Eating for pain
management
The Anti-Inflammatory diet
EAT WELL LIVE WELL
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Contents
What’s involved? 3
How does it work? 4
Polyphenols in foods 5
Benefits and side effects 6
What do I do? & What should I be eating? 7
Accessibility and Healthy Values 8
Food Pyramidfor Dietary Management of Pain 9
Menu ideas 10 – 12
Who can help and Tips 13
References 14
Glossary
Foodbank A place which provides food items
free
Kai Food
NSAIDs A group of pain-relieving medications
Non-Steroidal which have an anti-inflammation
Anti-Inflammatory action
Drugs
Pain experience Our individual experience of pain
Persistent pain Pain that continues past the normal
time of healing (11)
Hauora Well-being
Whānau Family
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Welcome
Eating for Hauora/ well-being
We know that there are links between the food we eat and
persistent pain. Our nutrition is often overlooked when treating
persistent pain.
Unhealthy habits and lifestyles can make our pain worse.
What’s involved?
1. Improving your pain by taking control of your diet.
2. Choosing healthy fresh foods.
3. Adopting healthy eating habits at home.
What you eat can have an impact on your hauora and pain.
This leaflet will give you information on eating well and how to
follow an anti-inflammatory/polyphenol rich diet.
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How does the treatment work?
The positive effects on pain from eating a healthy diet is thought
to be from the link between pain and inflammation.
Inflammation is a normal defence mechanism in our bodies- it
keeps us safe. Too much inflammation for too long can cause
harm.
Lots of ongoing inflammation in the body has been linked to
chronic painful disorders (1).
We know that some foods, such as processed foods high in sugar
and fats can make inflammation and pain worse (2).
Eating a diet high in foods known to have anti-inflammation
effects can improve pain and increase general health.
What does the research say?
More high quality research is needed into the relationship
between what we eat and our pain.
Studies so far have found;
1. Diets with high intakes of olive oil and fish + low
intakes of red meat and dairy lessen pain and lower
inflammatory markers (3).
2. Strawberries and blueberries have been found to
improve pain and stiffness (4) (5).
3. Diets high in Omega 3 and low in Omega 6 have less
chronic diseases associated with persistent pain (6).
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Polyphenols in foods
Polyphenols are compounds found in certain foods that
have important anti-inflammatory effects which have
been shown to lessen pain (2). They are mainly found
in plant-based foods.
Scientific evidence has linked diets high in polyphenols
with preventing inflammation associated with pain,
heart disease and cancers (12).
This diet advocates eating lots of foods high in
polyphenols to gain their anti-inflammatory effects.
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Side effects
1. Unlike some medications which may have many negative
side effects it is unlikely that eating a healthy diet would
cause any negative effects.
2. Nutrients found in anti-inflammatory diets are thought to
have similar effects to Non-Steroidal Anti-inflammatory
Drugs (NSAIDs) without their common side effects (9).
Benefits
1. Following an anti -inflammatory diet can have
positive effects on relieving pain (3).
2. Healthy diets help weight control.
3. May relieve constipation from pain medications
(1).
4. You can include the whole whānau.
5. Improve general hauora / well-being.
6. Benefits can last a life time!
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What do I do?
Choose healthy, fresh foods to prepare and enjoy with you and your
whānau.
Consume foods that have anti-inflammatory properties.
You can follow this treatment alongside your usual therapies.
EATING WELL IS ONE PART OF THE PICTURE.
EXCERCISING, SLEEPING WELL AND STAYING
CONNECTED TO PEOPLE AND THNGS WE
LOVE HELP US LIVE WELL WITH PAIN.
What should I be eating?
Lots of –
Olive oil
Vegetables
Fruit
Berries
Yogurt
Avoid –
Processed foods/meat
Lollies
Fizzy drinks
Fish
Wholegrain breads
Spices
Soy
Seeds and nuts
Fast food
White bread
Pastries
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Accessibility
We know that healthy fresh food is better for our health and
controlling pain. We also know that it is more expensive and often
less readily available than unhealthy food.
YOU implement this treatment. YOU oversee the success.
High cost food can be a barrier to health. By following the Healthy
Values below, we can try and manage costs.
Healthy Values
Manaakitanga- sharing food/hospitality. Sharing with whānau
and community.
Whanaungatanga – family relationships. Strengthen relationships
with kai.
Kaitiakitanga- caring for the environment. Plant and grow our
foods.
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A Food Pyramid for the Dietary
Management of Persistent Pain
This food pyramid gives you an idea of the number of servings
for anti-inflammatory and polyphenol rich foods.
Rondanelli et al. Food pyramid for subjects with chronic pain: foods and
dietary constituents as anti-inflammatory and antioxidant agents.
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Menu ideas
Examples of an anti-inflammatory diet
Breakfast
• Oat porridge with berries
Blueberries have been found to reduce pain and stiffness in patients
with arthritis (5). Oats are high in fibre.
• Scrambled eggs with turmeric on wholegrain toast
Turmeric contains a compound called curcumin. Studies found
curcumin can reduce pain and swelling (7).
• Pineapple smoothie
Pineapple contains bromelain which has anti-inflammatory and pain
killing properties (8)
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Menu ideas
Examples of an anti-inflammatory diet
Lunch
• Salmon avocado sushi
Salmon is high in Omega 3. Diets high in Omega 3 have lower incidences of
chronic inflammatory diseases (6).
• Pumpkin bean and coconut soup
Made with legumes which contain phytochemicals which have antiinflammatory properties (10).
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Menu ideas
Examples of an anti-inflammatory diet
Dinner
• Tofu veg curry
Tofu is a soybean product; soy contains polyamines which has
effects on pain and inflammation (2).
• Piri- Piri chicken with smashed chickpeas
Chickpeas make a great healthy alternative to potatoes.
• Chia crusted salmon with Asian greens and soy
dressing
Chia seeds are the highest plant source of Omega-3 fatty acids
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Who can help me?
• Your GP practice can offer advice on healthy diet and exercise
• Registered Nurses and Doctors in your pain clinic
• Get the support of your whānau to form healthy habits
Alternative options
You can follow this therapy alongside your usual treatments.
Supplements could be used as an alternative option.
Tips
Try and stay away from fast food-keep as a treat!
Make your plate colourful
Canned fish is cheap and good for you
Avoid foods with lots of ingredients you can’t pronounce
Use a community garden
Visit local markets for low cost fruit and veg
Find out if there is a local foodbank in your community
Stay active
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References
1. Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory
and antioxidant agents. Rondanelli M, Faliva MA, Miccono A, Naso M, Nichetti M, Riva A,
Guerriero F, De Gregori M, Peroni G, Perna S. 2018 Jun, Nutrition research reviews, Vol. 31, pp.
131-51.
2. Does diet play a role in reducing nociception related to inflammation and chronic pain?. Bjørklund
G, Aaseth J, Doşa MD, Pivina L, Dadar M, Pen JJ, Chirumbolo S. 2019, Nutrition, Vol. 66, pp. 153-
165.
3. A randomized controlled cross-over trial investigating the effect of anti-inflammatory diet on disease
activity and quality of life in rheumatoid arthritis: the Anti-inflammatory Diet In Rheumatoid Arthritis
(ADIRA) study protocol. Winkvist A, Bärebring L, Gjertsson I, Ellegård L, Lindqvist HM. Dec.
2018., Nutrition journal., Vol. 17.
4. Strawberries improve pain and inflammation in obese adults with radiographic evidence of knee
osteoarthritis. Schell J, Scofield R, Barrett J, Kurien B, Betts N, Lyons T, Zhao Y, Basu A. (9), 2017,
Nutrients., Vol. 9, p. 949.
5. Blueberries Improve Pain, Gait Performance, and Inflammation in Individuals with Symptomatic
Knee Osteoarthritis. Du C, Smith A, Avalos M, South S, Crabtree K, Wang W, Kwon YH,
Vijayagopal P, Juma S. (2), Feb 2019, Nutrients., Vol. 11, p. 290.
6. The diet-induced proinflammatory state:: A cause of chronic pain and other degenerative diseases?. .
Seaman DR. Mar 2002, Journal of manipulative and physiological therapeutics., Vol. (3), pp. 168-79.
7. Combining pain therapy with lifestyle: the role of personalized nutrition and nutritional supplements
according to the SIMPAR Feed Your Destiny approach. De Gregori M, Muscoli C, Schatman ME,
Stallone T, Intelligente F, Rondanelli M, Franceschi F, Arranz LI, Lorente-Cebrián S, Salamone
M, Ilari S. 2016., Journal of pain research., Vol. 9., pp. 1179-1189.
8. Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an
open study of otherwise healthy adults. Walker AF, Bundy R, Hicks SM, Middleton RW. (8), Jan
2002, Phytomedicine., Vol. 9., pp. 681-6.
9. Phenolic compounds: Natural alternative in inflammation treatment. A Review. Ambriz-Pérez DL,
Leyva-López N, Gutierrez-Grijalva EP, Heredia JB. (1), Dec. 2016., Cogent Food & Agriculture., Vol.
2.
10. Freer, C. The Anti-Inflammatory Cookbook. Sydney/ London : Murdoch Books, 2019.
11. Classification of chronic pain: descriptions of chronic pain syndromes and definitions of pain terms. .
HE., Merskey. s.l. : Pain., 1986.
12. Mediterranean diet polyphenols reduce inflammatory angiogenesis through MMP-9 and COX-2
inhibition in human vascular endothelial cells: a potentially protective mechanism in atherosclerotic
vascular disease and cancer. Scoditti E, Calabriso N, Massaro M, Pellegrino M, Storelli C, Martines
G, De Caterina R, Carluccio MA. (2), Nov. 2012, Archives of biochemistry and biophysics., Vol. 527,
pp. 81-9.
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Kirsty Roper
Northland Area Pain Service
Whangarei
New Zealand