Diet as an adjunct to PMR Treatment

Bones, joints and muscles
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For years on and off I've struggled with a plant based diet that eliminates animal fat, oil, and as much sugar as possible.  I've fallen off of it more than I've been on it, but I have stayed on it for nearly a year at a time.  Why?  Because such a diet can halt and even reverse the progress of heart disease.  See dean ornish, Caldwell esselstynn and others who have peer reviewed studies.  The science is strong, but for someone who is used to a diet worse than most westerners its a real challenge.

While I've been struggling with PMR for the last 20 months my diet and weight has suffered.  Its hard enough just getting through a day let alone  spending hours preparing various vegetarian dishes...sooo...I've had a bad diet, and increased weight.

Nevertheless, using DSNS I'm down to 5mg a day.  However, I was starting to get increased pain, feeling very sluggish and just before I was hoping to start on 4.5mg.  Feeling sore and depressed, I also realized my diet was doing myself no good, and maybe getting back on it would help me feel better in general.

So, I went back on a very low fat (10% total calories) all vegetarian diet.   Meaning no animal products, no oil, very low sugar, and no dairy.  All the good things happen that always do, clearer head, higher energy level, but here is the kicker...

My PMR pain levels went down down down in just a few days!  Suddenly I could help around the house and get some work done!  I'm going to wait 5 more days, and if this continues I'm going to start DSNS to 4.5mg.

High levels of fat and animal protein cause arterial inflamation.  Perhaps there is some sort of connection?  Sugar levels are also dropping because I've cut out all sugar treats and virtually all processed foods, which in the US always contain lots of fat, sugar, or my favorite:  lots of fat AND sugar.  Sugar appears to be either directly or indirectly atherogenic.

I'm not a doctor, and I don't even play one on TV, but my reduction in pain in a short period is profound.  My Wife would tell you that she can't believe the difference.

This is something you can try.  I recommend Dr Caldwell Esselstyn's work, "Prevent and Reverse Heart Disease".  Its nothing to do with PMR, but the diet within seems to have related benefits.

I'll update this discussion in another week or so.  Will I continue to feel better, or will my fortunes reverse?  Turn the page...

Mark

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I'd suggest a read of this "Why Almost Everything Dean Ornish Says about Nutrition Is Wrong. UPDATED: With Dean Ornish's Response:  A critique of the diet guru's views on high-protein diets, followed by a response from Ornish and a reply from the author" if you can find it.

While there are a lot of things about his diet that may (or may not) be good, his approach is muddled. Be that as it may - if it works, fair enough.

But any successful diet has to be one you can cope with and stick to. And you are struggling. Maybe you could find a halfway house that is better? Taking sugar and refined carbs out makes a major difference - without necessarily removing good animal protein.

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PS - having a peer reviewed study doesn't mean it is correct. It just means there are others who agree with the premise and/or feel it deserves to be put out there for discussion. There is some utter rubbish publised as "peer-reviewed" - the place it is pubished is often a signpost.

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I read accounts of diets that have had spectacular results and I'm full of admiration for those who can cope with them but am at a loss to understand how it is done. 

I am fortunate in that all my life I've disliked sweet and also salty things. I use to give away my sweet ration coupons as a child!

No animal products, no oil, no dairy would be pretty joyless for me. I eat very little meat but I do like cheese and butter and full strength milk. Fish a couple of times a week and a lot of fruit ( so, presumably a fair helping of sugar there )and I make my own organic bread. Not 100% wholemeal as it makes rotten toast but a malted grain variety which has a lovely flavour and is 85%.

I look at pictures of plates piled high with leaves and I just know I'd never chew my way through it all.

I've never eaten a takeaway meal; where I live you'd have to go ten miles to find one. If there is an organic choice I take it ( butter, milk chicken etc. ) I avoid coffee because it gives me stomach ache.

It has worked for me so far but I know there will be lots of people who wouldn't want to eat my diet!

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Mark, do you have coronary heart problems or are you using the Dean Ornish research findings as a preventative measure? As far as I remember this researcher's patients had recently experienced a 'cardiac event' and had therefore a coronary angiogram before embarking on his 'program' and a repeat angiogram at the end of one year. If your interest is for primary prevention, it would be difficult  for you to avail of these procedures -  and therefore you'd be unable to check whether your considerable efforts paid off . . . And, as you may know, diet is only one aspect of this rigorous program, the others being intense exercising, relaxation training etc.

When I worked in Cardiology this researcher's work was deemed by the cardiologist  to be interesting but impossible for an ordinary person to implement for any length of time as almost all of us 'Westerners' would find it, not just difficult but hugely stressful.  You certainly have my admiration for all of your efforts - and you seem to enjoy some clear benefits. . . can't knock that!

The other aspect to consider may be your low dairy intake.  I presume you have really good alternatives for protein and calcium.  I made a big mistake here, having followed a pretty woeful vegetarian diet for years with low animal protein (or alternatives)  and it played some role in my development of osteoporosis. At the same time the lovely PMR reared it's ugly head so I was doubly blessed!  Thankfully, the PMR (after 4 and a half years) is almost gone. 

Kind regards,  J

In sum, I think Eileen's " halfway house " comment is the most intelligent approach. As I know to my cost, being wise with hindsight isn't a comfortable place !!! 

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No, it doesn't mean its correct, but it is.

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There is no good animal protein when you have atherosclerosis (which you have to some extent if you eat a western diet), and as Esselstynn says, "moderation kills".  I'll keep struggling.

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Juno, I've never had a cardiac event, but I do have atherosclerosis, so does _everyone_ who eats a western diet in varying degrees.  Mine is at a more severe point, and since most everyone in my family has died of heart disease, I take it seriously.  Moderation is not the answer if you want to reverse and open your arteries.  Moderation will just let you die more slowly. 

Protein and calcium are not issues is you eat properly.  Really though, I'm not out to convince people that you can reverse coronary artery disease in this discussion group.  If you're interested, great, if not that's fine too.  My point is that a few days on the diet seems to have significantly reduced my PMR pain levels.  That was my point...the point nobody seems interested in responding to.  That's okay too.  However, I've had something positive happen to me, and thought I'd share.  FYI,  I vastly prefer Esselstyn's approach over Ornish, and his results were better too.

mark

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Ornish's results were good, but Esselstyn's were better, and his approach simpler too, no mediation or even exercise required, although the latter is a definite plus.  Its less muddled you might say.

The diet is difficult, but most things worth doing are.  However, the point of my original post wasn't to convince anyone of its efficacy with respect to heart disease.  Believe what you like.  My point was that only a few days in on the diet I experienced a significant reduction in PMR pain and fatigue.  I thought that might be worth passing along to the group.  I find the idea of of diet impacting on disease intriguing, most particularly in the case of PMR.

Mark

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Betty, I was just sharing the fact that the diet I'm on seems to have been instrumental in reducing my PMR pain and fatigue.  I thought that might be interesting.  Seems not.

mark

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I did mention that your efforts showed some clear benefits - and by that I meant improvements in your PMR symptoms. . . . 

You touched on the possible effects of a specific diet on inflammation in the coronary artery walls and it's HERE I think there will be big findings in the future. Inflammatory activity can be related to inherited factors, diet, stress etc. and it seems, is an important factor in causation of many common chronic diseases like. Alzeimers, Crohns, MS, RA CHD .and others. .  Huge research is ongoing here in the development of anti-inflammatory medications -  because the benefits of success are enormous.. .

As for " moderation will make you die more slowly" -  well, maybe it will, but aren't we all dying slowly anyway?  If the alternative is to die an 'extra'  little more slowly, and be miserable, I'll opt for the

'more- enjoyment- but-not- stupid'  option and live a bit - while I'm still here!!!   Sorry to be so mawkish! 

Best wishes, and thanks your your interesting posts.  J

 

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Mark,

I am convinced there is a direct relationship between what I eat and the level of PMR pain and stiffness.  

While I haven't strictly cut  them out,  based on my experience, sugar and carbs today equal pain and fatigue tomorrow.  My  doctors, and literature I've read, do not support such claims.

Thanks for sharing your experience. Good luck reducing to 4.5 mg. I hope you have continued success. 

Thanks for sharing your 

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Danielle,  I'm not aware that there's ever been a study of how diet might affect PMR.  The disease itself isn't that well studied.  As for what doctors say;  here in America at least doctors know very little about nutrition.

I'm eating a fair amount of carbs in my very low fat diet, but I eat complex carbs; vegetables, legumes, and fruit.  I stay away from simple carbs.

That said, I've drastically reduced sugar in my diet along with fat.

Whatever the case, each day I feel better and better and feel more certain that its diet related.   We'll see.

Mark 

 

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Hi Mark, thanks for sharing your experience. As you know everyone is different, so don't be surprised at the response you get on this forum. I have not found that diet impacts PMR in my case. However, I did find that moderate exercise and stretching helps me thru the day.  I dont think my diet is typical western diet, since we don't eat as much meat, but I dont avoid carbs  or dairy or sweets or coffee or drinks.  But again that is my choice.  I have seen "research" on dairy or coffee or animal fat flip 180 just about every 10 years or so.  I think the results depends more on who is financing the study then what the study is about biggrin.

P.S. I think Eileen's point was that no diet is good unless you can take it for life. Most of the studies I have seen shows that people revert back to old habits within a years time.  That is why "halfway house" may work better in a long run.

 

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But it was interesting! That was the point I was trying to make. Must try harder as I used not to write on my pupil's work.

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Mark, I have a terrible time with diet and am "allergic" or intolerant of so many foods it's frightening.  I seem to react to sulfites and salicyclates which maybe, jus maybe is due to a genetic disorder that results in an inability to process the enzymes found in these foods?,,so my diet is extremely, extremely limited.  I think that my body's reaction to so many foods and environmental triggers contributed to my inflammation which resulted in pmr...plus the fact that a doctor did test me for the celiac gene which I don't have so she insisted that I eat gluten to fill in my very limited diet.  A year later:  pmr.  Unlike you, I haven't seemed to have found the right combination of low inflammation foods but I think they are a contributor...wishing you well....

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It is interesting - but you are missing my point which Juno, Betty and Nick have expressed far more clearly than I obviously did. I'm not dissing diet - what I am dissing is a diet that requires major input and as a result may cause stress. Because PMR and stress of any sort do not mix well either. 

It depends to a great extent what your starting diet is - you say "western diet" as if that is universal. It isn't. It may be particularly bad in the USA and cutting the amount of meat and processed foods you eat there probably is an excellent idea. But lliving here in central Europe I eat less than 100g/4oz of lean meat any day, a litre of milk lasts the two of us 4 days and I eat almost no processed meats and processed baked goods about 3 times a year. Nor, as it happens, any more home bakes than that. The only oils/fats I use are olive oil and butter. I do eat the occasional icecream - living in Italy it would be rude not to!

Within the last few years I have had both carotid artery scans and cardiac wall vessel scans - there is no visible athersclerosis. 

Like Betty, to go vegan and also remove oils from my diet would be totally joyless. And frankly - I don't want to live longer but be unhappy. And the exercise aspects of the diets are not always options for many patients with PMR - and before you pounce on that, there are many reasons for that.

Long term use of a diet like Ornish's will also put you at risk of other problems - whatever he claims, very low fat diets are not always healthy for us. The body requires fat to work well. He recommends soy-based foods - even in his "cancer diet" which is a total nonsequiteur. A high carb diet causes a lot of things that in PMR may not be helpful. So please be careful in the long run and check you are not developing nutritional deficiences.

I'm not disputing your diet has, in the short term at least, done YOU good. My asthmatic granddaughter has also benefited from a vegan diet. But I still have serious doubts about Ornish's proposed diets and their benefits in general. So I think we will have to agree to disagree. 

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Many years ago we were all lead to believe that a high fat diet made us fat. Made sense to me. Research over the years has proven this to be wrong. When the diet of obese people has been studied it was apparent that their biggest intake was in fact carbohydrates. Carbohydrates are now the evil nemesis!

i personally believe moderation is the key to good health. We need fat. We need carbs. We also need proteins and minerals. If you eat a diet high in vegetables, moderate amounts of lean protein I believe you will nourish your body and with some exercise, avoid obesity.

i haven’t found eating too much or too little of any particular food makes a difference to my PMR. Sure, moderation may lead to a slow death...but a much more pleasant one than limiting myself to one food group or eliminating one food group. It’s not that you are dying slowly, it will just FEEL like it! Haha

And the mind is a wonderful thing...you can convince it of many things...including an improvement in pain levels! 

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Hi Mark,

Yes, I believe diet is an adjunct treatment. I have had GCA for around 2 years and have done lots of research. My diet is pretty fine tuned to me and when I go off it I have a flare or worse, I have relapsed. 

Wish you the best,

Karen

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"My diet is pretty fine tuned to me " - and THAT is the point!