Article by Victoria Mann (dietitian)
Lifestyle factors such as smoking, poor diet and sedentary routines 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. Until recently, the role of lifestyle and nutrition was not well researched in this area. However, it is becoming increasingly clear that these factors can have a big impact on prognosis and quality of life.
Excess weight and obesity is an ever increasing problem. Recent statistics show 29% of adults in England are now classified as obese. It makes sense when we think 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 also leads to further declines in physical activity and daily movement thereby 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 have an impact on whether inflammation is promoted or mitigated by the body.
As anyone who has tried to lose weight and keep it off will tell you, it is a serious challenge! We live in environments which promote excess calorie consumption and limited physical activity. Obesity is complex and often has 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.
Some Common Methods of Dietary Monitoring and Control
For those who may be tracking what they eat using a food diary or app, in order to become more aware of the nutritional value of foods, there will be some foods that surprise you - foods you think are healthy but are actually providing more fat or calories in your diet than you realise. The process of tracking foods is a good way to bring nutrition to the forefront of our minds. Often, we do things out of habit or routine without much thought. Therefore, food tracking can help us to stop and question our behaviours.
For others, it may be more about addressing the root causes of detrimental eating habits. Do you eat for comfort, when you are stressed, when you are bored or anxious? Is there a more helpful habit you could replace this with? Food is more than just the nutrition it provides; the we make regarding food have many different interlinking reasons behind them (our culture, upbringing, social circumstances, etc).
For some, lifestyle habits will have changed over the years but their diet has not necessarily changed alongside them. For example, at retirement, energy expenditure may change significantly. Research has shown, when women start cohabiting with a male partner, they become more likely to gain weight as they begin eating similar portion sizes even though men have greater energy requirements. Dietary intake, therefore, needs reassessing at key life points.
The word 'diet' often fills people with dread and conjures up notions of severely restricted eating habits and cutting out major food groups. Extremely restrictive diets may work in the short term , however, they will not give you the long term health changes you desire. They are too restrictive to be maintained and often lacking in essential dietary components. The changes you make should be long term lifestyle changes not a short term 'diet.'
Some Foods Which Can Help to Naturally Decrease Inflammation
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 diseases and this is likely to be no different when treating lower back pain. The Mediterranean diet promotes meals abundant in 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 minerals and advises the avoidance of processed foods. It also limits the consumption of red meat by looking more to fish, beans and nuts as sources of protein and healthy fats. Saturated fats are replaced with healthier unsaturated fats (for example, choosing olive oil rather than butter).
Refined carbohydrates and processed foods have become an increasing part of the British diet. Unfortunately, these foods are often stripped of their nutrients like fibre, vitamin and minerals and can leave a diet deficient. Getting back to a less processed, more wholesome diet will not just have anti-inflammatory effects , it can also help manage weight gain 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 vegetables of different colours, consume lean protein such as chicken, fish or tofu and add small portions of high fibre carbohydrates like 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.
The Importance of Eating Your 'Five a Day' Every Day
Only 29% of adults in England are reaching the recommended five portions of fruit and vegetables per day. Bulking meals up with extra vegetables is a great way to feel full for longer and stop hunger pangs later in the day. Add chopped peppers and courgettes to a bolognese sauce, snack on vegetable sticks, add a side salad to main meals or add swede or carrot to mash (potatoes don't count as a veg portion!) Aim to 'eat a rainbow' - this means making sure you include fruits and vegetables in a variety of colours to ensure you get a full range of nutrients.
We should all be aiming to include two portions of fish a week, at least one of which should be oily fish like salmon, herring or mackerel. The omega 3 fats found in these 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 alleviate back pain, book an appointment with our dietitian today.
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