1. Nutrition and Exercise Class Three: Nutrition and Exercise for Pain Management for Veterans August 29, 2015 By Heather Díamani

2. The Connection Between Nutrition & Exercise for Pain You are what you eat. Nutrition and Exercise are a marriage, you can’t have one without the other A nutritious diet and regular exercise can help improve your pain

3. Benefits of Nutrition & Exercise for Pain Benefits of Nutrition Eating a healthy diet can improve inflammation and circulation If heavy, losing weight though a nutritious diet can help relieve pressure on the painful areas Replace medication with natural foods. Experience no side effects! Benefits of Exercise Strengthen weak injured muscles Improve balance and flexibility Improve posture Weight loss through exercise for heavy people helps relieve extra pressure

4. What Your Diet Should Look like: Example of Healthy Eating Men ages 19-50: Aim for 3 cups (or servings) of vegetables daily, 2 cups of fruit daily, 7-8 ounces of grains daily, 6-6.5 ounces of protein daily, 3 cups low-fat or non-fat dairy daily Women ages 19-30: 2 cups of vegetables daily, 2 cups fruit daily, 6 ounces of grains daily, 5.5 ounces of protein daily, 3 cups low-fat or non-fat dairy daily Women ages 31-50: 2 cups of vegetables daily, 1.5 cups fruit daily, 6 ounces grains daily, 5 ounces of protein daily, 3 cups low-fat or non-fat dairy daily (ChooseMyPlate, 2015) Calories intake will vary with height, weight and age. Check your intake at: https://www.supertracker.usda.gov

5. Effects of Sugar and Alcohol on Pain Sugar causes attack on tissues and cells which can cause inflammation Body can naturally regulate inflammation unless sugar interrupts the regulatory system. Medication and alcohol don’t mix; it causes more damage to the liver. Alcohol may only provide temporary relief. Alcohol abuse can be an issue. Alcohol is a depressant.

6. Herbs and Supplements for Pain Herbs Turmeric for inflammation Devils Claw for joint pain (anti- inflammatory) Kava (relaxing, analgesic) Topical capsaicin cream for sore muscles Cramp bark for muscle spasms Meadowsweet for joint and muscle pain (anti-inflammatory, mild analgesic) (Skidmore-Roth, 2010) Supplements L-Glutamine for muscle and tissue pain Vitamin D and Calcium for joint health Glucosamine sulfate for joint pain SAMe for osteoarthritis Magnesium for migraines, muscle spams, fibromyalgia Acetyl-L-carnitine for nerve pain (Keifer, 2012)

7. Importance of Hydration Drink water to avoid inflammation! Water helps lubricate joints Water helps avoid or alleviate muscle cramps Keep muscles and tissues functioning properly Water cleanses out toxins Water can aid in weight loss by speeding metabolism Improves digestion Can improve headaches caused by dehydration

8. Exercise for Pain Management Strength training (resistance band exercises or weightless workouts) Yoga Tai-Chi Cardio on the bike if jogging is painful Consider a personal trainer that can create exercises

9. Importance of Stretching or Foam Rolling Stretching Relieve muscle tension or aches Improve flexibility Increase blood flow and oxygen to muscles Improve range of motion Foam Rolling Soothes tight muscles Decreases lactic acid build up Limit soreness and tightness by increasing blood flow and flexibility

10. Time to Stretch! Let’s watch this video and stretch together: https://www.youtube.com/watch?v=6LuXDbNxV7M https://www.youtube.com/watch?v=6LuXDbNxV7M

11. Self-Assessment & Create Your Own Plan Fill out the Diet Assessment Questionnaire Fill out exercise assessment Create your own pain management plan

12. References ChooseMyplate (2015). “Daily recommended intakes”. United States Department of Agriculture. Retrieved from: http://www.choosemyplate.gov Keifer, D (2012). “Supplements for Pain Relief”. WebMD. Retrieved from: http://www.webmd.com/vitamins-and- supplements/lifestyle-guide-11/chronic-pain-relief?page=4 Lasich, C. (2009). “Sugar leads to spike in chronic pain”. Health Central. Retrieved from: http://www.healthcentral.com/chronic- pain/c/23153/92035/goblins-pain/ Skidmore-Roth, L. (2010). Herbs and Natural Supplements (4 th ed.). El Paso, TX: Mosby-Elsevier Publishing.

13. The End! Thank you all so much for coming! Congrats on taking the steps to take control of your pain!