What is nutrition? Nutrients are the chemical components that make up food. Nutrients are what you eat to give your body the base it needs to keep running, also known as metabolism. Certain nutrients such as carbohydrates, fats, and proteins provide energy. Some substances such as water, electrolytes, minerals and vitamins are needed in the metabolic process. Nutrition is all the chemical changes that take place in our bodies every day with what we eat. Good nutrition means that what we eat increases my health. Once we digest and absorb it, food does important work in our bodies. Tissues need good nutrition to grow and repair. We get good nutrition by eating foods and various supplements that contain all the right and necessary ingredients, and what we swallow needs to be fully digested for us to get good nutrition. Then we must absorb the nutrients into our blood and other body fluids. When cells take in the right nutrients, the body can metabolize or work efficiently and healthily. Based on the definition above, we know that many of the things we eat are not nutritious. When we take a purple pill or drink a blue sports drink, what we eat does not do anything in our bodies; that purple or blue color is not a chemical that the body needs to use. The same goes for some of the things in our grains like preservatives. These chemicals are there to keep the grains in the box from getting moldy. The same goes for the traces of hormones and antibiotics left in our meat and everyday foods that we don’t need. When we eat French fries at a fast food restaurant, the fried oil becomes a fat that our bodies cannot use. In fact, it becomes a “trans fat. “Trans fats” damage the body’s cell walls, which leaves your body with more work to do. What is metabolism? Metabolism refers to all the physical or chemical changes that occur in our bodies every minute of every day. Producing energy is part of the body’s metabolism. All the physical movements that occur within the cells are also part of the metabolic process. Metabolism includes all the physical activity and chemical changes that occur daily in bone, connective tissue, body fluids and organs. Metabolism is the process by which the chemical energy in the nutrient components of a cell is converted into mechanical or thermal energy. Metabolism consists of two basic processes, anabolism and catabolism. In anabolism, the body transforms the simple chemical components it eats into complex components, such as blood, bone, connective tissue, etc. In catabolism, complex parts are broken down into simple pieces. When we break down the apple we chew and swallow, it is a catabolic process that is broken down into water, fiber, vitamins and minerals. Catabolism often culminates in excretion. When anabolism and catabolism are in the right balance, we are healthy. Our bodies have a good way of recognizing which foods we eat are useless and can remove it. But telling the good from the bad takes a lot of good nutrients out of the equation. It also takes cellular energy to get rid of the harmful stuff you eat. Nutritional Drugs Nutritional drugs are important if you have pain, if your joints are inflamed, or if you’re overweight and your food doesn’t provide enough nutrients to do all the necessary work. Although the standard American diet is a good one, with fruits, vegetables, whole grains and the right amount and type of protein, there is often not enough nutrition for all the work your body needs to do. We use a lot of chemical fertilizers to grow fruits and vegetables. When fruits and vegetables are on the plate, the chemicals from the fertilizer are still left on them. The same goes for the pesticides and herbicides that are sprayed on plants before they are harvested. We pick and harvest fruits and vegetables before they are ripe, and then they are transported thousands of miles to our markets. Harvesting fruits and vegetables when they are not quite ripe means they don’t have full nutritional value yet. Harvesting them early makes them less likely to get crushed and bruised when they’re loaded and unloaded on the truck, and they look good when you buy them. But when you eat them, they don’t have all the nutrients you need. The right balance We face challenges that our grandparents didn’t know existed. There are extra chemicals in our food and water. Our food supply is not as nutrient dense as we need them to be. A reasonable balance between protein and high-fiber, starchy foods is important for good nutritional health. It’s important to understand that nutrient components often work together. Nutritional medicines can be helpful when your diet is not perfectly balanced. The same is true when you can’t do everything you eat organically. Supplementation with vitamins, minerals, amino acids and fatty acids is a way to help you meet all of your body’s needs on your own, including growth and repair after injury, as is the metabolic activity needed to feel good, be strong and live a healthy life. Healthy fats are needed for growth and the repair of normal connective tissue, bone and body fluids. Your body was born dependent on the fiber and carbohydrates found in whole grains and fresh produce. Oils found in olive oil, deep-sea fish (such as salmon and sardines), nuts and seeds are all part of good nutrition. Organically raised vegetable cattle and poultry as well as wild sea fish provide good quality protein. When you can’t eat organically raised meats, you need to reduce your exposure to harmful chemical residues. You can do this by removing all visible fat before searing the meat. Specific problems may be related to deficiencies or excesses of a single vitamin or mineral. But the human body needs the correct amounts of all nutrients for proper function. You can think of it like a recipe. When all the ingredients in your soup are balanced, it tastes good. Too much spice and not enough salt can make what is really good food taste bad. The same goes for the nutritional “soup” in your body. You need to consume the right amount and the right ratio of nutrients to make your body’s systems work best. Each vitamin, mineral, amino acid and fatty acid has hundreds of tasks to perform. If a nutrient is not well managed in relation to other nutrients, it will not do its job well. How does nutrition affect the spine? Nutrition determines the strength of your teeth, bones, and connective tissue. We begin building our bones and connective tissues before we are born. What we eat as children will play a major role in how strong we are in adulthood. What we eat throughout our lives will determine your ability to repair your bones, cartilage, ligaments, tendons, and muscles. Everyone needs to renew the body’s tissues because of the normal wear and tear that occurs every day. Some of us also need to cope with trauma and repair after surgery. The unprocessed repair material comes from our diet. Vitamin C, all types of B vitamins, vitamin D, vitamin K and the minerals calcium, magnesium, copper, zinc, boron and manganese are especially important for bones and connective tissue. Drinking adequate amounts of water is also necessary. The spine is the bones in your back. The bones of the spine are called vertebrae. There are generally 33 vertebrae. Between each vertebral body is an intervertebral disc made of cartilage, which has a fluid center. The discs provide a cushion for the bones in the back to bend and twist. When we walk, run, or jump, the discs act as shock absorbers. Each vertebral segment consists of two adjacent vertebrae and a cartilage cushion in between, which are connected by connective tissue, ligaments and tendons. Degenerative disc disease is an example of a nutrition-related connective tissue injury. Everyone has some degree of damage to the spine, and this damage continues throughout life. The discs can be injured and can protrude from between the bones, and in time, most people have tiny tears in the outer layer of the disc. If you are malnourished, you are more likely to have an injury and less likely to get good healing. Malnutrition means not getting enough vitamins C, A, B6 and vitamin E, as well as the minerals zinc and copper. Daily wear and tear can accumulate during work and sports, and accidents can damage the discs of the spine. Good nutrition and adequate hydration (access to sufficient fluids) are essential to the body’s ability to repair damage and restore inflammation, the latter being the cause of pain after a back injury. Connective tissue, like the ligaments and tendons that bind the joints together, is primarily made up of collagen. Collagen is a protein and water. Strong collagen fibers need a steady supply of dietary protein, and they also need vitamins C, A, B6 and E, as well as the minerals zinc and copper. Building bones with good nutrition Joints need good nutrition to build, maintain, repair, and protect them. Bone is made up of minerals such as calcium, phosphorus, magnesium and boron. Bone also contains water and collagen. The maintenance and repair of bone and connective tissue requires the correct amount of vitamins and various nutrients to work together. Another bone disease related to diet and nutrition is called osteoporosis. Osteoporosis means that bone becomes weaker and more brittle and breaks easily. Lifestyle and nutritional factors can lead to bone loss causing osteoporosis. These include what you eat during the childhood and adult skeleton-building stages. Nutrition throughout adulthood is also important for maintaining good bone density. Calcium intake is a major factor in building bone density. If you don’t consume enough calcium, the strength of your bones will decline. Likewise, although calcium is consumed, it is not absorbed or is not metabolized properly. Too much calcium may also be excreted from the urine because of the effects of the diet chosen. Other conditions such as chronic mental or emotional stress causing inflammation of the digestive tract can prevent calcium absorption. Lack of proper acidity in the digestive tract can also allow calcium to pass through without being absorbed. Vitamin D is essential for maintaining and regulating the health of bones and teeth, in addition to being involved in many other functions in the body. This compound is more of a hormone than a nutrient and other vitamins, and plays an important role in regulating immune function and cell growth. The absorption of calcium in the intestines requires the involvement of vitamin D. Vitamin D prevents the loss of bone and helps build new bone. Vitamin D is also required in the enzymes that strengthen collagen. Collagen is a major component of bone and connective tissue. Vitamin D has also been shown to help with nerve and muscle function. How can I get enough vitamin D for good body and bone health? Sunlight produces vitamin D in your skin. 5-30 minutes of sun exposure to your skin twice a week from 10 a.m. to 3 p.m. is usually enough to make your own vitamin D. As we age, the ability to make vitamin D through light exposure slowly diminishes. Diet can help, but not usually with food. Except for cod liver oil and certain types of fish (salmon, tuna, mackerel, sardines), vitamin D is not found in our food. only those foods fortified with vitamin D, such as milk, cereal, yogurt, orange juice, have significant levels of this vitamin. A very low-fat diet makes it difficult to absorb vitamin D from foods. lack of light and inadequate intake of vitamin D-fortified foods may mean you need a nutritional vitamin D supplement. your doctor will determine which and how much you choose to supplement based on your age, health status and risk factors. Vitamin D supplementation may need to be based on your current blood levels of vitamin D. Some people don’t rebuild bone as fast as they lose it, and nutritional deficiencies make this problem worse. Caffeinated beverages such as coffee and cola can lead to increased calcium loss from the urine. Coke beverages contain higher levels of phosphorus also disrupt calcium metabolism and affect bone health. Magnesium is as important to bone health as calcium. Fifty percent of the body’s magnesium is found in the bones. Magnesium is needed to transport calcium to the bones. Magnesium is also required for the activation of vitamin D. The typical American diet contains less magnesium than the daily recommended amount. Magnesium is excreted in the urine. It occurs when people are stressed. Studies have shown that some common things such as loud noises can cause increased magnesium loss. Alcohol and many medications used for heart disease and high blood pressure can also cause magnesium loss. Bone repair requires large amounts of magnesium, usually much more than the daily recommended amount. Lysine is an amino acid that humans need to activate the absorption of calcium in the intestine. Without sufficient lysine, much calcium is excreted in the kidneys. Lysine is essential for building the collagen framework. Minerals such as calcium and magnesium are woven into the collagen to form bone. You may need to supplement with these minerals, vitamins and amino acids. It is needed if you work indoors or rarely go out in the sun. You are also at high risk if you are elderly, or sedentary and drink a lot of coffee and cola-based beverages. If you have poor digestion or eat very little fat, it’s important to use high-quality supplements to protect your bones. Specific nutritional factors that increase pain and inflammation: Insufficient Omega 3 fatty acids from sea fish; Insufficient fruits and vegetables and fruits in the diet; Low sun exposure and insufficient foods fortified with vitamin D Risk factors for vitamin D deficiency (e.g., old age, dark; colored skin, use of sunscreen, obesity, kidney disease, liver disease, use of certain medications, milk intolerance, etc.); Insufficient minerals such as potassium and magnesium; Insufficient protein inadequate high-quality fats in foods used to produce enzymes that control inflammation; excess sugar and starch in the diet, leading to weight gain and excessive insulin secretion; free radical ions originating from acidified and hydrogenated fats, low-nutrient refined foods, excessive chemical additives and chemical residues. Nutrition and Inflammation Inflammation is often thought of as redness, swelling, heat, and pain that occurs after injury. Whether it is a surgical incision or a spider bite, the body will react in this way. Inflammation sometimes occurs when there is an infection, such as septic pharyngitis or painful, feverish knuckles in rheumatoid arthritis. Wound healing and symptomatic inflammation are just some of the ways in which inflammation is activated. Inflammation has occurred in the human body from time to time to a greater or lesser extent. Medical science is beginning to recognize the relationship between inflammation and many chronic degenerative diseases. Some diseases, such as cancer, heart disease or diabetes develop quietly for many years before they cause symptoms. We don’t even realize they exist. Pain is not always a part of these diseases. Sometimes people don’t even feel pain when a lot of tissue damage has occurred. Some diseases, such as osteoarthritis, gallbladder disease, or degenerative disc disease, are very pronounced, and pain levels in these diseases range from mild to unbearable. All of these diseases have one thing in common. There is inflammation of the tissues in the affected body part. The process of inflammation depends on different chemical elements. These are called inflammatory mediators. Chemical mediators release certain types of white blood cells. These white blood cells are part of our immune system. First, they travel to the target area. Then they cause a series of tissue changes in response, which we call inflammation. At first, this process is actually a repair response to some kind of tissue damage. Later, the inflammatory process may then turn chronic and cause further damage. Inflammation and Back Pain Healthy repair depends on good nutrition. Poor nutrition leads to a damaging inflammatory response in the spinal joints. The inflammatory response causes a loss of the cellular framework that holds bone and connective tissue together. Studies have shown that some people with osteoarthritis have more rapid joint damage because they have more inflammatory chemicals in their bodies. People may or may not experience back pain when the bone and cartilage in the spine changes. For example, some people have x-rays that show flattened, bulging discs, or they may have osteoporosis, yet they have no pain. It is inflammation that causes the tissue changes that produce the sensation of pain. Inflammation stimulates the proliferation of new blood vessels in the joint tissue. This proliferation process also leads to the proliferation of new nerves around the cartilage in the joints. Doctors believe this new nerve proliferation may be why back pain occurs along with inflammation. This is because inflammation increases tissue activity and swelling making the new nerves very sensitive. All the steps in this inflammatory process (new blood vessels proliferate, new nerves proliferate) put each other into a never-ending cycle. Stopping inflammation will reduce pain and slow down joint damage. Back pain and obesity Abdominal obesity adds to spinal problems in a very important way. The fat in the middle of the body causes tension in the muscles and ligaments that support the spine. The spine is especially vulnerable to daily wear and tear if it lacks support. Most of us gain weight because we eat too much starchy, refined foods that stimulate the production of more insulin. Insulin gives a signal to enzymes in the body. These enzymes increase the level of inflammatory cells. They also increase cholesterol and constrict (or close) blood vessels. All of these activities increase your perception of pain. The cells that make up belly fat are the most active in making inflammatory chemicals, and these inflammatory mediators cause damage to all joints. The more belly fat you have, the more inflammatory chemicals you make. Some thin people are also at risk for this. How does nutrition affect healing after an injury or surgery? Reconstructing and repairing surgical incisions, injured bones or connective tissues, such as cartilage and ligaments, requires good blood circulation. Blood vessels carry all the raw materials needed to maintain proper strength and function of bones and connective tissues. Your blood vessels also carry away from these parts of the body all the waste products of normal wear and tear and injury. Eating too much starch and candy, instead of enough protein and healthy lipids, causes blood vessels to constrict. As a result less blood flows to the injured areas that need repair. The growth and repair process is made up of chemical reactions, and all of this work requires good nutrition. Herbs, fruits and vegetables contain food-borne anti-inflammatory chemicals that are needed for tissue healing. Plant foods contain antioxidants that reduce the chemicals that trigger inflammation. This type of plant is known as a flavonoid. Flavonoids are plants that have physiological and metabolic properties in the body. They also promote the healing process by tightly weaving collagen fibers into the connective tissue. The result is tightly healed skin and blood vessels, dense bones, and strong, flexible ligaments and tendons. If you have spinal lesions, what changes can you make to your diet and nutritional supplements? Trying to choose what nutritional supplements to take can be confusing. With spine-related lesions, it is often difficult to know which foods to eat and which not to eat. Different musculoskeletal lesions will have different nutritional needs. The form of supplementation for each substance is also important according to what it does for your lesion. For example, the nutritional powder or liquid form in a capsule is more likely to be fully digested and absorbed. Tablets are usually cheaper, but tend to be difficult to break down in many people’s digestive tracts. Osteoporosis is an example of the strong correlation between spine-related disorders and nutritional status. Most people with osteoporosis are advised to take at least a calcium/magnesium supplement. Osteoporosis mineral supplements are best quality when powdered and made in citric acid form (e.g., calcium citrate). Vitamin D should be routinely included in anti-osteoporosis formulations. Antioxidant nutrients, such as vitamin E, are beneficial for inflammatory lesions. It must be natural vitamin E, not synthetic. For best results, it should be mixed with tocopherols. At least 5 meals per week containing fish will improve any inflammatory lesion. A daily supplement of high quality, pure fish oil is also helpful. To improve your spinal condition, you can make these changes below. By following these general principles, most people can observe results in less than 2 weeks. Drink 8 large glasses of water or herbal teas daily. Avoid juices and other beverages with coloring or added preservatives, including soda pop. Eliminate simple sugars. Remove candy and starchy, refined white flour foods from your diet. Avoid colored snacks that contain preservatives and colors. Take a high-quality multivitamin and mineral supplement with each meal three times a day. If you have any form of arthritis or other inflammatory disease, take a pure fish oil supplement. A daily intake of 1-3 grams of Omega 3 fatty acids can be helpful for many people. Look for EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid, brain gold) in the label Add vitamin D3 to the supplement. make sure you get 800-1000 IU per day. you may need more if you have a history of impaired absorption (e.g., celiac disease, inflammatory bowel disease, cystic fibrosis, gastric bypass, etc.). Long-term dietary changes are beneficial for spinal health. If overweight, consult a health professional to help you lose weight, especially belly fat. Many people would be safe to do the following: eat fresh, raw or steamed vegetables daily; eat 2-3 fresh fruits daily; eat 5-7 fish meals per week; eat 3-6 ounces of net lean beef, poultry, lamb or game daily. For most people, eggs are also a good source of protein; use olive oil daily for salads or cooking. Consume fresh nuts and seeds. Almonds, walnuts, and pumpkin seeds give us high quality, healthy fats. If you are not in the habit of exercising regularly, spend the money to find a professional to teach you how to strengthen your muscles and protect your joints. Certain exercises may be great for some spinal conditions, but can be harmful for others. An exercise professional is your best bet who can design a safe, effective program specifically for you. How long will it take to see the effects of these changes? Many people see results quickly after changing their diet. The difference in body pain levels will be noticed within a few days. A reduction in inflammatory response is quickly felt by blocking the sugar and starch triggers. When antioxidant chemicals are added, the effects of the dietary change are even more pronounced Dietary supplements can significantly facilitate the healing process. When an illness or injury follows, it takes several months of steady supplementation to rebuild tissue. This depends on how deficient you are in a particular nutrient. It takes 3-6 months to experience the benefits of a specific nutritional supplementation program. This time frame varies depending on your condition. Your doctor will give you advice. For the health of your spine, you want a specialist to start a nutritional program, you should go to a nutritionist or a certified naturopathic physician. A nutritionist with special training may be right for you. Many registered dietitians and traditionally trained nutritionists have limited ability to provide individualized attention to inpatients. You may have to seek out an assertive practitioner with more advanced training. The ongoing support of a motivated dietitian will help you start new and healthy habits that will become a permanent part of your daily life. For helping patients develop healthy nutritional habits for their spine, a naturopathic physician is also a good fit. Naturopathic physicians practice the art and science of natural health care. They are trained in trusted medical schools. Partnerships between doctors and naturopathic physicians are becoming quite common in the United States and Canada.