At plantarfasciitis.co.uk, we have over the last 12 years successfully championed the use of cryosurgery in the UK.
A treatment that involves applying targeted extreme cold to the inflamed structures in the heel responsible for heel pain, to cure chronic, stubborn cases of plantar fasciitis.
Having seen so many heel pain sufferers over the years, we like to think that we have a ‘finger on the pulse’ of all things heel pain, and we like to keep an eye on what is trending because some trends can be really helpful to our patients and others can be total red herrings.
Since 2015, we have seen a big rise in our patients asking us if certain diets can help treat or prevent plantar fasciitis. The rise in these types of questions has been fuelled in part, by TV programs like Jamie Oliver’s 2015 series ‘Super Foods’. More recently in 2019, we have been asked about the anti-inflammation diet which seems to be gaining momentum this year.
So, this is our take on the anti- inflammation diet. There’s a bit of science terminology but don’t be put off.
Hippocrates, a Greek physician born 470 B.C., from the island of Kos, was the first person in medicine to document the positive effects of cryotherapy to treat inflammation and pain, so we already like him for that!
He was also the first to describe the relationship between diet and good health, he once famously said, “Let food be thy medicine and medicine be thy food.” 2000 years later, few in medicine would disagree that food seems to be a powerful medicine in itself. Diet seems to play an important role in many diseases and conditions that affect health.
Unfortunately, the modern western diet has become increasingly ‘bad medicine’ containing processed foods, high levels of salt, refined sugars and unhealthy fats. This has led to increased rates of obesity, diabetes, cancers, cardo-vascular disease and the argument goes, low level chronic inflammation in most, if not all, bodily systems.
The anti-inflammatory diet is an eating plan designed to prevent or reduce low-grade chronic inflammation. The typical anti-inflammatory diet emphasises fresh colourful fruits and vegetables, lean protein, nuts, seeds, and healthy fats.
So what role does inflammation play in disease? We asked Dr Care.
Dr Ailsa Care of www.drailsacare.co.uk a Yorkshire GP, and practitioner of functional medicine, (an approach that focuses on identifying and addressing the root cause of disease, eg. treating the person with the disease, not the disease within the person) argues that chronic diseases are caused by inflammation. Dr Care goes on to say that inflammation has various causes that include: food sensitivities, pro-inflammatory foods like sugar and damaged oxidised fats.
Many scientists are now concerned about the damage oxidised fats cause within the body. Oxidised fats are usually fats high in polyunsaturated fatty acids like sunflower oil, flaxseed oil and corn oil. These oils (when exposed to the high temperatures involved in roasting and frying) become damaged, leading to molecular changes that lead to the formation of free radicals within the body. In short – many scientists think eating a diet high in damaged polyunsaturated cooking oils places extra burden on the body, because it has to deal with the toxic by-products of the damaged oils.
Polyunsaturated fats also contain varying degrees of essential fatty acids. Broadly speaking, there are two types of omegas that you need to be aware of, omega 3’s which are considered good and anti-inflammatory, found in rapeseed and olive oil and omega 6’s which are pro inflammatory and linked to inflammation, heart disease and cancers.
The human body absorbs omega 6 and omega 3 fatty acids using the same pathways. This means a diet high in omega 6s will ‘drown out’ the absorption of beneficial omega 3s.
Many scientists believe that the optimum ratio of omega 6 to omega 3 should be 4:1. However in the U.S. the ratio is now in the region of 16:1 in favour of harmful omega 6’s.
So, let’s take a closer look at the anti-inflammation diet again.
When you break it down to its bare essentials it’s basically the same as the Mediterranean diet, a diet that scientists have long known to be beneficial to health and wellbeing. The Mediterranean diet consists of vegetables, fruit, herbs, nuts, beans and whole grains, chicken, eggs and not too much red meat. The fats found in the Med diet are good fats, high in anti-inflammatory omega 3s and low in pro-inflammatory omega 6s.
With that in mind, in case you were wondering, do the Mediterranean countries have lower rates of plantar fasciitis? Well if you search the medical literature you won’t find any evidence that that the Greeks or other Mediterranean’s have any less plantar fasciitis than American’s per head of the population.
So, is the anti-inflammation diet a dead-end regarding plantar fasciitis? Well, no, you can’t jump to that conclusion because the Mediterranean populations have mostly abandoned their healthy Mediterranean diet in favour of the cheaper more affordable western processed diet.
To truly answer that question, you would have to follow in Jamie Oliver’s footsteps and go to the Greek island of Ikaria, where Jamie filmed his Super Foods first episode. Ikarian natives live on average 8-10 years longer than Americans, are 2.5 times more likely to reach their 90’s & 100’s, and less likely to develop Alzheimer’s disease.
Unfortunately, even if you followed Jamie to the centenarian haven of Ikaria, you still won’t be able to find the answer to the question “does the Mediterranean-anti-inflammation diet reduce the rates of plantar fasciitis?” because no one has done the study.
My guess is that if someone did do the study, they would find lower rates of plantar fasciitis compared to those that consumed the western processed diet.
Would this be down to the anti-inflammatory effects of the anti-inflammation diet?
Possibly, but I suspect there would be more to it than just diet. People in Ikaria are less likely to be overweight (a big risk factor for plantar fasciitis), they generally live less stressed and happier lifestyles, they take regular exercise because the island is so hilly to walk anywhere gets the heart rate up, they take naps (shown to reduce blood pressure) and enjoy a sex life into their old age.
Living a healthy lifestyle in general is likely to make you less vulnerable to plantar fasciitis.
Dr Care says “…in functional medicine, we find we find a big factor for a lot of people, in not getting better, is that they are chronically stressed. That means the body is in survival mode and not bothered about repairing anything. What’s the point of tissue repair if you are going to be eaten by a tiger!…” Dr Care goes on to say that stress management is an important aspect in treating and chronic inflammatory disease.
To me as a Podiatrist specialising in plantar fasciitis this does seem to make perfect sense. If the body is in fight or flight mode, it is pumping out the stress hormone Cortisole.
Cortisole releases glucose (needed for energy for running from the tiger) and also suppresses the digestive and immune system, which as those who read our last blog about magnesium, will know that a healthy immune system is needed for breaking the deadlock of plantar fasciitis.
Dr. Care’s functional medicine perspective does chime with our experience. We tend to find most of our patients suffering from chronic plantar fasciitis are often very stressed. It’s hardly surprising that someone is going to be stressed if they are in high amounts of pain and are struggling to function at work as well as home due to heel pain.
So, in conclusion
I think the anti-inflammation diet just makes perfect sense and is probably one of the healthiest diets that you can follow. It should help you maintain a healthy weight, and its high omega 3 content is likely to help break the deadlock of plantar fasciosis where the breakdown and repair process has become skewed in favour of breakdown. However, it can be expensive and takes some time to prepare. Diet alone is only one part of the equation.
The take home message is; try and have a healthy diet high in anti-inflammatory omega 3’s and low in inflammatory omega 6’s, reduce your stress levels, take exercise and be happy.
Of course, of this takes time to work, and if you are stressed and at the end of your tether and not up for a bit of ‘Zen harmony’ then cryosurgery is a fantastic way of hitting the re-set button, giving you the chance to make these positive life changes whilst being pain free.
Keep your eye’s peeled for our next blog post, which will be focussing on the best painkillers for easing Plantar Fasciitis symptoms.