Anti-inflammatory diet

[LMali]

I am relatively new to this site and think it is great! I read a couple of posts every day with great interest. I was diagnosed with PMR in August 2020 after a couple of months of excruciating pain in my shoulders. My GP pretty quickly suspected it and confirmed it with a short course of Pred (15 mg). I have tapered to 7 mg with monthly blood tests. When I first read about PMR and understood it was an inflammatory disease / condition, I immediately started thinking about things I could do to enable getting off steroids as soon as possible. The first book I read was "Anti-inflammatory diets for Dummies"! Basically mediterranean diet, substitute brown for white, certain foods are particularly anti-inflammatory (salmon, blueberries etc) and some are inflammatory (refined processed and deep fried). Then I got a pre-diabetes diagnosis. Sigh. So I am now on low-carb, anti-inflammatory diet. So I am curious that there is not much discussion on this forum (that I have seen anyway) about diet. Any views?

[DorsetLady PMRGCAuk volunteer]

If you look at “related posts” - may be on right hand of screen or below posts depending on which device you are using you will find plenty of other posts. Or just use search facility by typing in your question.

[LMali in reply to DorsetLady]

Hi! Yes, I hadn't really appreciated that column on the right hand side until after I posted my post. I then read some of them and seems to be that lots of people do try the anti-inflammatory diet. At least it is healthy and feels like you are doing something, even if it is not a cure.

[DorsetLady PMRGCAuk volunteer in reply to LMali]

Well it certainly won’t do any harm.....

[EnduranceEngine]

Hi I resubmit this for what it's worth. It may be of interest to you. It tackles both pre-diabetes and inflammation.

Sorry for the long post.

Keto can be a good way to go to lower inflammation, if done properly. Dairy is inflammatory, so a lot of Keto is pro-inflammatory. However, it's also great in that it takes out all the bad sugars, which are inflammatory. Clean keto would be the way to go, so mostly animal fats and good protein, which we all need as we age. And saturated fat is not going to raise cholesterol. The FDA has reversed it's thinking on that, as has the American Heart Association.

I have been Paleo for 5 years, which is higher in fat and lower in carbs than a standard recommended diet. However, it's very nutrient dense, and cuts a lot of the pro-inflammatory foods out.

When I got PMR, given that it is autoimmune (but not triggered by food like some autoimmune diseases I should note), I switched to the Paleo Auto Immune Protocol (AIP). This eliminates the most allergenic and pro-inflammatory foods. It cuts out things like wheat and rye, and nuts and seeds, as well as dairy and nightshades. It leaves you with meat and fish and lot's of veg, with some treats made with other non grain flours and a touch of honey instead of those nasty Keto sweeteners. Also, no alcohol as it's very inflammatory (not what anyone wants to hear at Christmas!) Here is a link to some information:

thepaleomom.com/aip-dos-and...

There is a ton of good info on this site.

So for me, I was given 20 mg of Pred to start. I tapered by 5 mg every 4 weeks. Then the last week, I went down to 1 mg, then to zero. I was on Pred for a total of 64 days. I've never had to go back up. I've now been at Zero for 148 days and feeling pretty damn fine (no remissions and no flares). I can now lift more weight than I was before PMR, and am back up to running 8K and doing hill sprints. I have no issues. Otherwise, I'm very much like I was. I'm still eating AIP Paleo, and will through Christmas and into the new year before reintroducing some foods. It's not a hard diet, and I find I eat most of my favorite foods, so not feeling hard done by. And you can do this diet in a keto version as well.

I know everyone is different, and results will vary, but for me, it may have been the thing that allowed me to get back to fit faster (though I'm still a long way from the fitness I enjoyed pre-PMR), and off Pred faster as well.

[LMali in reply to EnduranceEngine]

Hi EnduranceEngine! Thank you for your response. That is very interesting. I am pescatarian anyway (fish eating vegetarian). Of late, I have a lot less dairy anyway (have switched to oat milk with my granola and in coffee). I do eat nuts and seeds as I thought they were anti-inflammatory (and I like them). It can get a bit confusing . . . as I am also trying to lose a bit of weight!! Some food is very healthy but high in calories!!

[EnduranceEngine in reply to LMali]

If you eat fish then canned sardines are decent for calcium. I eat them a lot. Very easy and the have good omega 3 which is also anti inflammatory.

But definitely stay toward the low carb model and avoid things like flours and deep fried foods. Also things that spike your blood sugar like rice and banana. If you have a continuous glucose monitor it is easy to see which foods are better and which ones will send your blood sugar up. You may be surprised!

[PMRpro Ambassador]

"I am curious that there is not much discussion on this forum (that I have seen anyway) about diet. "

Then I can only suggest you look at more than 2 posts per day and look through past posts as bedtime reading maybe!! There is a vast amount of discussion about low carb diet on this forum - for the benefits of avoiding weight gain and developing steroid induced diabetes. Low carb itself is antiinflammatory because it removes sources of sugar. There is also often discussion about using turmeric and ginger in cooking - as opposed to buying supplements which can be problematic in the doses used.

But do be careful about your calcium intake if you don't eat dairy. We have had plenty of both veggie and vegan members of the forum - it didn't stop them developing PMR and GCA though. Whatever diet you choose, it needs to be one you can maintain long term. If you want to try vegan then these days it is relatively easy - a study some years ago found a strict vegan diet reduced RA joint pain in half of the subjects but reintroducing even the smallest amount of animal protein stopped the effect. But even so, few of the patients studied continued with the diet at the end of the study because they found it too restrictive and costly when it was up to them to fund it.

[LMali in reply to PMRpro]

Thank you for your help and sorry I missed the other threads. Diet related posts did crop up in the side bar AFTER I did my own post . . . but diet had not cropped up in any of the post titles in the daily email since I started receiving them. My fault for not searching more deeply and being too impatient! Apologies.