Inflammation and Diet: New Boy. Retired Stroke... - PMRGCAuk

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Inflammation and Diet

JockDaw profile image
51 Replies

New Boy. Retired Stroke Specialist Nurse (lectured and prescribed)

Continuing interests Stroke/Arteriorsclerosis/Diabetes/Depressions

Learned and taught "when we eat fat it goes round our body and clogs our arteries" Now understand that's complete rubbish

Been researching Low Carb Healthy Fat way of eating for two years. Relative became T2 Diabetic and introduced me to LCHF. Since then have learned there's increasing evidence that

INFLAMMATION caused by INSULIN RESISTANCE=CARBOHYDRATE INTOLERANCE

and is a significant, possibly, principal cause of above disease.

For reputable sources on LCHD check out: Public Health Collaboration (not Public Health England though daughter works there!) Prof Tim Noakes, internationally recognised sports nutrition expert and marathon runner, for the medical research on diet Ivor Cummings, (thefatemperor) engineer who is mappping out the pathophysiology of IR lowcarbdownunder.com The Aussies and Kwiwis are way ahead

Met old nursing colleague being conventionally teated for likely PMR with no dietary advice. Also have partner with "Fibromyalgia-type" symptoms.

Keen to swap evidenced-based info on all above

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JockDaw profile image
JockDaw
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PMRpro profile image
PMRproAmbassador

I assume you mean medical literature-type evidence base? However - if you search for low carb in the search box for PMRGCAuk you will find a whole load of anecdotal evidence from members of this forum who find that eating low carb has taken them out of pre-diabetes status or helped them lose pred-associated weight and others who experience flares of PMR when they fall off the low carb eating habit waggon.

JockDaw profile image
JockDaw in reply to PMRpro

Yes, starting with randomised double-blind controlled trials (not easy in nutrition) and working down. But also triangulating with questions like, Who's funding, e.g, apparently the Australian Dietetic Association has meetings in a Coca Cola building and their chief exec is on something like 500,000 Aus Dollars. Where do guidelines come from, e.g. I'm in Scotland and our govermnent guidelines are lifted from England who lifted them from the good ol' USA. And their guidelines were set politicians with grain states and based on the now discredited work of Ancel Keyes. Also suspect professions (especially doctors) who will never admit they're wrong. And now, as LCHF is becoming more acceptable, look out for the shysters coming on board where they smell new money

I'm looking for the best info on diet in PMR and in "Fibromyalgia" in exchange for my findings with the Diet-Heart hypothesis IHD/,Stroke, Diabetes, Depressions and Dementia

PMRpro profile image
PMRproAmbassador in reply to JockDaw

You can't do randomised double blind trials in nutrition - you would have to lock the patients up and deny them any choice over a very long period, a few weeks isn't long enough. Really not very ethical and I doubt that even if there were funding you would struggle to get ethical board agreement.

There isn't going to be funding either - such trials would cost rather a lot and they aren't going to benefit anyone with money. That is of course how Ancel Keys work was funded so enthusiastically by the food industry - eliminating expensive fats from commercially prepared products and replacing it with cheap HFCS led to cheaper food which kept at room temperature for longer - also a major benefit to them.

I have followed and agreed with the wicked sugar theory ever since John Yudkin was in vogue - not only because of his work but also my own education and training told me the fat story couldn't be right. But the tide is turning and more and more authorities are coming round to realising the link between sugar/processed carbs and obesity and diabetes. But like everything that isn't going to be supported by Big Food or Big Pharma - it will take time to reeducate the world.

I think it is a bit much to say doctors will never admit they are wrong - Aseem Malhotra has and so have a lot of others. But in any field, it is very difficult to persuade people that what they learned at a certain stage of their education is wrong.

The best diet in PMR is the one that works for you and that you need and accept. If you had been around this forum in the last year or so you would have seen repeated posts suggesting someone switch to low carb to help avoid weight gain or steroid-induced diabetes. But it is hard to see you need to change the habits of a lifetime and probably even harder to do it on your own. That often changes when someone is faced with steroid -induced diabetes - and there have been a few cases recently where that has happened, the fear of needing insulin prompted a trial of low carb - and lo and behold, their Hba1c or their weight fell. Seeing is believing and suddenly it is easier.

Others have discovered by trial and error that omitting certain foods make them feel better - and when they forget or there is a celebration with the usual suspects on the table that they can't resist - "because you have to have a treat don't you" or "a little of what you fancy does you good" - they find they get a "carb hangover" next day. But for others it makes little difference what they eat. The one certain fact with PMR is that everyone is different - in how and why their PMR developed, how they respond to pred, the dose they need or how they can reduce. That extends to foods - and while I can eat nightshade vegetables in shed-loads without having any bad effect someone else will find a tomato salad will mess up weeks of watchful eating. Just as a piece of birthday cake can mess up your keto diet for a week or more.

Instead of depending on work by others - indulge yourself and do your own research. Lots of us have!

yogabonnie profile image
yogabonnie in reply to PMRpro

You are so wise.

I love everything you post.

thanks!

Have to say "Evidence Based" must be one of the most abused expressions of our time!!

It seems to say true! But appears not necessary so! Grumpy day for myself!

PMRpro profile image
PMRproAmbassador in reply to

I quite agree - since the low fat theory also claimed to be evidence-based! Like peer-reviewed is not always a guarantee it is good work either. All depends on who the peers were...

in reply to PMRpro

Just don't get me going on the house of Lords!

PMRpro profile image
PMRproAmbassador in reply to

Even they do have some good points - one elevated gentleman has done a great deal to support GCA diagnosis provision.

in reply to PMRpro

Bless him. Top lad he is. Thanks for the reminder. Not sure about some of the others though!

yogabonnie profile image
yogabonnie

I agree that doing the lo carb sure helps ..my markers towards diabetes have dropped into normal range... and I think it must help with inflammation. BuT not sure I think we would not have gotten this disease by having done it before. I have a friend (male) who has been very thin, fit, lo carb, no sugar eater for the last 20 years and was just diagnosed with PMR 4 months ago. He had a hip replacement then skin cancer surgery within one month and I think ( because I am a famous doctor scientist haha) that the trauma of both and the need for his body to heal.. his immune system couldn't keep up. I had a bike/car accident (I'm on the bike) then a 7 hour flight and virus caught on flight within a week of eachother and got PMR. Thanks for this information. Food for thought!

ConventCassie profile image
ConventCassie

I was whole food Plant Based no oil so I discussed Nutrition with my Rhummy every visit because she is Vegetarian. Last visit she just said “Eat whatever you want.” She obviously saw no reason to hand out dietary advice. But that’s most docs. I like the comparison I read to a Vet.. the first question with your pet is, “What is he eating?” I’m on the LCHF plan now, but I fear loosing more weight.

PMRpro profile image
PMRproAmbassador in reply to ConventCassie

Then you need a bit more carbohydrate - if you don't need to lose weight you don't have to be so strict...

JockDaw profile image
JockDaw in reply to PMRpro

Why not more healthy fat?

PMRpro profile image
PMRproAmbassador in reply to JockDaw

Because if you are eating low enough carb to lose weight adding more healthy fat to your diet will be unlikely to result in weight gain. That is the entire physiological point of a low carb way of eating - your body switches to ketogenic metabolism and once it has exhausted the supply of glycogen in the muscles starts to burn fat instead of carbs.

ConventCassie profile image
ConventCassie in reply to PMRpro

So it will still be anti inflammatory if it’s low carb (adding a little more) & low fat? That will help me gain? Low fat? I used to do the DASH DIET and weighed 106 (instead of 86) & was healthy.

HeronNS profile image
HeronNS in reply to ConventCassie

If you find the secret to gaining just a few pounds please share with me. I weigh just over 100 lb and have not gained back any of the pre-pred weight loss.

ConventCassie profile image
ConventCassie in reply to HeronNS

Yep. Mine was a PMR thing too.

ConventCassie profile image
ConventCassie in reply to HeronNS

Apparently we don’t want to be in Ketosis so not high fat. Like I’ve said on several posts...I’m confused.

in reply to HeronNS

Heron I'll gladly post you a few of my extra pounds. I think wine puts weight on! Works for me!

HeronNS profile image
HeronNS in reply to

Gives me headaches. :(

in reply to HeronNS

Oh well! Think of the money you're saving! And all those empty calories I'm consuming! Plus the vineyards I'm keeping going on those steepy slopes of Chile!

Wraysbury profile image
Wraysbury in reply to

🤣

ConventCassie profile image
ConventCassie in reply to

Doesn’t work for me. I keep trying thou :)

in reply to ConventCassie

"Could Do Better" & "Must Try Harder". Ahh! Still have my school reports.

ConventCassie profile image
ConventCassie in reply to

😉

xdbx profile image
xdbx in reply to ConventCassie

Yes if your added carbs are slow release, nutritient dense carbs like root vegetables rather than say potatoes or grains. You need some fat with the carbs to help slow them down and avoid blood sugar spiking. Avocados are very good or avocado oil, coconut oil and olive oil (but don’t cook with olive oil). These are all anti-inflammatory 😊

AliDeJ profile image
AliDeJ in reply to xdbx

Why should you not cook with olive oil?

angiek profile image
angiek in reply to AliDeJ

I'd like to know the answer to that too please?

PMRpro profile image
PMRproAmbassador in reply to xdbx

There is no reason not to cook with olive oil - just don't heat it above 410F/210C and use filtered oil rather than non-filtered, it is the solid bits that catch if you heat them too far and form the health problem.

Have you heard of the Pioppi diet? In Pioppi I doubt anyone uses anything other than olive oil for frying and down there they fry an awful lot of things! They live long and healthy lives.

xdbx profile image
xdbx in reply to PMRpro

Yes of course you're right it's to do with the smoke point. I also cook with lard and tallow now.

The Pioppi Plan looks wonderful and I like that it includes walking - and not sitting for long periods, 7+ hrs sleep, mindfulness/stress management and socialising as well as a colourful anti-inflammatory diet with lots of omega 3 fatty acids. It also cuts out many, though not all, of the foods that can cause inflammation. Lovely!

PMRpro profile image
PMRproAmbassador in reply to xdbx

I've been thinking of going back to lard for frying. OH thinks potatoes only come as chips and are his staple! Given that he now weighs a whole 51 kg at 1m 65cm (5' 7" or so), his Hba1c is 35 and cholesterol is extremely low I'm not going to complain! I have a tiny fryer for the campervan and so a solid fat is best - the locally available Fritin is palm oil...

xdbx profile image
xdbx in reply to PMRpro

Lard makes everything so tasty! We have a campervan too...mmm the enticing aroma of camp cooking. Yum!

ConventCassie profile image
ConventCassie in reply to PMRpro

I sure like that book-the Pioppi Diet - but my gosh! One has to have their own cook! I’ve never seen such complicated recipes. He had me feeling guilty about a grape or a cherry. I guess I’ll just enjoy the ‘natural’ fruits a little more. Haven’t had processed anything in years. And the omega 3 - I found a terrific way to bake salmon. (Missing my gas grill parted with in Colorado.)

PMRpro profile image
PMRproAmbassador in reply to ConventCassie

Yes - I boggled at the recipes! But he must be of Indian extraction so they think nothing of having a long list of spices...

PMRpro profile image
PMRproAmbassador in reply to ConventCassie

No, not low fat, normal fat. You have to eat something! But if you have cut the carbs too far when you don't need to, you will lose weight.

The problem with "low fat" is that any products that trumpet they are healthy because they are low fat are likely to have a lot of hidden sugar in them - if you take fat out of food you have to add something to make them palatable. That is usually otherwise totally unnecessary sugar in some form - and it is the source of much of the "added sugar" that we are constantly told to avoid. It is what leads in many cases to insulin resistance - which is an early stage of starting to develop Type 2 diabetes. You don't have to be overweight to become diabetic - even if you are slim and eat a lot of added sugar. A healthy diet has a good amount of fat and a good amount of sugar - much less than is found in the modern western diet and replaced by complex carbs - less-processed wholegrain products and fruit and vegetables.

There are two reasons that people on here support the low carb approach to eating: one is because of the weight gain associated with taking corticosteroids and the other is because in a lot of patients steroids cause increased blood sugar levels and this CAN lead to steroid-induced diabetes. If you don't gain weight with pred and/or your Hba1c level remains in normal range then you don't need to eat low carb. Cutting your carbs doesn't mean cutting them out - everyone is different in the amount they can eat and not lose weight and you have to identify YOUR level, not mine, not anyone else, YOURS. If you don't gain weight - no need to cut carbs as much. And if you lose weight when you don't need/want to - you eat more healthy carbs.

HeronNS profile image
HeronNS in reply to PMRpro

I cut the carbs because of blood sugar levels, not weight issues. Now I'm out of the habit of eating grain based carbs in any form, and usually feel quite unwell if I have more than a single slice of pizza or a scone, or similar amount in a day. It doesn't help that I have little appetite.

Whenever I try to find something useful and appealing to me on the internet about gaining weight it seems all the weight loss sites completely crush the search. Mostly you get junk about those chemically laden nutritional drinks.... Blech.

PMRpro profile image
PMRproAmbassador in reply to HeronNS

I know what you mean - look at what I just wrote about OH! He had been the same weight he was at Uni (lucky devil we thought) but after 10 days in hospital because of fluid on the lungs he has lost 7kg - almost all will have been fluid. It has gone off the lungs at least - but obviously his right heart failure had led to a lot of other oedema that his former dose of diuretic wasn't dealing with. He really could do with some flesh on him - not to mention muscle but HOW??? He eats next to nothing - except the few days in hospital he was on pred...

HeronNS profile image
HeronNS in reply to PMRpro

Well, if either of us comes up with a solution we must share! I'm thinking I should stop trying to be politically correct and buy more avocados. Politically correct about avocados? Habitat destruction in Mexico. Sigh.

theguardian.com/lifeandstyl...

PMRpro profile image
PMRproAmbassador in reply to HeronNS

I know! But I don't see OH accepting avocados either! Peas and beans are his limit. He really needed much longer in hospital - he was eating all sorts of things there!

piglette profile image
piglette in reply to ConventCassie

I read in the papers today that they are doing a trial on training medics in nutrition and cookery. They are hoping to set up training for patients who have such things as diabetes, obesity, etc. They think that encouraging people to eat healthily might make for a healthier patient. I asked my rheumie about nutrition and PMR and he did not seem to have a clue, in fact he did not even seem interested in finding out either.

JockDaw profile image
JockDaw in reply to piglette

Familiar meme. Even good doctors whom I've known have a bit of a blank here. Partly due to there not being much good research and the obfuscation of Big Food. But the tide is turning.

any details on that trial?

piglette profile image
piglette in reply to JockDaw

It is being started next month by the Bristol Medical School. It was in the Telegraph today, the Power of Culinary Medicine. A good diet can be as effective as pills.

kc4t profile image
kc4t

Just to share my own experience I've been trying the AIP diet. Broadly it's all vegetables and fresh food and I think it helps me. I've never been offered dietary advice from hospital or doctor other than to reduce salt as my kidneys are damaged. So it's all been under my own research.

xdbx profile image
xdbx in reply to kc4t

Good to hear it's helping you too. How long have you been on it? I like that it helps us work out our individual tolerances and sensitivities and isn't a 'one size fits all' programme. We're all so different.

I've also never been offered any dietary advice by the medics I've seen apart from "avoid sugar" as if that were a complete answer!

PMRpro profile image
PMRproAmbassador in reply to xdbx

It's a start! And more than a lot of people have been told!!!!!!

Janicep profile image
Janicep

Do omega 3 capsules make any difference to inflammation?

PMRpro profile image
PMRproAmbassador in reply to Janicep

Maybe, maybe not! I can't say I noticed any difference myself.

What is always far better than supplements in the form of pills/capsules/tablets is a good diet with balanced sources of omega-3 and all the other stuff as FOOD. They are far better than artificial sources - suggesting that there is something unidentified in the food that is important. One example of that is the fibre in fruit and veg but there are probably other nutrients too.

Janicep profile image
Janicep in reply to PMRpro

Thanks

xdbx profile image
xdbx

My own experience and the enormous wealth of anecdotal evidence I’ve come across suggest that diet is a key factor in autoimmune inflammatory disorders - but it’s not the only one.

A metaphor I like is a base with four pillars. Sleep is the base and the pillars are diet, exercise, stress management and socialising. We seem to need all of these in balance for healing and good health.

I reversed type 2 diabetes and lost over 50lbs by attending to all of these, and especially low carb diet and walking. This was pre-PMR.

I then experienced an enormous amount of stress over several months. I developed Hives and then PMR but was undiagnosed for almost a year during which time, due to pain and immobility, I slipped off my low carb and walking regime and regained much of the weight. I was then prescribed Pred which relieved the pain and immobility but over time made weight loss very difficult even with a return to a low carb diet and walking.

I had two flares in the last year and each time had to go back to my 15mg Pred starting dose.

Curiosity, desperation, and more than a little misery, have led me to following the Autoimmune Protocol (AIP) lifestyle, including full elimination diet, for nearly three months. This means attending carefully to the base and all four pillars!

The dietary element of AIP is a healing diet designed to remove foods potentially causing immune reactivity, gut irritation and inflammation, and to add in nutrient dense and anti-inflammatory foods. The aim of the protocol is to heal from autoimmune disease, or to better manage symptoms of autoimmune disease.

I’ve lost 11lbs in 11 weeks, which to me is a good rate, and have tapered from 10mg Pred to 8.5mg over that time with no ill effects whatsoever. I have osteoarthritis as well as PMR and the OA pain I’ve had for over 20 years has gone. I keep forgetting to take the paracetamol and codeine I’m prescribed for OA. I used to be watching the clock to see if I could take them yet!

I have much more energy and the ‘deathly fatigue’ has also gone. I can continue being active all day instead of being exhausted on the sofa from midday onwards.

I still have a long way to go. I don’t know what condition my adrenals are in but time will tell, hopefully sooner than later, as I continue to taper the Pred.

So this may all be anecdotal and personal experience but I don’t need a scientific double-blind trial or medical paper to tell me something’s definitely working!

I do think, however, that the medical profession needs to wise up fast to what actually does work in terms of immune health, and health in general, and it’s good to see signs that this is beginning to happen at last.

Peggles profile image
Peggles

I'm longing for some evidence ref an antiinflammatory diet.

I've always considered I eat well. Cook from scratch. Grow my own food without chemicals, incl. veg, eggs, chicken, beef, lamb and venison. Plus a little 'sustainably produced fish'.

I don't eat refined shop bought carbs, occasionally bake a cake or eat pancakes and don't eat much bread - home made sourdough.

Yet still, at 51 got this vile vile disease and cannot get it under control!

I haven't put on any weight since starting the pred 20 months ago but am starting to resemble a chipmunk

ConventCassie profile image
ConventCassie in reply to Peggles

Sorry about the chipmunk thing. I had my Passport pic taken at the height of that. Nice keepsake :)

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