Mark Gostine MD, age 54,
at the finish of the
2005 Boston Marathon

Many patients wish to help themselves and change the course of chronic musculoskeletal pain. Frequently, this means working with doctors, nurses, and therapists using medications, injections, physical and behavioral therapy.  However, patients also want to know “what can I do on my own to help this pain problem?”

In 2002, at the age of 51, I decided to run the Detroit Marathon, a 26 mile race. For the four years prior I had seriously cut back my running because of a hip problem.  Nonetheless determined, I intensified my program of diet, vitamins and other supplements to see if I could conquer the hip pain in a natural fashion without the use of drugs.  Well something worked and I ran the race to completion in October of 2002. In April of 2005, 2007, and 2008 I also ran the 26.2 mile Boston Marathon.  In between the marathons I have run the 15.5 mile River Bank run in Grand Rapids. To run the races properly I train regularly and this puts a great deal of stress on my joints. I have constructed a nutritional program to protect my joints and prevent musculoskeletal pain from inflammation associated with arthritis. In my case, it has evidently been successful.

In addition, inflammation seems to be a common link to many disease states, such as arthritis, cancer and heart problems, including heart failure and coronary artery obstruction. The diet below represents the best foods and supplements I know of that help reduce inflammation.

• Take 4 grams of fish oil per day, since each capsule is usually a gram that means 4 capsules a day. I take two in the morning and two in the evening. This is the single most important recommendation. Get a brand that contains 300mg of EPA and 200mg of DHA per capsule.   If you prefer a liquid, take Carlson’s brand, lemon scented and keep it refrigerated; it tastes surprisingly okay, much better than the cod liver oil of old.  If you can’t take fish oil capsules, try flax seed oil, liquid form – 2 teaspoons per day.  Keep it refrigerated, and buy it new every six weeks.  It oxidizes easily.

• Take a vitamin D3 supplement, at least 2000 IU’s per day.  I take 7000 IU’s per day.  The RDA set by the government is miserably low at only 400 IU’s per day.   That has recently been increased in children but the government, in its infinite wisdom did not increase it in adults.   According to the government, this means a 200 pound adult needs as much as a 30 pound child which is ridiculous.  Do not trust the RDA for adults; it needs to be updated as well. 

• Eat kefir and yogurt, which are very healthy. Kefir is a highly concentrated liquid yogurt and the various strains of beneficial or probiotic bacteria are outstanding.  Probiotic bacteria help protect your intestines from other bad bacteria that cause stomach ulcers and contribute to acid reflux or GERD.  Probiotic bacteria also help break down your food properly; reducing the incidence of food allergies.  A lot of musculoskeletal pain is related to food allergies that are hard to diagnose.  I buy Lifeway brand kefir from Forest Hills Foods or Harvest Health in the dairy section.   Stoneyfield plain yogurt also has the most beneficial bacteria for keeping your gut well protected.  I like it much better for this reason than Dannon.  Stoneyfield yogurt is available in the yogurt section of all major grocery food stores.  However, Dannon’s products, Dan Active and Dannon Activia are also good choices.   Buy them all and eat a helping of at least two of them throughout the day.   Sweeten the plain yogurt with a little jelly or jam if it is too sour for your taste. Don’t buy already sweetened or artificially flavored yogurt.  It is overly processed and not as effective.

• Season your food liberally with the herb Turmeric.  This is a yellow spice found in mustard. It has an earthy flavor like cumin and is used in curry, an Indian spice mixture. It has potent anti-inflammatory qualities, with over 1,000 articles in the Medline Internet database that have studied its effectiveness.  A recent editorial in the New England Journal of Medicine even suggested it could cure Cystic Fibrosis!!!  Another recent article in the Journal of Biological Chemistry indicated that it may prevent Alzheimer’s disease, a common form of dementia.

  I sprinkle tumeric on almost everything I cook including meat, fish, eggs and soups.  It seems to work at least as well as anti-inflammatory drugs, doesn’t irritate the stomach, and costs only a few dollars at any grocery store.  Look for it in the spice aisle.  I also take turmeric extract in capsules.  The extract is much higher in curcumin, the active ingredient that protects your joints and general health.

• Drink dark juices of all types, grape, cherry, blueberry, pomegranate, and black currant daily.  Mix them up drinking a helping of one or two of them daily.   Better yet, eat fresh or dried cherries, blueberries and grapes.   Dark fruits and berries help protect your brain and heart.

• A little bit of alcohol each day is good for your cholesterol.  No more than one drink a day.

• Take Metamucil® once a day because increasing the fiber content in your diet reduces:
  • risk of colon cancer
  • risk of heart disease
    

    Fiber binds the cholesterol in your stool and prevents the absorption in the small intestine.  This helps keep your blood cholesterol lower.

• Get your protein from multiple sources:
  • Lean cuts of red meat, trimming all visible signs of fat
  • chicken
  • seafood
  • New eggs high in Omega 3 oils.  These eggs are available in the grocery stores.
    
    
• Use only olive oil for cooking. Try to substitute olive oil for butter.
  
  
• Drink one glass of soy milk per day. I think Silk brands taste the best.
  
  
• Eat 7 helpings of fruits and vegetables because they are high in antioxidants that help relieve inflammation.  Dark greens are very beneficial.
  
  
• Drink green tea instead of coffee. It helps unlock your metabolism. Jasmine green tea lightly sweetened with honey is less bitter than traditional green tea.  I drink a couple of eight ounce glasses per day.
  
  
• Artificial sweeteners are particularly bad for your health.  These chemicals are so sweet they fool the body into thinking they are sugar and your brain sends a signal to your pancreas to release insulin.  Insulin makes you fat; it is the fat storage hormone.  Avoid all artificial sweeteners like NutraSweet, Splenda, and Crystal Light etc.
  
  
• Avoid drinking or eating out of plastic.  Compounds in plastic, like BPA, are perceived by our bodies as similar to our hormones and this confuses our body.  Plastic compounds that act like estrogen cause premature development in girls, feminization in men, and weight gain in everyone.  Frogs in our lakes and streams that have been subjected to pollution from plastic compounds become hermaphrodites (exhibiting both female and male genitals).  Drink filtered tap water (I like Britta, I checked with them and their containers have no BPA) or buy something in glass or old fashioned milk cartons.  Don’t buy your milk in plastic. 

• Take 4 Fish Oil capsules containing 300mg of EPA and 200mg of DHA per capsule

• Turmeric extract and spice

• Take 2000 IU’s of vitamin D3 per day. Vitamin D is developing an amazing reputation for preventing multiple sclerosis, cancer, and musculoskeletal pain

Eat a low Glycemic diet. The glycemic index is a rating system for foods and essentially ranks them according to the amount of sugar or simple carbohydrates each foodstuff contains. Example of high glycemic foods are candy, mashed potatoes and cookies. Low glycemic food categories are meats, eggs, dairy, whole grains, certain fruits and vegetables.

High glycemic foods raise insulin which makes your body store fat.   The fat cells make chemicals that cause inflammation so you are more prone to cancer, heart disease and arthritis.  By eliminating high glycemic foods that release insulin you can lose weight and reduce inflammation.

DON’T BUY HIGH GLYCEMIC FOODS OR KEEP THEM IN THE HOUSE. YOU CAN’T EAT THEM IF YOU DON’T HAVE THEM.

Eat Only These Foods to Lose Weight:

• Fruits:
  Apples, oranges, grapefruit, tangerines, pears, apricots, strawberries, raspberries, blackberries, blueberries, prunes, and plums are the lowest glycemic fruits. Bananas and fruit juices are high glycemic fruits, avoid them.
• Vegetables:
  All lettuce, spinach, fresh corn, green or yellow string beans, raw carrots, tomatoes, cabbage, broccoli, cauliflower, peas, and beets are very good food choices. Avoid fried vegetables, especially potatoes.
• Dairy:
  Plain yogurt that says “contains live culture” is very good for you, especially women who need the calcium and protein for their bones. Cow’s milk is a good choice and for whatever reason, high consumption of dairy milk seems to be associated with a lower risk of breast cancer. Drink away.
• Beans:
  Lentils, beans of any variety, and peas are all great choices. They increase the fiber in your diet and are a good source of protein. Humus is a bean dip from the Middle East and makes a great dip for vegetables.
• Nuts and Seeds:
  Pecans, walnuts, almonds, sunflower seeds, pumpkin seeds are good sources of protein and fiber and reduce the risk of heart disease. Eat a handful at least every other day.
• Fish, Chicken and lean Red Meat:
  Most salmon today is farm raised and not as healthy as wild caught salmon.  To avoid problems with any one food group, eat a balanced diet of lean red meat like cube steak or sirloin trimmed of fat, chicken and the smaller fish because they contain less mercury than large fish like tuna and halibut.    

Don’t eat bread, pasta, potatoes, cereal (except high fiber cereals like All Bran), soda pop, chips, candy, donuts, ice cream, cake, pie or sugar, essentially nothing out of a bag box or wrapper.  Drink unsweetened ice tea instead of diet pop. 

Lastly, you may never run a marathon, but get out and walk 2 miles a day. You will feel better.