dr. Sanjiv Lakhia: 13:33
Polyunsaturated fats, so particularly the omega-6 fatty acids are somewhat questionable for your health. This comes from things like corn oil, vegetable oils, canola oil. You have to be careful. In this country, there's much more predominance of omega-6 fatty acids versus omega-3 fatty acids in the standard American diet, so you want to flip the ratio a little bit. And you can do that in this food plan by eating freshwater fish, using olive oil and really staying away from fried foods which have a lot of trans fats in them and high levels of saturated fat.
Dr. Sanjiv Lakhia: 14:09
As we go through the Mediterranean food plan, I want to speak a little bit about nuts. Nuts, I've heard for years, people are told eat nuts, but be careful, it's going to cause weight gain too many calories. And I have never seen anyone become obese eating nuts. In fact, if you switch out all the processed food in your diet and eat nuts to your heart's content, I think you're going to come out doing really well in the end. So nuts are a rich source of monounsaturated and polyunsaturated fats. They provide fiber and minerals and other nutrients. And there's really good research, again, demonstrating their positive health benefits, research demonstrating that they can reduce CRP, interleukin six and other inflammatory chemicals. Again, in the PREDIMED study, the finding suggests that consuming just three servings of nuts per week can reduce all-cause mortality by 39%. Think about that. Three servings of nuts per week reduces your risk of death by almost 40%. Talk about a safe and healthy and cheap intervention, I just gave it to you.
Dr. Sanjiv Lakhia: 15:09
Carbohydrates have a lot of controversy around them, and in the Mediterranean diet you do eat carbs. This is not a necessarily a low carb diet, but it's the type of carbs that really matter when you're making your food choices. So in the Mediterranean diet you want to look at whole grain carbohydrates. And whole wheat bread is not a form of a whole grain. Whole wheat bread is basically processed grains, processed flour, and it rapidly spikes your blood sugar and insulin almost equivalent to the response your sugar would have if you drink a can of Coke. But you want to get whole fiber where the bran is intact and the bran has a coating around the seed and it contains the fiber and the B vitamins and minerals. Within it is the germ and then you have endosperm. So these are all nutritional powerhouses. And because you have the coding on the whole grain, when you have a whole grain, your blood sugar spike will be much less. It will be much slower and more spread out over time.
Dr. Sanjiv Lakhia: 16:11
So foods that can offer you this would be quinoa, steel-cut oats, buckwheat. And if you haven't tried any of these, I encourage you to go ahead and get some from your local grocery store that ... These steel-cut oats, it's very simple to make. I make mine for my kids in our instant pot and they love it. It's delicious. You can really doctor it up with plenty of nuts and seeds and low-glycemic berries and it's a terrific way to start your day. So I encourage you to research yourself more about whole grains, it's a big part of the anti-inflammatory diet. And again with carbohydrates it's more of the type than carbs themselves. You also get a tremendous amount of carbohydrates on this food plan from your fruits and vegetables.
Dr. Sanjiv Lakhia: 16:57
In terms of fruits and vegetables, on a Mediterranean food plan, it's encouraged to eat almost a rainbow pattern on your plates, so colorful, vibrant looking vegetables, very healthy for you. They contain a lot of what we call phytochemicals or phytonutrients, which lower cancer risk, lower inflammation, reduce cholesterol, improve your energy, improve your gut microbiome, which is the balance of good and bad bugs within your digestive tract and over all, they just make you healthier. So in particular, I recommend the green leafy vegetables like kale, Swiss chard. So these are ones that you would find in the produce section. Typically, I'd recommend organic. If you go back to one of our original episodes, we went over the dirty dozen of fruits and vegetables, which is a list that describes their toxicity from pesticide and chemical exposures. So you want to try and get organic when you can or even from your farmer's market.
Dr. Sanjiv Lakhia: 17:57
But there are certainly numerous vegetables ... I mean, you can make so many recipes, radishes, bell peppers. Now, peppers can be a part of this diet. And orange, yellow and red and green peppers, they're very rich in vitamin C and really provide flavor to your salads. I myself, I'm not a chef. I don't claim to be one, but I really have failed to find a group of vegetables that I can't make taste decent when I saw sauté it with a little bit of olive oil, add in some garlic and ginger, and maybe a little bit of low sodium soy sauce or Bragg's Liquid Aminos. You can even use some miso, miso paste in your sauté. So for example, this weekend in my Instapot I did a half a cup of quinoa, chopped up some leftover cilantro with kale, I also had some orange and yellow peppers that were about to go bad and I put those in, and then sprinkled in some mushrooms.
Dr. Sanjiv Lakhia: 18:52
Now mushrooms, we could do a whole episode on mushrooms, but mushrooms such as shiitake mushrooms, maitake mushrooms, they have tremendous immune benefits, so feel free to buy some of those and throw those into your stir fry. So I put that in, cook it for a couple of minutes in the Instapot, take it out, sprinkle some olive oil and some Bragg's Liquid Aminos, add in some pickled ginger and garlic, and there you go. If you want to increase the protein level, you can chop up some tempeh. Tempeh is a very, very healthy nutritional form of whole soy and it provides increased protein levels, particularly if you're on a plant based diet. Tempeh can be a lifesaver for you. So just get creative. There are certainly numerous recipes, YouTube channels, cookbooks out there that you should explore and figure out what works for you.
Dr. Sanjiv Lakhia: 19:40
The other part of the anti-inflammatory diet which I think is sometimes neglected is spices. We all have a rack of spices in our pantry and I would guess that many people don't really use those very much. Turmeric is a staple in the anti-inflammatory diet. It's the yellow, orangey spice that you'll see in traditional Indian dishes like chicken curry. The main ingredient is curcumin, although there's multiple other phytochemicals in turmeric that provide a variety of inflammatory benefit. Clinical trials have been done on curcumin showing an equivalent pain relief to ibuprofen and diclofenac for knee arthritis, it's been studied on rheumatoid arthritis as well, and it has a long track record of culinary use with excellent side effect profile. When I'm asked by my patients, I always encourage them to try and use it in their food versus supplement form. Turmeric though does have a bit of a problem with absorption, so you want to add it with some degree of fat. And black pepper can enhance the absorption systemically.
Dr. Sanjiv Lakhia: 20:39
One question that comes up on this food plan is alcohol usage. Excessive alcohol consumption is never recommended, but I think it's fine to consume red wine. Red wine is rich in polyphenols. That's basically what gives it the color. It's the red coloring or the coloring on the grape that is processed into wine. And again, polyphenols have antiinflammatory effects and health benefits. I think largely the research shows a positive effect of a small amount of daily wine intake or a periodic red wine intake on this food plan, probably more so than white wine.
Dr. Sanjiv Lakhia: 21:15
But again, other things, again, getting back to the spices, ginger, oregano, basil, thyme, rosemary, they all have antiinflammatory properties. You can grow these in your own garden, you can get them dried and bottled as something to add in your spice rack. But use those when you're thinking of reaching for salt, reach for some spices instead. You'll likely find the dish tastes even better without the negative effects.
Dr. Sanjiv Lakhia: 21:42
So that's a pretty good breakdown of the Mediterranean diet or the antiinflammatory diet. Again, there's research showing its benefit with so many conditions ranging from arthritis, to Alzheimer's, psoriasis, depression, inflammatory bowel disease. So do your own research, but this is a really good fundamental food plan. And then for your specific conditions, you can certainly adopt and customize for your own specific needs.
Dr. Sanjiv Lakhia: 22:12
What I'd like to do now for you is really go through an article that was on drweil.com where he went through the 16 top sources for the anti-inflammatory diet. This is going to give you a list of how much of each category to eat and what are some healthy choices. We touched on some of this before but let's give you some more details.
Dr. Sanjiv Lakhia: 22:33
The first category was the healthy sweets. Again, this is something you're going to do sparingly, maybe a couple times a week, predominantly from dark chocolate, unsweetened dried fruit and fruit sorbet. Dark chocolate provides polyphenols and antioxidant activity and you want to choose at least 70% pure cacao. And you can have that a few times a week, let's say a few ounces. And I would look at fruit sorbet over ice cream.
Dr. Sanjiv Lakhia: 22:59
Alcohol is the next category, and the primary choice here would be red wine. If you're really following the Mediterranean diet, no more than one or two glasses per day for men and half to one glass a day for women. Red wine is preferential because the red color is rich in polyphenols, resveratrol and antioxidant activity, so it's the color that gives it the power and the health benefit. Therefore, red wine would be slightly more beneficial for you than white wine. If you don't drink alcohol, I don't recommend you start, but if you do, then I would look at wine as a good option on this food plan.
Dr. Sanjiv Lakhia: 23:38
Other beverage sources, tea, I really am a big fan of tea, particular green tea, white tea, oolong teas, teas are rich in antioxidant compounds that lower your inflammation. You want to look for some high quality teas and sample and see what you like. Now, don't over sweeten the tea with too much honey or artificial sweeteners, you'll ruin the benefit. Tea does have a degree of caffeine in it, less than coffee.
Dr. Sanjiv Lakhia: 24:04
Now, if you're wondering about coffee, I'm not against coffee, I think there's good literature on the health benefits of coffee, but what I am against is what goes in most people's coffee. If you're out there and you love Starbucks, if my parents are listening, that's them and they have to have their Starbucks and that's okay, but you have to understand that when you order coffee and then you put in the coffee a large amount of cream and sugar with high fructose corn syrup-based sweeteners followed by some whipped cream, you're no longer drinking coffee. You're essentially drinking a dessert and you should treat it as such. It's going to have pretty significant effect on inflammation levels in your body. So I myself prefer a little bit of green tea throughout the day.
Dr. Sanjiv Lakhia: 24:50
We touched a bit on protein sources. Again, part of this also may include eggs on the anti-inflammatory diet. Eggs are recommended. Now, they need to be high quality, omega-3 enriched eggs. If you can get them from an organic source, free range, chickens, it's preferable. And then the other sources of proteins is going to be your beans or legumes, which you can wash or gently cook, meats, your fish and a little bit of chicken with minimal red meat. So you want to have one to two servings a week of cheese, egg or dairy, and then diversify from your legumes and your meats.
Dr. Sanjiv Lakhia: 25:33
Whole soy foods can be on this food plan, one to two servings per day. One serving is equal to about half a cup of tofu or tempeh, one cup of soy milk or half a cup of cooked edamame, or one ounce of soy nuts. Edamame is a really nice snack to have on. And you can cook that, sprinkle some sea salt on it and it's very healthy for you. Soy foods contain isoflavones and they have antioxidant activity and are protective against most cancers, so make sure that you choose whole soy foods over fractionated foods like isolated soy protein powders and imitation meats, maybe with soy isolate. I am not a fan of the imitation meat products on the market. Most of them are loaded with a high amounts of coconut oil, which is a big source of saturated fat, which could be a problem for you. And the rest of the ingredients, if I can't pronounce what's on the label, I just don't want to put it in my body.
Dr. Sanjiv Lakhia: 26:29
Moving on again to fats. You want to have about five to seven servings per day, so one serving is equal to about one teaspoon of olive oil, two walnuts, a tablespoon of flax seed or one ounce of avocado. My primary cooking oil is extra virgin olive oil. I also use avocado oil as well. We try and cook on a low temperature so you don't oxidize the oils. Again, you want to choose healthy fats that are rich in either mono and saturated or omega-3 fats.
Dr. Sanjiv Lakhia: 26:58
In terms of your whole grains, your options there are going to be your brown rice, your basmati rice or wild rice, buckwheat groats, quinoa, Barley's steel-cut oats, about three servings per day. And a serving is equal to about half a cup of cooked grains. The whole grains, again, as we said before, digest slowly so you reduce the spike in your blood sugar that, for example, you would get from white rice. Remember, whole grain means the grain is intact, so it should have some texture to it. More specifically with beans and legumes, there's multiple choices. Beans like not anasazi, adzuki and black, as well as chickpeas, black-eyed peas and lentils. If that sounds very complicated, you can just eat some hummus and you will do just fine. You can have some black bean soup or some lentil soup. Beans are rich in folic acid, magnesium, potassium and soluble fiber, which is really good for your gastrointestinal track and your gut microbiome.
Dr. Sanjiv Lakhia: 27:56
And then rounding it out, I would say the vegetables I think we've covered before, look for dark leafy greens like spinach, collard, kale and Swiss chard, cruciferous vegetables are excellent, broccoli, cauliflower, Brussels sprouts, bok choy. And I've been cooking a lot of bok choy lately, it has a really nice taste to it.
Dr. Sanjiv Lakhia: 28:16
And then the fruits. The one comment I would make on the fruit, try and pick low-glycemic index fruits such as raspberries, blueberries, strawberries, apples, cherries, pears. And fruits are rich in flavonoids and carotinoids, which again, antioxidant, anti-inflammatory powerhouses.
Dr. Sanjiv Lakhia: 28:34
And don't forget, lastly, plenty of water throughout the day. You want to drink pure water, filtered water if you can, and make sure you're drinking throughout the day. Stay well hydrated.
Dr. Sanjiv Lakhia: 28:45
So there you have it. That's a really good rundown of the anti-inflammatory food plan, Mediterranean food plan. It's something that has been researched for quite some time now. It's used at multiple hospitals across the country as a primary food plan through their cardiovascular programs. I think it's practical for most of you listeners, it's going to reduce inflammation in your body and it will help with your pain. And what I like to say is that eating well, eating high quality food, it's like putting down good fertilizer on your lawn. If you put an application of fertilizer, you don't expect a green grass the next day, but if you continue to put the fertilizer down, over the course of seasons, I promise you that lawn will turn green and look healthy. It's the same way with eating well. If you're in pain and you're listening to this podcast, if you start eating broccoli tomorrow and olive oil in your diet, well it's possible you could feel immediate results, chances are it's going to take some time to notice the benefits, but I encourage you to stick with it. It's well worth the long-term benefits and it will pay dividends in the long run.
Dr. Sanjiv Lakhia: 29:51
So take care of yourself, try need healthy and take care of your back. And I look forward to speaking with you on further episodes.
Outro: 29:59
Thank you for listening to this episode of Back Talk Doc brought to you by Carolina neurosurgery and spine associates with offices in North and South Carolina. If you'd like to learn more about Dr Lakhia and treatment options for back issues, go to backtalkdoc.com we look forward to having you join us for more insights about back pain and spine health on the next episode of Back Talk Doc. Additional information is also available at carolinaneurosurgery.com.