Turning Down the Heat The Effects of Diet and Nutritional Supplements on Inflammation and Repair...

Turning Down the HeatThe Effects of Diet and Nutritional

Supplements on Inflammation and Repair

Geoff Lecovin, MS, DC, ND, L.Ac, Geoff Lecovin, MS, DC, ND, L.Ac, CSCS, CISSNCSCS, CISSN

Stephanie Lecovin, MS, RDStephanie Lecovin, MS, RD

What do these people What do these people have in common?have in common?

Inflammatory TriggersInflammatory Triggers

Age-related wear and tearAge-related wear and tear Physical injuriesPhysical injuries InfectionsInfections EnvironmentEnvironment Adverse food reactionsAdverse food reactions Autoimmune diseasesAutoimmune diseases

Dietary Dietary imbalances and imbalances and deficienciesdeficiencies

Fluctuating Fluctuating blood sugarblood sugar

Hormonal Hormonal imbalanceimbalance

GeneticsGenetics

www.goodpsych.com/stress-psychology

Mediators of Acute Inflammation

Cumulative Injury CycleCumulative Injury CycleChronic InflammationChronic Inflammation

Adhesions

Altered neuromuscularcontrolCumulative

Sheer &Repetitive

Stress

Muscle Imbalance &Joint Dysfunction

Tissuetrauma

Inflammation

Muscle Spasm & Trigger Points

Modified from the NASM

MYOFASCIAL PAIN MYOFASCIAL PAIN SYNDROMESSYNDROMES

A myofascial trigger point is a highly A myofascial trigger point is a highly localized and hyper-irritable spot in a localized and hyper-irritable spot in a palpable taut band of skeletal muscle fibers.palpable taut band of skeletal muscle fibers.

TRIGGER POINT TRIGGER POINT SYMPTOMSSYMPTOMS

1. Local or referred pain 1. Local or referred pain 2. Pain with muscle contraction2. Pain with muscle contraction3. Muscle stiffness and restricted joint motion3. Muscle stiffness and restricted joint motion4. Muscle weakness4. Muscle weakness5. Paresthesia and numbness5. Paresthesia and numbness6. Proprioceptive disturbance6. Proprioceptive disturbance7. Autonomic dysfunction7. Autonomic dysfunction8. Edema and cellulite8. Edema and cellulite

Nutritional InadequaciesNutritional Inadequacies

Travell and Simons - ~ half of their patients with myofascial pain Travell and Simons - ~ half of their patients with myofascial pain syndromes required resolution of vitamin inadequacies for syndromes required resolution of vitamin inadequacies for lasting relieflasting relief

Vitamin inadequacies lead to:Vitamin inadequacies lead to: Impaired cell metabolism and functionImpaired cell metabolism and function Decreased synthesis of neurotransmitters and DNADecreased synthesis of neurotransmitters and DNA Impaired collagen synthesis and reduced nerve and muscle Impaired collagen synthesis and reduced nerve and muscle

functionfunction Increased irritability of trigger points and nervesIncreased irritability of trigger points and nerves

Nutrients of special concern in patients with myofascial pain are Nutrients of special concern in patients with myofascial pain are the water-soluble vitamins B1, B6, B12, folic acid, vitamin C and the water-soluble vitamins B1, B6, B12, folic acid, vitamin C and minerals such as calcium, magnesium, iron and potassiumminerals such as calcium, magnesium, iron and potassium

Travell & Simons. Travell & Simons. Myofascial Pain and Dysfunction: The Trigger Myofascial Pain and Dysfunction: The Trigger Point Manual (2-Volume Set)Point Manual (2-Volume Set).. Lippincott Williams & Wilkins; 2nd Lippincott Williams & Wilkins; 2nd edition. 1992. edition. 1992.

Biochemistry of n-3 and n-6 Biochemistry of n-3 and n-6 Fatty Acids SimplifiedFatty Acids Simplified

D6D and D5D are rate limiting enzymesD6D and D5D are rate limiting enzymes Delta 6 desaturase requires: Vitamin B6, Delta 6 desaturase requires: Vitamin B6,

magnesium and zinc as cofactorsmagnesium and zinc as cofactors Delta 5 desaturase requires: Vitamin C, niacin Delta 5 desaturase requires: Vitamin C, niacin

and zinc as cofactorsand zinc as cofactors If the diet is >4:1 (n-6:n-3) the production of If the diet is >4:1 (n-6:n-3) the production of

pro-inflammatory prostaglandins is favoredpro-inflammatory prostaglandins is favored The S.A.D. is significantly greater than 4:1 (closer to The S.A.D. is significantly greater than 4:1 (closer to

20:1)20:1) Sugar increases insulin, promoting arachidonic Sugar increases insulin, promoting arachidonic

acid metabolism, resulting in inflammationacid metabolism, resulting in inflammation Other factors include stress, disease state, age Other factors include stress, disease state, age

and environmental factorsand environmental factors

Key Micronutrients in Key Micronutrients in Eicosanoid SynthesisEicosanoid Synthesis

Omega 3 fatty acids: Omega 3 fatty acids: DGLV, flax, hemp, walnut, cold water fishDGLV, flax, hemp, walnut, cold water fish

Omega 6 fatty acids: Omega 6 fatty acids: grains, seed oilsgrains, seed oils

B6: B6: garlic, tuna, cauliflower, mustard greens, banana, celery, cabbage, mushrooms, garlic, tuna, cauliflower, mustard greens, banana, celery, cabbage, mushrooms, asparagus, broccoli, kale, collard greens, Brussels sprouts, cod and chard. asparagus, broccoli, kale, collard greens, Brussels sprouts, cod and chard.

Mg: Mg: Swiss chard and spinach, mustard greens, summer squash, broccoli, Swiss chard and spinach, mustard greens, summer squash, broccoli, blackstrap molasses, halibut, turnip greens, pumpkin seeds, peppermint. blackstrap molasses, halibut, turnip greens, pumpkin seeds, peppermint. cucumber, green beans, celery, kale and a variety of seeds, including sunflower cucumber, green beans, celery, kale and a variety of seeds, including sunflower seeds, sesame seeds, and flax seeds. seeds, sesame seeds, and flax seeds.

Zn: Zn: Mushrooms and spinach , sea vegetables, spinach, pumpkin seeds, yeast, beef, Mushrooms and spinach , sea vegetables, spinach, pumpkin seeds, yeast, beef, lamb, summer squash, asparagus, venison, chard, collard greens, miso, shrimp, lamb, summer squash, asparagus, venison, chard, collard greens, miso, shrimp, maple syrup, broccoli, peas, yogurt, pumpkin seeds, sesame seeds and mustard maple syrup, broccoli, peas, yogurt, pumpkin seeds, sesame seeds and mustard greens. greens.

B3: B3: Mushrooms, tuna, halibut, asparagus, sea vegetables, venison, chicken, and Mushrooms, tuna, halibut, asparagus, sea vegetables, venison, chicken, and salmon. salmon.

C: C: Broccoli, bell peppers, kale, cauliflower, strawberries, lemons, mustard and Broccoli, bell peppers, kale, cauliflower, strawberries, lemons, mustard and turnip greens, Brussels sprouts, papaya, chard, cabbage, spinach, kiwifruit, snow turnip greens, Brussels sprouts, papaya, chard, cabbage, spinach, kiwifruit, snow peas, cantaloupe, oranges, grapefruit, limes, tomatoes, zucchini, raspberries, peas, cantaloupe, oranges, grapefruit, limes, tomatoes, zucchini, raspberries, asparagus, celery, pineapples, lettuce, watermelon, fennel, peppermint and parsley. asparagus, celery, pineapples, lettuce, watermelon, fennel, peppermint and parsley. Source: www.whfoods.orgSource: www.whfoods.org

Food Allergies and Food Allergies and InflammationInflammation

Your Own Personal Your Own Personal PoisonPoison Antibodies (immunoglobulins): produced by the Antibodies (immunoglobulins): produced by the

immune system in an attempt to protect the body immune system in an attempt to protect the body from foreign invaders (antigens) from foreign invaders (antigens)

IgE: immediate reactionIgE: immediate reaction IgG: delayed reaction (AKA sensitivity)IgG: delayed reaction (AKA sensitivity) IgE and/or IgG: bind with antigens to form an IgE and/or IgG: bind with antigens to form an

“immune complex” which activates mast cells, “immune complex” which activates mast cells, triggering degranulation triggering degranulation

Mast cell degranulation results in the release of Mast cell degranulation results in the release of pro-inflammatory chemicals: histamine, pro-inflammatory chemicals: histamine, chemotactic chemicals, enzymes and eicosanoids chemotactic chemicals, enzymes and eicosanoids

Common Food AllergensCommon Food Allergens MilkMilk EggsEggs WheatWheat CornCorn TomatoesTomatoes SoySoy NutsNuts PeanutsPeanuts Shellfish/fishShellfish/fish CitrusCitrus Food coloring and preservativesFood coloring and preservatives CoffeeCoffee ChocolateChocolate

Factors Affecting Tissue Factors Affecting Tissue Healing and RepairHealing and Repair

Damaged soft tissue is continually re-Damaged soft tissue is continually re-injured injured

Prolonged NSAID use (e.g. Ibuprofen, Prolonged NSAID use (e.g. Ibuprofen, Naproxen)Naproxen)

Other medications (e.g. statins, steroids)Other medications (e.g. statins, steroids) Systemic factors: immune compromise, Systemic factors: immune compromise,

diabetes, peripheral vascular disease, diabetes, peripheral vascular disease, aging, geneticsaging, genetics

Nutritional statusNutritional status Diet (inflammatory or anti-inflammatory)Diet (inflammatory or anti-inflammatory)

Effects of NSAIDs on Effects of NSAIDs on HealingHealing

Impede tendon, bone and cartilage repair and Impede tendon, bone and cartilage repair and delay of muscle regenerationdelay of muscle regeneration

Block protein synthesis in muscleBlock protein synthesis in muscle Inhibit collagen matrix synthesis and accelerate Inhibit collagen matrix synthesis and accelerate

cartilage destructioncartilage destruction Interfere with satellite cell formationInterfere with satellite cell formation Common side effects include tinnitus, gastric Common side effects include tinnitus, gastric

irritation, GI upset, headachesirritation, GI upset, headaches

BOTTOM LINE: inadequately formed connective BOTTOM LINE: inadequately formed connective tissue that is easily re-injured (Cumulative Injury tissue that is easily re-injured (Cumulative Injury Cycle) and prone towards degenerative changesCycle) and prone towards degenerative changes

Turning Down the Heatwith Whole Foods

ORAC (Oxygen Radical Absorbance Capacity)ORAC (Oxygen Radical Absorbance Capacity)The Power of ColorThe Power of Color

RED (RED (anthocyanidins, lycopenesanthocyanidins, lycopenes)- strawberries, cranberries, )- strawberries, cranberries, raspberriesraspberries, , cherries, grapes, beets, pomegranates, bell pepperscherries, grapes, beets, pomegranates, bell peppers

ORANGE-YELLOWORANGE-YELLOW ( (beta carotene, letein, zeaxanthinbeta carotene, letein, zeaxanthin)- )- carrots, sweet potatoes, oranges, mangoes, cantaloupe, pumpkin, carrots, sweet potatoes, oranges, mangoes, cantaloupe, pumpkin, apricots, turmeric, gingerapricots, turmeric, ginger

GREENGREEN ( (beta carotene, luteinbeta carotene, lutein)- )- spinach, chard, kale, avocado, spinach, chard, kale, avocado, asparagus, broccoli, Brussels sprouts, watercressasparagus, broccoli, Brussels sprouts, watercress

BLUE-PURPLE (aBLUE-PURPLE (anthocyanidinsnthocyanidins)- blueberries, blackberries, )- blueberries, blackberries, plums, prunesplums, prunes

WHITE- WHITE- ggarlicarlic,, onion, cauliflower onion, cauliflower BLACK/BROWN- coffee, dark chocolate, black teaBLACK/BROWN- coffee, dark chocolate, black tea

Salicylates founds in diets high in fruits and vegetables Salicylates founds in diets high in fruits and vegetables can produce salicylic acid concentrations equal to 75 - can produce salicylic acid concentrations equal to 75 - 150 mg aspirin per day 150 mg aspirin per day (Hare, LG, et al. Dietary Salicylates. J Clin (Hare, LG, et al. Dietary Salicylates. J Clin Pathol. 2003 September; 56(9): 649–650.)Pathol. 2003 September; 56(9): 649–650.)

Anti-Inflammatory FoodsAnti-Inflammatory FoodsOils/FatsOils/Fats

Food Phytochemicals/ Properties

Mechanism Dose

Extra-Virgin Olive Oil

Polyphenols COX-1 and COX-2 inhibitors

3 ½ tbsp = 200 mg Ibuprofen1

Flaxseed oil ALA Precursor to EPA, DHA & anti-inflammatory eicosanoids

1-2 tbsp oil or 1-2 capsules daily (7 grams ALA per 15 mL or 1 tbsp)

Walnuts ALA & polyphenols

Anti-oxidants; increase PGE-1 and PGE-3

1.5 oz walnuts/day

Anti-Inflammatory FoodsAnti-Inflammatory FoodsFruits & VeggiesFruits & Veggies


Mechanism / Outcomes

Dose

Cherries Anthocyanidins Drinking tart cherry juice could reduce pain and damage in muscles induced by exercise 2 ; flavonols & anthocyanins exert anti-inflammatory effects

24 oz tart cherry juice per day

Pomegranates Polyphenols & flavonoids

Reduces pro-inflammatory cytokines and eicosanoids; strong antioxidants 3

Drinking 8 - 12 oz. of pomegranate juice per day

Tomatoes Lycopene Reduces TNF-α production 4

16 oz

Anti-Inflammatory FoodsAnti-Inflammatory FoodsOtherOther


Mechanism Dose

Dark chocolate Polyphenols Increases antioxidant status before exercise and reduces levels of F2-isoprostane 1 hr after exercise 5

100 grams of dark (70%) chocolate

Ginger Gingerols, shogaols, and paradols

Suppresses cytokines & chemokines 6

5 g of raw ginger or 0.1-1g of powdered

Green tea Catechin polyphenols (epigallocatechin gallate – EGCG)

Down-regulates IL-8, macrophages & PGE-2 7

24 – 36 oz/day

Probiotics Beneficial microflora

Balances activity of T-lymphocytes. Reduces NF-kB and TNF 8

Yogurt or supplement with8 billion live active cultures bid

Red wine Resveratrol Reduces CRP 9 1-2 glasses/day

Anti-Inflammatory TipsAnti-Inflammatory Tips

1.1. Eat a variety of fresh, whole, local, seasonal and organic Eat a variety of fresh, whole, local, seasonal and organic foodsfoods

2.2. Cold water fishCold water fish

3.3. Lean, free-range, 100% grass-fed meatLean, free-range, 100% grass-fed meat

4.4. Fiber from non-starchy vegetables and fruitsFiber from non-starchy vegetables and fruits

5.5. Use XVOO, almond oil, walnut oil, avocado oil, coconut oil Use XVOO, almond oil, walnut oil, avocado oil, coconut oil and avoid conventional, chemically processed cooking oilsand avoid conventional, chemically processed cooking oils

6.6. Flavor foods with spices and herbs (e.g. garlic, ginger, Flavor foods with spices and herbs (e.g. garlic, ginger, onion, turmeric, cayenne)onion, turmeric, cayenne)

7.7. Snack on raw nuts and seedsSnack on raw nuts and seeds

8.8. Avoid refined carbohydrates, sugar and HFCSAvoid refined carbohydrates, sugar and HFCS

9.9. Opt for water or green tea when thirstyOpt for water or green tea when thirsty

10.10. Identify and avoid food allergies/sensitivitiesIdentify and avoid food allergies/sensitivities

Healthy PlateHealthy Plate

Protein

Starch

Non-starchy veggies- raw or lightly cooked

Sweet potatoesSquashBrown/wild rice QuinoaOats

Beef (grass fed)Poultry (w/o skin)Wild gameFishDairy (Yogurt)Eggs*Grass-fed/Free-range

BroccoliCabbageCarrotsCauliflowerDGLV (e.g. Spinach, kale, chard, Brussels sprouts etc.)Green beansOnionsPeppersTomatoesHerbs/spices

+

•Healthy fats, including avocado, XVOO and nuts•Fruit for snacks•Water, wine, green tea, coffee•Dark chocolate

Organic or Non-organicOrganic or Non-organic

Dirty dozen Dirty dozen ((celery, peach, strawberry, apple, blueberry, celery, peach, strawberry, apple, blueberry, nectarine, bell pepper, lettuce, cherries, kale, potato, nectarine, bell pepper, lettuce, cherries, kale, potato,

grapegrape)*)* Clean 15 Clean 15 ((onions, avocado, corn, pineapple, mango, pea, onions, avocado, corn, pineapple, mango, pea,

asparagus, kiwi, cabbage, eggplant, cantaloupe, asparagus, kiwi, cabbage, eggplant, cantaloupe, watermelon, grapefruit, sweet potato, honeydew melon)*watermelon, grapefruit, sweet potato, honeydew melon)*

Toxic load – pesticides are pro-inflammatory Toxic load – pesticides are pro-inflammatory because they cause cell damage and produce free because they cause cell damage and produce free radicals radicals

*Environmental Working Group*Environmental Working Group

(www.ewg.org)(www.ewg.org)

Anti-inflammatory Botanical Anti-inflammatory Botanical MedicinesMedicines

Boswellia- large native tree of India

Inhibits lipoxygenase activity. Affects glycosamninoglycan synthesis and improves blood supply.

Bromelain- proteolytic enzymes from the stem of pineapple

Promotes fibrinolysis, inhibits kinins and PGE2s and stimulates PGE1.

Curcumin - yellow pigment that is the active component of turmeric.Well documented in over 2000 studies.

Decreases platelet aggregation, cytokines, kinases fibrinolysis and macrophage activity.

Olygomeric Proanthocyanidins (OPCs), e.g. pycnogenol and other bioflavonoids

Inhibits lipoxygenase activity (PGE2 and LTB4). COX 1 and COX 2 inhibition. Decreases affects of bradykinin. Affects cytokines, collagen cross-linkage and connective tissue. Antioxidant.

Quercetin- apples, onions, teas, berries, vegetables of the cabbage family, seeds, and nuts

Inhibits lipoxygenase activity and histamine. Decreases neutrophil lysosomal enzyme activity and lipid peroxidation.

Anti-inflammatory Anti-inflammatory SupplementsSupplements

Black current oil/Evening primrose oil/Borage oil(GLA)

See fish oil

Chondroitin Sulfate (GAG) Glycosaminoglycan that affects chondrocytes and articular cartilage

CoQ10 Affects creatine kinase and lactate dehydrogenase (not via inflammatory process).Anti-oxidant. Reduces CRP. Affects cytokines.

Fish Oil (EPA and DHA)- herring, mackerel, salmon, tuna

Changes balance of PGs and LTs. Decreases PGE2 , TXE2 and LTB4.Increases PGE1, TNF, IL1. Slows AA production.

Glucosamine Sulfate Building block of proteoglycans (ground substance of articular cartilage.

NOTE: Pregnant women and people taking medications should consult a physician or pharmacist before taking supplements due to potential interactions. A good resource is Food-Medication Interactions by Zaneta M. Pronsky.

Anti-inflammatory Anti-inflammatory SupplementsSupplements

Vitamin C Anti-oxidant and anti-histamine. Promotes collagen and elastin formation.

Vitamin D Low D3 levels are associated with markers of endothelial dysfunction and inflammatory activation.Normal range is 30.0 to 74.0 nanograms per milliliter (ng/mL) 25-hydroxy vitamin D

Vitamin E (mixed-tocopherols) Protects lysosomal and other membranes which may inhibit histamine and serotonin. Inhibits chemotaxis. Increases glutathione peroxidase.

Magnesium Needed for collagen synthesis and bone density; deficiency associated with free radicals, cytokines, histamine and Substance P.

Whey Protein Production of collagen and repair of the extracellular matrix; important for wound remodeling

Supplement DosagesSupplement Dosages Antioxidants: A, E, C, Se, Zn (e.g. Carlson’s ACES+Zn)Antioxidants: A, E, C, Se, Zn (e.g. Carlson’s ACES+Zn) Boswellia (standardized extract of boswellic acids 37.5%)- 400mg 3x/dayBoswellia (standardized extract of boswellic acids 37.5%)- 400mg 3x/day Bromelain- 2000-3000 MCU 3x/day away from foodBromelain- 2000-3000 MCU 3x/day away from food CoQCoQ1010: 150-300 mg/day: 150-300 mg/day EPO/BCO/Borage seed oil (GLA)- 300-600 mgEPO/BCO/Borage seed oil (GLA)- 300-600 mg Fish Oil – about 10g per day to equal at least 3g EPAFish Oil – about 10g per day to equal at least 3g EPA Ginger: standardized for 20% gingerol and shogoal, 100-200 mg 3x/dayGinger: standardized for 20% gingerol and shogoal, 100-200 mg 3x/day Glucosamine and Chondroitin Sulfate- 1500 mg and 1200 mg respectivelyGlucosamine and Chondroitin Sulfate- 1500 mg and 1200 mg respectively Magnesium- 2:1 ratio with CalciumMagnesium- 2:1 ratio with Calcium Multivitamin/Mineral (without Fe unless menstruating or anemic) Multivitamin/Mineral (without Fe unless menstruating or anemic) Pycnogenol (OPC)- 150 mg 2x/dayPycnogenol (OPC)- 150 mg 2x/day Quercetin- 400 mg 20 minutes before meals 3x/dayQuercetin- 400 mg 20 minutes before meals 3x/day Turmeric (standardized at 90 to 95% curcumin): 250-500 mg 3x/day Turmeric (standardized at 90 to 95% curcumin): 250-500 mg 3x/day

between mealsbetween meals Vitamin C with Bioflavonoids – start with 1 g/day and increase to bowel Vitamin C with Bioflavonoids – start with 1 g/day and increase to bowel

tolerancetolerance Vitamin D: 4000 IU/day maintenanceVitamin D: 4000 IU/day maintenance

Supplement considerationsSupplement considerations: capsules, no : capsules, no additives/preservatives/colors/excipients (inert dilutents). Herbs should be additives/preservatives/colors/excipients (inert dilutents). Herbs should be standardized extracts.standardized extracts.

Anti-Inflammatory Meals & Anti-Inflammatory Meals & SnacksSnacks

Breakfasts Dr. Geoff’s Pancakes*Flourless Honey-Almond Muffins*Happy Hippie*: quinoa or oats w/ toasted walnuts, blueberries, ground flax & local honeyHuevos Rancheros: heat a corn tortilla and spread vegetarian refried beans on it. Add a sunny side-up or scrambled egg and top with sliced avocado and mango or tomato salsaOrganic, plain yogurt with fresh berries and toasted nuts (almonds, walnuts, pecans, etc.). Add local honey for desired sweetness.Steel cut oats mixed with almond butter or nuts, diced apples or pears (cook them into the oats) and cinnamonSuper Smoothie*Veggie scramble with eggs, onions, mushrooms and spinach, and a side of turkey bacon or roasted sweet potatoes


Lunches Bean & Kale Scramble*Brown rice & beans with fresh Cranberry-Avocado Salsa*Garlic Chickpeas and Greens*Lentil and Green Olive Salad*Mango & Black Bean Salad* with corn tortillas (preferably sprouted corn)Tuna salad, chicken salad or egg salad on mixed greens with diced avocado (and any other colorful veggies desired) and homemade dressing*Leftovers!


Snacks Avocado with fresh lime juice and sea saltBerries (or any fresh fruit) + a handful of nuts or plain yogurtCelery or apples with peanut butter or almond butterDeli turkey (antibiotic-, hormone-, and nitrate-free) wrapped around apple slicesEdamameHardboiled egg and carrots or snap peas “Mary’s Gone Crackers” with wild smoked salmonPeanut Butter Balls*Pumpkin seeds (toasted & salted, if desired)Tomatoes, minced garlic, extra virgin olive oil, balsamic vinegar and chopped basil (fresh mozzarella cheese, optional)Tortilla chips and guacamole* (see recipes “Tasty Tortilla Chips” and “Josh’s Guacamole”)Trail mix with almonds, cashews, walnuts and dark chocolate chips or dried cranberriesVeggies (carrots, jicama, celery) with hummus


Dinners ¼ of plate: Choose a protein (preferably organic and w/o hormones or antibiotics) - fish, chicken/turkey w/o skin/fat, grass-fed meat, shellfish, beans/lentils or tempeh/tofu¼ of plate: Choose a starch (yams, sweet potatoes, squash, peas, corn, quinoa, brown rice, etc.) ½ of plate or more: Choose a variety of non-starchy veggies.

Specific dinner ideas: Hearty Soups and StewsChicken & Black Bean Chili*Ethiopian-Style Chickpea Stew*Olga’s Vegetable Soup*Tuscan White Bean Soup* with quinoa or brown rice

The Main Event: ProteinCod in Tomato Sauce* (the name is bland, but the fish is phenomenally flavorful!)Grilled Paprika Chicken*Salmon Cakes*


Dinners

SidesBeet and Kale Salad*Herbed Sweet Potatoes*Mohamed’s Saucy Dip (may be used as a topping or dip for almost anything!)*Roasted Kale* and Sauteed Kale Stems* Desserts:Chocolate Bark*Fabulous Fruit Crisp*No-Bake Chocolate Brownies*Raw Chocolate Macaroons*

Anti-inflammatory Anti-inflammatory RecipesRecipes

The Anti-Inflammatory Meal & Snack The Anti-Inflammatory Meal & Snack List and all associated recipes will List and all associated recipes will

available to download at no charge for available to download at no charge for two weeks after the conference. two weeks after the conference.

Just visit www.nutritionhousecalls.com Just visit www.nutritionhousecalls.com and click “Recipes”.and click “Recipes”.

References for Anti-Inflammatory References for Anti-Inflammatory Food SlidesFood Slides

1.1. Beauchamp, G.K., et al. Ibuprofen-like activity in extra-virgin olive oil. Nature, 2005, Beauchamp, G.K., et al. Ibuprofen-like activity in extra-virgin olive oil. Nature, 2005, 437, 45-6.437, 45-6.

2.2. Connolly, DAJ, et al. Efficacy of a tart cherry juice blend in preventing the symptoms of Connolly, DAJ, et al. Efficacy of a tart cherry juice blend in preventing the symptoms of muscle damage. British Journal of Sports Med 2006; 40:679-683.muscle damage. British Journal of Sports Med 2006; 40:679-683.

3.3. Jurenka, J. Jurenka, J. Therapeutic Applications of Pomegranate (Punica granatum L.): A Review. Alternative Medicine Review, 6/8/08, Volume 13, No. 2.

4.4. Journal of Agricultural and Food Chemistry, 2006, 54 (7), pp 2563 – 2566.Journal of Agricultural and Food Chemistry, 2006, 54 (7), pp 2563 – 2566.

5.5. G. Davison, et al. The effect of acute pre-exercise dark chocolate consumption on G. Davison, et al. The effect of acute pre-exercise dark chocolate consumption on plasma antioxidant status, oxidative stress and immunoendocrine responses to plasma antioxidant status, oxidative stress and immunoendocrine responses to prolonged exercise. European Journal of Nutrition, online first, 5 April 2011prolonged exercise. European Journal of Nutrition, online first, 5 April 2011

6.6. Phan PV, Sohrabi A, Polotsky A, Hungerford DS, Lindmark L, Frondoza CG. Ginger Phan PV, Sohrabi A, Polotsky A, Hungerford DS, Lindmark L, Frondoza CG. Ginger extract components suppress induction of chemokine expression in human extract components suppress induction of chemokine expression in human synoviocytes. J Altern Complement Med. 2005 Feb;11(1):149-54. 2005. synoviocytes. J Altern Complement Med. 2005 Feb;11(1):149-54. 2005. PMID:15750374. PMID:15750374.

7.7. Ahmed Salah-Uddin. EGCG inhibits IL-1Ahmed Salah-Uddin. EGCG inhibits IL-1ββ-induced IL-6 production and COX-2 expression -induced IL-6 production and COX-2 expression in rheumatoid arthritis synovial fibroblasts in-vitro. Study conducted by University of in rheumatoid arthritis synovial fibroblasts in-vitro. Study conducted by University of Michigan researchers and presented 4/29/07 at Experimental Biology Conference in Michigan researchers and presented 4/29/07 at Experimental Biology Conference in Washington, D.C.Washington, D.C.

8.8. Isolauri, Erika. Probiotics in human disease. Journal of Clinical Nutrition, Vol. 73, No. 6, Isolauri, Erika. Probiotics in human disease. Journal of Clinical Nutrition, Vol. 73, No. 6, 1142S-1146S, June 20011142S-1146S, June 2001

9.9. Issuree, et al. Resveratrol attenuates C5a-induced inflammatory responses in vitro and Issuree, et al. Resveratrol attenuates C5a-induced inflammatory responses in vitro and in vivo by inhibiting phospholipase D and sphingosine kinase activities. FASEB Journal in vivo by inhibiting phospholipase D and sphingosine kinase activities. FASEB Journal 2009; 23(8).2009; 23(8).

Other ReferencesOther References www.vitasearch.comwww.vitasearch.com Werbach, Melvyn R. Second Edition. Werbach, Melvyn R. Second Edition. Nutritional Influences on Nutritional Influences on

Illness: A Sourcebook of Clinical ResearchIllness: A Sourcebook of Clinical Research. Third Line Press. 1993.. Third Line Press. 1993. Werbach, Melvyn R.. Werbach, Melvyn R.. Botanical Influences on IllnessBotanical Influences on Illness: : A Sourcebook A Sourcebook

of Clinical Research. of Clinical Research. Third Line Press. 1994Third Line Press. 1994 Healthnotes. Healthnotes. The Natural Pharmacy: Complete Home Reference to The Natural Pharmacy: Complete Home Reference to

Natural Medicine.Natural Medicine. Prima Publishing. 1999 Prima Publishing. 1999 Gaby, Alan R. Gaby, Alan R. Nutritional MedicineNutritional Medicine. http://www.doctorgaby.com. . http://www.doctorgaby.com.

20102010 Marz, Russel B. Marz, Russel B. Medical Nutrition from Medical Nutrition from MarzMarz. Omni Press. 2002.. Omni Press. 2002. Seaman, David R. Seaman, David R. Clinical Nutrition for Pain, Inflammation and Clinical Nutrition for Pain, Inflammation and

Tissue HealingTissue Healing. NutrAnalysis. 1998. NutrAnalysis. 1998 Simopoulos AP. Essential fatty acids in health and chronic disease.Simopoulos AP. Essential fatty acids in health and chronic disease.

Am J Clin Nutr. 1999 Sep;70(3 Suppl):560S-56Am J Clin Nutr. 1999 Sep;70(3 Suppl):560S-56

Geoff Lecovin, MS, DC, ND, L.Ac, Geoff Lecovin, MS, DC, ND, L.Ac, CSCSCSCSEvergreen Integrative MedicineEvergreen Integrative Medicine(425) 646-4747(425) 646-4747www.geofflecovin.comwww.geofflecovin.comgeofflecovin@[email protected]

Stephanie Lecovin, MS, RDStephanie Lecovin, MS, RDNutrition HousecallsNutrition Housecalls(206) 604-5239(206) 604-5239www.nutritionhousecalls.comwww.nutritionhousecalls.comstephanie@[email protected]

Turning Down the Heat The Effects of Diet and Nutritional Supplements on Inflammation and Repair...

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