In my practice, I am asked several times a week about diet and its relationship to pain. It doesn't matter what body part is aching; it could be back, knee, neck, you name it, people want to know what they should and shouldn’t eat, and the conversations go on. Years ago, I would claim that there wasn’t enough research to back up any advice. There is no one diet or type of foods to eat or avoid to feel better.
Thank goodness, times have changed. If you start to look at the literature around the human gut microbiome, you could swear that having a perfect gut is the answer to all your problems. If you have just the right bacteria, fungi, and viruses, you could live a long and active life in your new lean and healthy body, which would be pain-free. It seems that every new yogurt, bread, supplement, or drink has the perfect blend of probiotics that can make your gut healthy and keep you free from inflammation in any of your tissues and therefore live a disease-free life. But holy cow, the only problem is I don’t know which Kombucha to buy that is right for me. Kombucha drinks have become very popular over the past decade because they have a vast assortment of probiotics in their teas that can help promote a healthy gut. Kombucha is an ancient Chinese tea with more healthy ingredients than tea, including more antioxidants and probiotics. This fermented drink is full of healthy bacteria that can help improve the intestinal microbiome (previously called intestinal flora). Many people that have been exposed to repeated antibiotic treatments in their life are looking for safe and natural ways to improve their gut health.
The research
The research is still in its infancy (two decades of studies) around the gut microbiome and mental health (i.e., depression), obesity, Crohn's disease, and knee pain secondary to osteoarthritis. Even high-level athletes of all sports have been steered in the direction of improving upon their gut health. In the past decade, with the advent of high-tech sequencing and microbial identification, has the whole breadth of the organisms in the gut become apparent. So far, no conclusions have been drawn in these early investigative studies of high-level athletes except that what you eat, where you live, and what type of exercise you do makes up your gut flora. The gut microbiome is very different even amongst elite athletes that live together and eat the same diet.
A Belgium study of 1054 subjects was looking into the microbiome of people with and without depression. They found that people with depression lacked two types of microbes, which were present in the subject who were free from depression. Their study had similar results when compared with a Dutch study of 1064 subjects. Furthermore, both studies showed that these people with depression also had a higher number of certain microbes that have been linked to Crohn's disease. So, Crohn’s disease, which is an intestinal inflammatory disease, has a direct link to our mental health and the joints of the body.
Our Joints and an inflammatory gut
Obesity is a well-known risk factor for knee osteoarthritis (OA) by increasing the mechanical load on the joints. However, there are instances when there is OA in non-weight-bearing joints of obese patients. It is thought that this joint destruction is occurring through low-grade systemic inflammation. The obese person has a different microbiome than non-obese people.
Gluten and joint pain
It is common knowledge now that some people with gluten intolerance or celiac disease can be affected by joint pain and swelling. The symptoms may come on slowly or abruptly. My patients will typically tell me about their experiment with eliminating gluten to see if it helps ease their pain. Low and behold, they are amazed and unaware that they had been on an inflammatory diet for years. Other foods that trigger inflammation are sugar and alcohol.
Oral hygiene and general health
Lastly, I have to tell you about the importance of maintaining good oral hygiene. All my dentist friends will thank me for this one. Did you know that gum disease is associated with an increased risk for developing heart disease, and tooth loss patterns are connected to coronary artery disease? The gastrointestinal (GI) tract, which starts in the mouth is the first place to think about good healthy eating and cleaning. Most importantly, remember that we are what we eat, and we need to go with our gut feeling when it comes to making healthy choices.