Lifestyle factors such as smoking, poor diet and sedentary lifestyle have long been associated with chronic diseases such as heart disease and type 2 diabetes. Lower back pain is one of the most common health problems worldwide, up until recently the role of lifestyle and nutrition was not well researched in this area, but it is becoming increasingly clear that these can have a big impact on prognosis and quality of life.
Overweight and obesity is an ever increasing problem with latest statistics showing 29% of adults in England are classified as obese. It makes sense when we think that any additional weight we carry, particularly excess fat (muscle provides physical function alongside its weight whereas fat does not), puts additional pressure on our spine and can therefore contribute to lower back pain. Obesity may also itself lead to further declines in physical activity and daily movement, further exacerbating lower back pain.
Obesity has also been seen to lead to generalised inflammation in the body. Higher levels of inflammation have been associated with increased pain. The types of foods we eat can also impact on whether inflammation is promoted or dampened down by the body.
As anyone who has tried to lose weight and keep it off will tell you, it is hard! We live in an environment which promotes excess calorie intake and limited physical activity. Obesity is complex often with social, psychological, environmental and physiological elements. What works for one person may not work for the next. It is therefore essential to make realistic, sustainable changes that work for you.
For some people that may be simply tracking what you eat better using a food diary or App so you become more aware of the nutritional value of the foods you are eating. There will often be foods that surprise you that maybe you thought were healthy but actually are providing more fat or calories in your diet than you thought. The process of tracking our food also just brings it to the forefront of our mind. Often we do things out of habit or routine or without much thought, tracking can help us to stop and question our behaviours.
For others it may be more about addressing the route cause of eating habits, do you eat for comfort, when you are stressed, when you are bored, anxious? Is there a different more helpful habit that you could replace this with? Food is more than just the nutrition it provides, the choices that we make regarding food have many different interlinking reasons behind them, our culture, upbringing, social circumstances will all have an impact.
For some, their lifestyle will have changed over the years but their diet has not necessarily changed alongside this. For example, at retirement, energy expenditure may change significantly. Research has shown that often when women start co-habiting with men they gain weight as they start to have more similar portion sizes to the men who often have greater energy requirements. Dietary intake therefore always needs reassessing at key life points.
The word ‘Diet’ often fills people with dread and conjures up images of severely restricted eating habits often involving cutting out major food groups. These extremely restrictive diets may work in the short term but will not give you the long term health changes you desire. They are too restrictive to be maintained and are often lacking in many essential dietary components. Changes you make should be long term lifestyle changes not a short term ‘diet’.
So what about inflammation? Can we do anything with diet to address this? A traditional Mediterranean style diet has long been associated with improved health and reduction in disease and this is likely to be no different when treating lower back. The Mediterranean diet promotes a diet rich in a range of fruits and vegetables which contain helpful antioxidants, high in omega 3 anti inflammatory fats (found in oily fish), plenty of wholegrains containing fibre and vitamins and mineral and avoidance of processed foods. It also limits the consumption of red meat looking more to fish, beans and nuts as good sources of protein and healthy fats. Saturated fats are replaced with more unsaturated fats for example choosing olive oil rather than butter.
Refined carbohydrates and processed foods have become an increasing part of the UK diet and these foods are often stripped of their nutrients such as fibre, vitamin and minerals which can leave the diet deficient. Getting back to a less processed more wholesome diet will not just have anti-inflammatory effects but can help manage weight and prevent a whole host of diseases such as cancer, heart disease and type 2 diabetes.
It can be difficult to think about preparing food from scratch when we are all so busy and short on time. However wholesome, unprocessed meals don’t have to be complicated or time consuming. Make sure your plate is filled with a variety of colours of vegetables, have some lean protein such as chicken, fish or tofu and add a small portion of high fibre carbohydrates such as wholegrain rice or new potatoes. Snack on a small handful of nuts or a portion of fruit rather than reaching for processed crisps or chocolate bars.
Only 29% of adults in England are reaching the recommended 5 portions of fruit and vegetables per day. Bulking meals up with extra veg is a great way to feel full for longer and stop hunger pangs later in the day. Add chopped peppers and courgettes to a bolognaise sauce, snack on vegetable sticks, add a side salad to main meals or add swede or carrot to mash as potatoes don’t count as a veg portion. Aim to ‘Eat a Rainbow’, this means making sure you include a variety of colours of fruit and vegetables to ensure you get the full range of nutrients.
We should all be aiming to include 2 portions of fish a week, at least one of which should be oily fish such as salmon, herring, mackerel. The omega 3 fats found in this type of fish are difficult to find elsewhere in the diet in this format. Omega 3 fats have strong anti-inflammatory properties and are beneficial to short and long term health.
If you need help making positive changes to your diet to improve your health and back pain then book an appointment with our Dietitian today.