Julie Wendt, a licensed nutritionist practicing at GW Center for Integrative Medicine, provides her insights and key strategies to avoid persistent pain and cognitive decline.

A recent article published last year titled “Association Between Persistent Pain and Memory Decline and Dementia in a Longitudinal Cohort of Elders”, Whitlock et al revealed a relationship between elders reporting pain and an increase in the rate of memory decline and probability of dementia. This finding is especially alarming when you consider that 25-33% of older adults report chronic pain. This study revealed the pattern but doesn’t explain the big question that comes next: “Why?”.

From the perspective of a functional nutritionist, I have a lot of ideas about why chronic pain could affect brain health. As someone who looks for the root cause of the symptoms that we experience, the imbalances that lead to chronic pain are the same imbalances that I look to address in the prevention of cognitive decline.

Dr. Dale Bredesen, a neurologist and researcher who published a book in 2017 called “The End of Alzheimer’s: the first program to prevent and reverse cognitive decline”, suggests that there are 3 primary reasons for cognitive decline: inflammation, toxicity, and lack of tropic (anabolic) factors. I want to explore these areas in more detail as they relate to the relationship between pain and cognition and close with some key steps that anyone experiencing chronic pain can take to support a healthy brain as they age.

The million dollar answer to all of this is INFLAMMATION!

Inflammation has become a catch-all phrase for doctors to use to explain the cause of nearly every chronic disease. It is the common thread that links Dr. Bredesen’s other 2 causes of cognitive decline: toxicity and hormone depletion. At the risk of sounding unimaginative, I agree and yet that isn’t the end of the story. While inflammation is a natural processes that we need in order to understand that we are injured, when inflammation becomes chronic, our bodies experience a disruption at every level of functioning from the cell to the organ to the person as a whole. All chronic disease from chronic pain to heart disease to depression to dementia share this common underlying driver. Where the inflammation shows up in the body is where the individual has genetic predisposition and lifestyle habits that specify the target of inflammation. Scientists agree that 80% of chronic disease is preventable with lifestyle changes. It’s my mission to help people modify their lifestyle so that they are reducing the risk of all sources of inflammation with a particular focus on cognitive health.

There are many sources of inflammation in the body:

– Inflammatory foods that over stimulate our immune system, inflame our gut, and
create nutritional deficiencies that make it harder for our body to support all the
functions in the body including our cognition.

– Environmental toxins from our air, soil, water, and food supply that overwhelm our
body’s innate ability to remove toxins and compete for the binding sites of the minerals that are designed to allow proper function. The brain and nervous system is particularly sensitive to toxic exposure.

– Chronic sleep deprivation which can trigger inflammatory messengers like cortisol and insulin and create an pro-inflammatory state within the body.

– A dysregulation in the stress response which triggers similar inflammatory messengers as sleep deprivation- cortisol and insulin- among others.

I am interested in understanding where the inflammation is coming from so that we can find supports that will interrupt the cycle of inflammation. The beauty of functional medicine is that one of the solutions to each of these reasons share a common nutritional solution: the anti-inflammatory diet!

The food choices that people suffering from chronic pain should be aware of include:

– Processed foods with refined carbohydrates, sugars, and artificial color/flavor.

– Individualized food sensitivities, the most common being cow’s milk, wheat/gluten,
eggs, soy proteins, and nightshades (tomato, potato, eggplant, peppers).

– Low intake of anti-inflammatory foods such as fruits and vegetables.

How can you begin to adjust your diet so that you can reduce your pain symptoms?

– First, review the list of sources of inflammation and determine how your current
lifestyle looks.

– Next, identify one area that you want to work on, find one small change that you can
make that might help you reduce your pain.

– Identify who and what you need in order to implement the change. For example, if
you want to decrease your toxin exposure, set aside some time to review information on the Environmental Working Group’s website (www.ewg.org) to see where you can start shifting your lifestyle. Their Clean 15 and Dirty Dozen lists are particularly helpful in prioritizing your food spending while at the same time reducing your toxin exposure.

– Keep in mind you need to make space for the change process to happen. Schedule it, decide what you aren’t going to do that you normally would, and let someone else know about it so they can check in on you and provide support.

For more information about the study and the Institute for Functional Medicine’s approach to chronic pain using food check out these links:

• https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2629448

• https://www.ifm.org/news-insights/alternatives-opioid-therapy-chronic-pain/? utm_medium=newsletter&utm_source=clickdimensions&utm_campaign=afmcp-2018- oct&utm_term=interested-8-23-2018&utm_content=f1&_cldee=andlbmR0MjRAeWFob28 uY29t&recipientid=contact-b3f0d773a8dce511942400155d019e02- da99d5992e654253ae293704a74ed0da&esid=2f64d5b7-46a6- e811-80d6-00155d019e03

Julie Wendt is a licensed nutritionist practicing at GW Center for Integrative Medicine. Her passion is the prevention of cognitive decline. She offers an online course to help support lifestyle changes that align with cognitive health. You can find our more information about Your Healthy Mind by visiting www.brainpowerlife.com or emailing Julie at info@brainpowerlife.com.