Become a Creator today!Start creating today - Share your story with the world!
Start for free
00:00:00
00:00:01
You Don't Know How Good You Can Feel (Until You Do This) | Chloe McLeod
68 Plays10 days ago
Is what you eat making your pain worse? In this episode, I sit down with Chloe McLeod, founder of Verde Nutrition Co, Accredited Practising Dietitian, and Advanced Sports Dietitian with over 16 years of experience. Chloe is one of Australia's leading experts in gut health, food intolerance, and autoimmune conditions. Chloe has been featured in Women's Health, Body & Soul, and House of Wellness. We unpack the real connection between nutrition and chronic pain, whether gut health is all hype and what you can actually do to start feeling better. If you live with fibromyalgia, rheumatoid arthritis or persistent pain, this one's for you.
RESOURCES
KEY TOPICS & TIME STAMPS
00:00:53 — Introduction to Chloe McLeod & Verde Nutrition
02:02 — The connection between pain and what we eat
03:37 — Nutrition's impact on fibromyalgia & rheumatoid arthritis
05:19 — Is gut health just a craze?
05:49 — The gut-brain axis explained
07:04 — Case study: How 7 days of fast food changed a man's microbiome
09:20 — How to know if your gut is healthy
11:25 — Microbiome testing: Is it worth it?
16:42 — Big ticket items for improving gut health (water & fibre)
18:39 — Resistant starch hack: Cook, cool, and reheat pasta/potatoes
20:32 — Meat, dairy, and gluten: Do you need to eliminate them?
22:26 — Intermittent fasting and chronic pain
25:38 — Processed meat: No safe level of consumption
27:25 — Food chemical sensitivity and pain
29:22 — Added sugar: How much is too much?
31:07 — Omega-3s and extra virgin olive oil as "liquid gold"
32:03 — Working with fibromyalgia, rheumatoid arthritis & osteoarthritis
33:11 — Plants for Joints study and plant-based eating
36:34 — Navigating nutrition with eating disorder history
39:57 — Case study: Fibromyalgia client success with multidisciplinary care
45:36 — The research connecting gut health and fibromyalgia
47:10 — Excitotoxins (artificial sweeteners, MSG) and fibromyalgia
49:05 — The role of supplements in pain management
50:14 — Supplements are "sprinkles on the icing on the cake"
52:23 — Top supplements: Omega-3s, collagen, magnesium
54:40 — Curcumin, probiotics, glucosamine: Second-tier supplements
56:49 — Supplement quality and contamination risks
58:33 — How to screen for quality supplements (Informed Sport, HASTA)
01:00:36 — Final advice for someone struggling with chronic pain
Recommended
Transcript
Introduction to Nutrition and Health
00:00:00
Speaker
Most people don't realize how good they can feel by eating better. If you are making poor decisions, so eating lots of ultra processed foods, foods which are rich in saturated fats, sugar, salt, et cetera, over time that causes your body to be less healthy, it recovers less well when you get sick or injured. When it comes to chronic pain, nutrition has a huge impact on those conditions and can really influence some of the symptoms that people are experiencing. Really interested to hear your thoughts on gut health. Is it all just a big craze and what impacts and influence it can have on pain?
00:00:35
Speaker
This podcast is for educational purposes only. The views expressed in this podcast do not constitute medical advice and are general in nature. You should obtain specific advice from a qualified health professional before acting on any of the information within this podcast.
Chloe and Verde's Philosophy
00:00:53
Speaker
Chloe, thank you so much for joining me on Pain Coach. You're a dietitian. We've worked together with some people with with chronic and persisting pain um and your business is called Verde. Now, when I was looking at that, I was like, that means green. Does this give us a bit of a clue into your, I guess, bias or slant towards diet d in general? ha have Great question. No one's ever asked me that before. and And firstly, thank you so much for asking me to come on the show. yeah um I've been really looking forward to our chat for for quite some time now.
00:01:28
Speaker
and so But Verde, it means green. And I think when it comes to nutrition, eating plenty of greens and without making it boring is one of the best things that you can do for your health and wellbeing, regardless of if you have chronic pain or not. And I think it's, you know,
00:01:46
Speaker
calling the business green probably wasn't really going to work. So here we are. Yeah, no, that's that's awesome. I think um it'll be interesting to dive in a little bit further into what that looks like and what we should eat if we live with persistent pain.
Nutrition and Pain Management
00:02:02
Speaker
But firstly, i think there's going to be a lot of listeners that are kind of going, what is the connection between pain and what we put in our mouth. um Can you give us a little bit of a snapshot of that relationship? Yeah, absolutely. So and i think that there's ah a number of different ways that we can look at this, but if we really break it down, if we think about when we're eating food, if you are making poor poor decisions, so eating lots of ultra processed foods, foods which are rich in saturated fats, sugar, salt, et cetera. Over time, that causes your body to be less healthy. It recovers less well when you know when you get sick or injured and you generally don't feel as good.
00:02:47
Speaker
And if you flip that around and think about when you're making really great nutrition choices, you fit just generally, you feel a lot better. And the risk of developing chronic health issues and is significantly reduced. and And something that I find myself saying quite a lot is that I think most people don't realise how good they can feel by eating better until they start to eat better and realise how much better they feel.
00:03:15
Speaker
Because, you know, we all eat every day and Sometimes it can be really hard to find that distinct impact that nutrition can have until you really notice how much better you can feel. And I think that's one of the things that I really love about this space of nutrition and and how it can have such an impact on your body and and how you feel each day.
00:03:37
Speaker
When it comes to chronic pain, and you know, there's a number of different ways that we could be looking at chronic pain, but if particularly if we're focusing on folks with fibromyalgia or rheumatoid arthritis or something similar, nutrition has a huge impact on those conditions and how you're then able to function day to day and can really influence on some of the symptoms that people are experiencing.
00:04:01
Speaker
For sure. It's definitely a growing field. And so i think that's why it's important to sort of get people up to speed on on where we're at right now when it comes to nutrition. You know, I think 20 years ago, there probably wasn't much research around nutrition and pain, but it's growing and especially in the areas that you've mentioned.
00:04:22
Speaker
And we'll talk a little bit about um those conditions a little later. It seems to be like, so when it comes to persistent pain, pretty much every system in the body influences and affects um persistent pain in some way, shape or form. It's, you know, the the immune system, the nervous system, the musculoskeletal system. There's lots of different systems that are involved.
00:04:48
Speaker
And when it comes to diet, it seems to be, i guess, downstream from, what we call sensual sensitization which is basic and basically the the ah signals that are sent from the body can either get amppl amplified or reduced in the nervous system and it seems like this is the place where ah diet seems to maybe contribute to this And in particular, gut health.
00:05:19
Speaker
um And I'd be really interested to hear your thoughts on gut health. Is it all just a big craze? Obviously, there's a lot of ah gut health talk out there at the moment.
00:05:30
Speaker
And what impacts and influence it can have on pain?
Gut Health and Overall Well-being
00:05:34
Speaker
Well, and it's I don't believe it's a craze at all, first and foremost. So when we look at the role that our gut has in our body, but you you may have heard about something called the gut-brain axis.
00:05:49
Speaker
So the gut-brain axis refers to the bidirectional relationship that is happening between your gut and your brain. What's going on in your gut influences what's going on in your brain and vice versa.
00:06:00
Speaker
There's also axis similar to that across many other areas of the body as well. So there's the gut skin axis, the gut lung axis and so on and so forth as well. and Undisputedly, given where the research is now up to, what is going on in your gut will have a huge influence on what is going on in the rest of your body. And when you then think about chronic pain and coming back to what I was talking about earlier, the influence of what you are eating is huge when it comes to your gut health. So if you're able to foster exceptional gut health, that is going to have a flow-on effect to your overall health and wellbeing. Now, i'm not going to sit here and try to say that, you know, if you eat perfectly and have the best gut health in the world, then you're going to fix every health issue. And that's that's just not true.
00:06:51
Speaker
However, you can give yourself a really great opportunity for for helping with recovery and simply feeling better each day by making better food choices more often than not.
00:07:04
Speaker
And we think about there was there was a case study, and I know it's only a case study, but it's I think it's a really interesting one that came out a number of years ago where somebody tested their microbiome with their with their usual healthy diet, plenty of fiber and so on and so forth, and then changed their diet to a major food fast food chain.
00:07:26
Speaker
only for seven days. And when you they he then tested his microbiome after that as well. And the change in the bacteria in this man's microbiome in just that seven day period was absolutely astounding. And it wasn't just the change in the microbiome, it was also the change in how he felt and his perception of everything else that was going on in his body.
00:07:50
Speaker
And I think, you know, that is a really great example of the influence that of nutrition on not just on your like how you're feeling in general but when you get down to that level of being able to test what's going on in your microbiome it literally changed the bacteria that were there so there was more unhealthy bacteria less of the healthy bacteria and i mean i'd be really interested to see a follow-up on that of like you know him maybe being able to change it back again and how quickly it's able to change back i haven't seen that but um we do know that
00:08:23
Speaker
with eating well, your microbiome can change quite quickly. So it's a really fascinating space. And, you know, you mentioned like 20 years ago, you know, I've been a dietitian for 16, nearly 17 years now, and I don't recall learning about chronic pain specifically at uni. You know, it was like lots about diabetes, lots about heart disease and,
00:08:48
Speaker
you know, or like all of the other sort of, I'll say more traditional parts of nutrition. But it's been really interesting over my career so far, being able to see the change in this space and the interest as well as the embracing of of people going, actually, this can change my life and this can actually have a huge impact on how I feel.
00:09:08
Speaker
Yeah. Yeah, no, it's's it's exciting times. And I think it, it like I said, it's it's very new and growing and emerging field and it's exciting to see what's coming out. So when it comes to gut health,
00:09:20
Speaker
how do I know whether my gut is healthy or not? Do I need to go and get one of those fecal tests or but how do I go about it? Yeah. so i again, there's different levels of it and i'm I'm sure there's, there's a number of different ways to answer this at a really base level though. My, my answer is that you can tell that your gut is healthy if you're not really noticing that there's anything going on with it.
00:09:46
Speaker
So yeah, I suppose what I mean by that is if you are not noticing that you're constipated or constantly bloated or experiencing abdominal pain and experiencing diarrhea, so on and so forth, if it's everything is just sort of working smoothly and you know it's it's not something which is coming up for you as being a problem, chances are things are probably going pretty well.
00:10:15
Speaker
As much as I'm saying that, though, probably takes a level of health literacy and self-awareness around that as well. So because sometimes, you know, you don't know what you don't know. And particularly when it comes to our bowel issues, and it's, you know, not exactly dinner table conversation and and people can get really uncomfortable with talking about it.
00:10:33
Speaker
I talk about it all day, every day. So it's not something that it really bothers me. um But it's, ah um you know, people can get really uncomfortable about it. What I think is is something for maybe maybe people to think about if they're like, I've never really thought about my gut before, so you know how how do I know if it's normal? So you know if you are experiencing regular pain or or bloating in ah in your abdominal area, If you're noticing that it's quite difficult for you to go to the bathroom, maybe when you when you do a poo, if it's looking like a sausage when it's in the toilet, that's that's pretty great. If it's more like rabbit poo or if it's really loose and sort of falling apart, that neither of those are so good. And that's where maybe speaking with a dietician around what's going on with your gut can be really helpful to get some some insight there.
00:11:25
Speaker
That said, I do believe there is a space for microbiome testing or fecal testing. but it's not at the point yet where I'd say everybody should go and test it because you know the science is still relatively new and you know some really cool things are happening in this space, don't get me wrong. i was actually at a conference a week or two ago and there was someone talking about microbiome testing in military personnel and being able to assess how someone might perform based on their microbiome. I'm like, that's wild. but that study is currently unpublished and so, you know, it's it's a watch this space thing still. So um I feel like in the next few years the science will extend significantly. When you look at, you know, when you look at how many um
00:12:18
Speaker
peer-reviewed papers have come out relating to gut health specifically, you know, in the last five years, in the last 10 years, it's like, you know, perfect hockey stick curve of of going straight up. So, you know, it's a huge space and there's there's heaps of research coming out, but there's also still so much that we don't know as well.
Improving Gut Health Through Diet
00:12:36
Speaker
we Yeah, for sure. I wonder whether when it comes to the investigations of the yeah, the microbiome, whether it changes the way you treat it as a dietician. Because, you know, there's many things in the musculoskeletal world that that, yeah, we could do an investigation and find out more details, but it doesn't actually change our management or our treatment so much. Is that the case? Or what yeah value? you Or can you actually target things that are particularly of interest if you find things in the microbiome tests?
00:13:16
Speaker
So in the in my experience with with people using them and and doing them, and pretty similar to what you've just said, to be honest, at at this point in time with the level of of specificity that they provide in that In most instances, it's really not changing what you would be doing without the test anyway. I think a test like that can be really helpful for individuals who are like really data driven and like to be able say, you know, oh, there's this much of this bacteria at this test and now it's gone up by this much for that test.
00:13:50
Speaker
But some people love that level of detail. But, you know, the tests can be quite expensive and I wouldn't say i must have. there I'd say they're more of a nice to have at this point in time. And, you know, in most instances, all it's really telling us is that, yes, we know that you need to eat more of your greens. Eat more of your veggies overall. roll Eat more of your fiber and be really mindful of those ultra-processed foods, sugar-sweetened beverages, so on and so forth. So, again, it's not really changing that what we'd be saying to someone in practice, but it can add weight to it if people are needing a little bit of encouragement. So it's not something that I'm against, but it's not something that I use all the time either. it would It's a real case-by-case basis.
00:14:35
Speaker
Yeah. how Just on average, how often do you recommend those tests? and Not that often, to be honest. and So it's more if somebody is really asking about that level of detail and is wanting to do it and and there There is a company that is the company that I would use if I'm getting someone to get a test done.
00:14:58
Speaker
But like if I thought about this year, what are we? We're at the start of December. I've probably ordered maybe five so far this year. That said, i'm I'm not doing like I'm only seeing clients a couple of days a week. So I don't have a huge caseload at this point in time either. So it's I'll use them occasionally to to help inform things. and You know, particularly I think, you know I've got a ah client who I'm thinking about with fibromyalgia and we we did a test for her, not the person we're talking about before we started recording.
00:15:34
Speaker
ah but somebody else. And and and i know that they found it really helpful for them with being able to see the change over time. But this person was also incredibly data-driven and having that extra level of data was really helpful for her. Whereas I've got other clients who I'm like, that is like probably the last thing I'm going to suggest because there's so many other things that we can do that are going to be more of value to that individual. So I think being able to, you know, it's like having those tools in your toolbox, if you like, and just because you've got a tool there doesn't mean you have to use it. And picking and choosing what you're going to use to be help you to best help that client achieve their goals is, you know, how great is it that as health practitioners, we've got so many different tools in the tool shed, so to speak. Yeah.
00:16:20
Speaker
Yeah, absolutely. Okay, so if we find out that we have poor gut health, how do we actually go about um influencing it that or improving it? You mentioned, like you know, briefly you mentioned a few, you listed off a few themes, but what are the big ticket items and how should someone change their diet to improve their gut health? Oh, yeah.
00:16:42
Speaker
Big question. Big ticket items when it comes to improving gut health across the board, I would say regardless of what your symptoms are like, number one is ensuring you're drinking plenty of water. So 35 to 45 mls per kilo, approximately two litres per day for most people. But ensuring you're drinking plenty helps with flushing everything through. um And that's you know particularly if you're somebody who's experiencing constipation, but also if you're more the other way and you're going to end up dehydrated pretty quickly as well. So making sure that you've got an adequate fluid going in. and Number two would be ensuring you've got plenty of fibre. So twenty five thirty grams um on average for Australians. There are studies that say having more than that is actually really beneficial as well, particularly when it comes to um helping with managing and chronic health issues.
00:17:35
Speaker
That said though, if you're nowhere near that number and you suddenly jump up to 30 grams, then you're going to end up really uncomfortable and probably more bloating, more more abdominal pain and so on. So it's really important that with fiber, you go low and slow is what I like to say. So increase it really slowly in small amounts over time rather than jumping it up quickly because of because of that potential impact on gut health.
00:18:02
Speaker
And outside of that, and I said, sorry, I'll go back slightly. So when I'm talking about fiber, I'm talking about foods which contain plenty of fiber. So things like your whole grains, legumes, nuts and seeds, vegetables, particularly starchy vegetables and fruits, particularly and things like, you know, like your apples and pears and bananas have a bit more than something like your berries. So, all you know, not negating the benefits of berries, and I'm going to come to those in a moment, but i'm ensuring that you're getting plenty of those those starchy foods that that are going to help with feeding the bacteria in your microbiome as well.
00:18:39
Speaker
and And I mean, we could really like go into huge amounts of detail here around like resistant starch and soaking oats because then they get more starch and cooking and cooling potatoes and pasta. I think, you know, one of my favourite little nutrition hacks is Whenever you're having pasta or potato, cook extra and then save it and then have it the next day. Because when you you cook those things up and then cool them down, what happens is there's a change in how the fiber is and it produces more resistant starch. So now when you have like the bitter of potato or pasta at the bottom of the like the saucepan and it ends up being this like jelly-like substance, You don't want to rinse that off or throw it away. That's that's the resistant starch. You want to like mix that back through and and consume that because that's like extra fiber. And I like for for any, um I want to say females, but for really anyone who like talks about skincare, hyaluronic acid is like, you know, this beautiful substance you put on your skin to help it to be more hydrated. I imagine that the the resistant starch is a bit like that for your gut. It's like really soothing. It's really easy to digest, but it's also really great for your gut health.
00:19:47
Speaker
and to sort of pull back out of that level of detail. and I think then looking at overall nutrient density in the diet as well. So it's not just about fiber. It's also about consuming all of those other micronutrients, the anthocyanins, the vitamin Cs, all of that sort of thing. Ensuring you're getting adequate nutrients overall and will help your body to function better.
00:20:10
Speaker
And I think that's part of the you know, not realizing how much better you can feel until you feel better. And a lot of the systems in your body, they'll find a way to work. But when we've got those those micronutrients included, it helps all of your systems function better because they've got everything that they need. And as a result, you'll end up feeling better.
00:20:32
Speaker
So that that'd be my sort of top three. thiss There's a lot of discussion around if meat's okay, if meat's not okay, dairy, gluten, so on and so forth. and Meat, eat some, not too much. um Overconsumption can contribute to to certain health issues. But and particularly for people who have chronic pain. And if we're looking at some people with fibromyalgia, rheumatoid arthritis, iron deficiency is often a real issue as well. So and sometimes we need to make sure they're getting a little bit more red meat than would recommend in other populations as a balance.
00:21:09
Speaker
I do want to say like as a caveat though, like that's a really individualized thing. So I wouldn't be suggesting on suddenly. and Make huge dietary changes without getting some advice. When it comes to things like gluten and dairy, the research around those when it comes to chronic pain is really interesting. And some people seem to benefit from removing, others don't. So my suggestion is youd like to individuals is usually, and but let's leave it in.
00:21:38
Speaker
unless there's a reason to take it out because why restrict someone's diet unless we need to? And the research very clearly shows that the more diversity there is in your diet, whether we're looking like base level of gut health or if we're looking at like you know, IBS and, you know, going on low FODMAP diets and and all that sort of thing, the more diversity that there is in your diet, the more diverse your microbiome will be. And the more diverse your microbiome is, the healthier your gut will be.
00:22:07
Speaker
And it ends up all like these flow on effects. so we don't restrict unless we need to. And if we need to restrict, keep that to an absolute minimum from a timeframe perspective because because of the impact it can have on the the person's microbiome as well.
Dietary Strategies for Pain Management
00:22:26
Speaker
Yeah, fascinating. What about intermittent fasting or those kind of things? There's a little bit of talk around it. Yeah, great question. um i mean, that there iss a there's I'd say there's a lot of chat around it, particularly when it comes to the pain side of things.
00:22:44
Speaker
it's Again, it's not a go-to, but it's again, it's a tool in the toolbox. So, It can work really well for some individuals. If there is a history of disordered eating or eating disorders with some medications, and it's absolutely not recommended and is like a firm no, but there are some individuals who do respond really, really well to it. And whether that's looking at it from a weight management perspective or or potentially from a pain management perspective.
00:23:14
Speaker
I think there's one of the challenging things with nutrition is there's so many different kind confounding factors as well. So it's not necessarily just about what the person's putting in their mouth. It's also about what's going on in their environment, what their stress levels are like, you know, what might have happened to them throughout their life from a trauma perspective and how how is that contributing to the pain. and nutrition can feed into all of this because it's not just fuel. It's something that we, you know, when we're eating, we're often with others. It's often a social thing. You know, it's how we, food is part of celebration. Sometimes, you know, it's something, you know, that's part of when when we're we're feeling really sad and, you know, food is often linked to emotions. And so I think, and I know I've come away from your IF question, which I'm going to come back to in a moment, but I think to try to say that
00:24:05
Speaker
like but I think when it comes to nutrition, we need to be really mindful. It can impact so many different parts of us, not just physiologically, but emotionally as well. Yeah. so I guess that's a sort of a very long answer around the intermittent fasting, but a short answer would be like,
00:24:23
Speaker
perhaps it can help but I wouldn't say it will help for everybody it's not my go-to strategy but it's something which can be used at certain times with certain individuals depending what else is going on so which is a very fence sitting art answer for me which I appreciate yeah No, I love that. I love that. you can so You can tell that someone's thought deeply about these things when it's not an easy black and white answer. So I do appreciate that. And it and obviously it depends on the um individual for sure. I mean, I think anyone listening can say if someone's had an eating disorder in the past, it's probably not best to suggest that they do intermittent fasting. Yeah. um So i i I really appreciate the the nuance. So I feel like overall this is pretty good news. i don't necessarily have to eliminate anything.
00:25:16
Speaker
i need to drink water and I need to eat a variety, vast variety of diet, particularly plant foods. yeah um and And you're not even saying necessarily that we have to avoid or remove meat products? No, we don't. So overconsumption, not great.
00:25:38
Speaker
and Processed meat, um you know, everyone hates me, but I'm like, that'd be the number one thing I'd say that maybe we do need to remove. and There's just... There's just nothing good about it other than the taste, if you like the taste. But from, ah you know, you look at the World Cancer Research Fund, they have said there's no safe level of consumption of processed meat. So, um and they've been saying that for a really long time as well. So it's not like that's new new news. However, it's still in the food supply. And that's a whole conversation of itself.
00:26:10
Speaker
Outside of that, though, I think, and even including that, if I'm honest, I think Everything can have its place. It just depends on the individual, their goals, and what's going to work for them.
00:26:22
Speaker
And some people, you know, would have a non-negotiable of, you know, some people like, I love my bacon. I'm not giving up bacon. It's like, okay, cool. like Let's find ways of working around that. But if that's what, if that's something that has to stay in your diet, that's your choice. But you're then making that choice with the knowledge around it.
00:26:40
Speaker
And that's where I think when it comes to nutrition, like what can be really powerful in that, whether it's looking at someone who has has a food sensitivity of some sort, so does need to do some level of of elimination and removing and adjusting.
00:26:56
Speaker
That doesn't mean they can never have that thing again. It just means that they need to be more mindful of how much they have and when. And I'm thinking about a client that I have at the moment and this person has food chemical sensitivity. So everything we eat has um different chemicals in it. And for the majority of the population, they eat those foods and the healthy foods. It's like, you know, it's your green veggies and your berries and know tomatoes and and all sorts of things.
00:27:25
Speaker
These things, we know that they're good for us, but for people with food chemical sensitivity, and they can cause huge amounts of issues, and including contribution to pain. Now, it's not about never having these things again. It's about working out where your your dose response is and what you can tolerate. And I think this is a really important nuance when it comes to pain and when it comes to manipulating diet to help with managing it.
00:27:50
Speaker
Because never eating some of these things again, and there's a few parts to this, but never eating these things again, i think can then contribute to disordered eating, fear of food, which as a cycle can then end up causing more pain because then they never eat it and then they try to eat it and it's worse because they haven't eaten it in so long and then there's that fear around it as well.
00:28:15
Speaker
But secondarily, you don't, unless it's an actual allergy, you don't have to remove it entirely. And knowing that you can have some can give people a bit more confidence, a bit more self-efficacy, but also it means that as an example,
00:28:29
Speaker
and thinking about a client that I, that as I mentioned before, this person now knows what um their sensitivities are. And as a result of that, they might still go out and eat the food that they know is going to trigger symptoms for them.
00:28:44
Speaker
But they do that with the knowledge that that's now going to happen. And so it makes it easier to manage that they know that that's happening. So it's not about avoiding it entirely. It's about understanding what's going on in your body and managing it in a way that best suits you as an individual.
00:28:58
Speaker
and yeah Yeah, they must feel a little bit more control exactly over their situation. And if they choose then to do that, at least they understand why. And there's there's a reason which where as sense-making individuals, we we like to know why things are happening and it feels like they're back in control. So that that sounds sounds really good. If we were to dive, actually before we do,
00:29:22
Speaker
What about added sugar? Yeah. Like heavy sugar content. Yeah. So minimal, like, it again, it's one of the things where I'm like, I don't want to tell people that they're not allowed to have it, but it's not something that I'd be suggesting you have much of, if at all.
00:29:38
Speaker
So, you know, let's remove the sugar sweetened beverages. Let's you know, let's minimize things like your lollies and your cakes and your biscuits and so on and so forth. And again, similar to the bacon, if that's something that's like an you know, and non-negotiable for you that you really must have, well, let's find a way to include it, but let's have a bit less.
00:29:55
Speaker
And less is more, but at the same token, I also am not here to be the food police. So, yeah. Yeah. Yeah, no, it's it's really cool. So overall, you've got we've got water. I'm just doing this for myself yeah as well as this is. Drinking more, eating a diverse range of foods, primarily plant foods.
00:30:17
Speaker
A little bit of meat if necessary and ah try to avoid highly processed meats and probably highly processed foods in general. ah Have a good relationship with your food. Be able to eat with abundance and lots of different things. If you do have some sensitivities, that there might be things that you can... remove to trial a lot alongside someone like yourself as a dietitian.
00:30:43
Speaker
And then lastly, limiting added sugar. um i think that's a that's a really good list for people to sort of take away. And I know obviously there's some nuance surrounding that, but ah sometimes people want those simple sort of tidbits that they can write down. If we dive in a little deeper into certain conditions, I would love to hear...
00:31:07
Speaker
Who are the primary people that you as a dietitian work with that have non-gut related pain, so musculoskeletal type pain or some of those more systemic arthritis type pains? Who who do you work with primarily? Yeah. Yeah, sure. So quickly before I go into that, I want to just flag what we haven't spoken about in the list that you just went through was your healthy fats and omega-3s in particularly. So omega-3 fatty acids are particularly anti-inflammatory and and are really helpful from that. that pain management perspective and then extra virgin olive oil as well is liquid gold is is how I will often refer to it and it's got some really incredible bioactive compounds in it that can help with so many different bodily functions improving gut health improving inflammation and so on so that should be both those should all be added into the list there as well and
00:32:03
Speaker
But thinking about who who I work with more so in this chronic pain space and is in particularly people with fibromyalgia and rheumatoid arthritis, and a lot of people with osteoarthritis, when we looking at that non-gut-related pain. I also work a lot in the gut-related pain space, so people with IBS and IBD.
Individualized Dietary Changes
00:32:21
Speaker
And a lot of those people are also, if we move away from musculoskeletal, I'm going to come back there, is a lot of athletes who are experiencing digestive issues. So people who are doing marathons and that sort of thing, but then experiencing gut issues associated with that, which is a bit of a sidebar area of interest as well. But if we come back to RA, the OA, the fibro it's it's a really fascinating space when it comes to nutrition and I think it's a really exciting space as well because there's so many things that we can often do with people's diets and it can have such a lovely influence on on symptoms and overall quality of life and and feeling in control of what's going on for them as well um
00:33:11
Speaker
Yeah, I recently just read a study called Plants for Joints. um And it wasn't just plants exclusively, but it was um also, you know, lifestyle factors like sleep and exercise and those kind of things. um And people listening already know that... um if they've listened along frequently, they know that the reason I'm mentioning this is because I actually have a tool called Pain Coach, which helps people with these lifestyle factors and how they influence their symptoms and to try to find targets for pain relief from those.
00:33:44
Speaker
But I did find that study fascinating. What is it about plant foods that can help joint-related issues? Do you sort of delve into that and and deep dive into that? Or do you kind of sort of, do you just really know the...
00:33:59
Speaker
the nutrients and and the practical advice surrounding it? I'd say i probably sit more in the the practical advice around it. I'd love to be a researcher, but my brain is more practical than then research in numbers and things.
00:34:13
Speaker
I think Without having read that specific study, when it comes to this group of health issues and the research around you know what is best, eating more plants is is absolutely, absolutely key.
00:34:29
Speaker
Does someone have to be vegan or vegetarian once they have one of these conditions? Maybe. Again, it's one of those tools in the toolbox. So some people absolutely feel better when they do remove all all animal products from their diets when they have these conditions.
00:34:48
Speaker
However, that isn't everybody. And also it comes back to that self-efficacy and choice. Some people might, but they don't want to, so they don't. And so and all of those things are okay. so And I think it's really important, and and i and I know you practice in the same way as well, is working with people with where they're at, not with where you want them to be at. And sometimes I think...
00:35:14
Speaker
You know, practically, you know, if everyone could have the perfect diet, that would remove a whole heap of health issues from our world. But that's not practical for for most people for so many different reasons. so helping people with where they're at and helping them to get to where they want to go is is I think, super important, but particularly in people who whose lives are impacted day-to-day with chronic pain because it help helping them with small steps at a time and knowing that it's not about perfection, it's about making that progress. And that's I think that's really important.
00:35:52
Speaker
Yeah, I think it's fascinating that you you you can keep bringing this up, this relationship idea with food and how we interact with it. And I think it's it's fascinating to me because these don't happen in silos. You know, like if if this food change is causing psychological distress and poor social um interactions and those kind of things, it's going to obviously have a negative influence when it comes to pain. Absolutely.
00:36:21
Speaker
And so it's really cool that you can see those things for the perfectionist or someone that's had, you know, eating disorders in the past.
00:36:34
Speaker
How do you go about these conversations when they have one of these conditions? Yeah, it's, it's really tricky. I'm going to say it comes back to helping them and working with them where they're at.
00:36:47
Speaker
So, It's and looking at that where they're at in the life cycle of that eating disorder as well. So is the eating disorder still active? Is it in remission?
00:37:00
Speaker
How long has it been in remission for? What support does the person have in place if it was to become more active again? Because some of what we might do might change a little bit depending on what is happening for that individual.
00:37:18
Speaker
As an example, and and I'm going to use an example that's more in in the gut space because I think it's really relevant to to the question you've just asked.
00:37:28
Speaker
And use again, using a ah case example, obviously de-identified, but this this individual has IBS um ibs and a history of an eating disorder that is no longer active.
00:37:43
Speaker
And when they came to see me, I was very concerned about doing investigation into the the triggers of the symptoms she was experiencing because of that history of the eating disorder.
00:37:57
Speaker
So what we did is we, well, I worked with her to ensure she had a psychologist or her her psychologist she'd sent in the past available because she really wanted to push in.
00:38:08
Speaker
figure out what was going on and with the support like of the psychologist but also her being aware, really aware of what was going on, we were able to do some elimination that I wouldn't have normally done with someone in that space and get to the bottom of what was going on. And and i think this is relevant because when there has been a history of an eating disorder, often will change your microbiome as well and food sensitivity is actually more common. so being able to work with people again with where they're at. And there's other people who I'm like, I'm never going to go and do an elimination diet with that person because the risk of it coming back is too high.
00:38:48
Speaker
So I think being mindful and aware of how how food can influence what's going on for somebody, both psychologically as well as physiologically is really, really important.
00:39:05
Speaker
And, and you know, really interestingly, often we'll see that food sensitivity. So there's some research around bulimia and food chemical sensitivity and that people with bulimia are slightly more likely to have food chemical sensitivity. Doesn't mean that they will have it. It just means that that's been something that's been found in in some of the studies that are out there. And from a, from a,
00:39:37
Speaker
non-researcher perspective unlike that actually like from a clinician perspective I think that makes a lot of sense because of how again how food can make you feel and the impact that that can then have on your food choices as well does does that make sense yeah for sure For sure. I want to switch gears because we have a mutual client and that we've been working with. She has kindly consented, obviously de-identified as well, to for us to sort of discuss her. has, for those that are listening, she's in her 60s. She has fibromyalgia. and I was using Pain Coach with her and it had identified this relationship between food and pain so her nutrition and pain in particular whole foods and we're we're sort of a multidisciplinary team with her so yourself and also a psychologist is involved and I think it's really awesome and she's had amazing results and I think
00:40:42
Speaker
I'm not allowed to, APRA doesn't allow me to boast about my own thing, but I can say, Chloe, that I think you've played a role in that. And so thank you for for the work that you've done. What is it about, ah what did you do with her and what was your rationale behind it when it comes to fibromyalgia?
00:41:01
Speaker
So when it comes to fibromyalgia and in particularly, we have looked at um really increasing the nutrient density of her diet and bringing more whole foods in and really focusing on and including more of more of the vegetables, more of the greens, more of the fibre-rich foods and and and really improving the overall nutritional quality of her diet.
00:41:31
Speaker
One of the other things we've been doing more recently has been more around that relationship with food and focusing on mindful eating and how the but how you're eating rather than what you're eating. and And I actually got an email from her last week around she'd been mindfully eating a mango. And the i think my response back was like, the way you've just described eating that mango has made me now want to go and eat a mango. It sounded amazing. And I think that relationship with food is can be really tied in to and somebody's fibromyalgia or or other health condition as well because of the pain and, you know, there's the food and then there's, you know, all the other and underlying things that can be going on for people. So, yeah, it's been really nice um to see
00:42:24
Speaker
the changes that that this person's been able to implement and yes, like is continuing to implement. She's doing such a great job. um Yeah. Yeah, it is it's such a cool thing to be a part of like a team of different and obviously way we don't we don't work for the same, well, we we run our own businesses and none of us actually work out of the same clinic, but it's really cool to be able to work in sort of multidisciplinary team to sort of provide the best case outcome for these type of individuals.
Research and Dietary Recommendations
00:42:55
Speaker
And I wouldn't have been able to do it without you and I don't think you would have been able to do it without her psychologist as well to those...
00:43:02
Speaker
food relationships or her relationship with food and some some past things that had went on. Yeah, and I think it's like to add to that, I think, you know, yes, it's a remote multidisciplinary team, but I think it's wonderful when health practitioners like-minded and are really open to all working together as well. And so you know, having the psychologist's involvement and um i think know,
00:43:30
Speaker
ye You brought her in as well to the team, I believe. And i think having the three of us has resulted in much better outcomes for this person than it would have if it was any of us individually because...
00:43:48
Speaker
because we all have our own specialties in that. And I think like our communication between the three of us, I think is really great as well. Like all of us are really good at giving updates on what's happening. And it means that we can touch base on some of those things in the session as well.
00:44:03
Speaker
And again, like coming back to like everything being linked, I like i know like if if I was the patient that would make me feel really good that my healthcare team are taking the time to go and talk about me separately to make sure that we're all on the same page to optimize care, even though we all live very in different, very like very different places and and and are not under the same roof. So, yeah, and I think that that MDT adds value in more ways than just that medical care. It's it's that helping the patient to feel connected and and cared for as well.
00:44:43
Speaker
For sure. Yeah. For sure. I was i was very, well, I don't know why, but I was kind of surprised that nutrition came quite high on the list. yeah We look at, with Pain Coach, it looks at exercise, social connection, psychological distress, distress sleep.
00:45:02
Speaker
Oh my goodness, I've forgotten one. Psychological distress, exercise, nutrition, social connection, and sleep. Yeah. PainCoach helps clinicians take the guesswork out of pain relief by tracking pain alongside key lifestyle factors.
00:45:18
Speaker
PainCoach analyzes this patient data to uncover lifestyle scores, relationships, and trends, helping clinicians guide their patients towards the habits most likely to bring pain relief. If you're a clinician, head to paincoach.online for a free trial.
00:45:36
Speaker
and And nutrition was was right up the list. and And it is fascinating because it's actually connected and supported by it some pretty cool research that's coming around about gut health and fibromyalgia.
00:45:50
Speaker
Can you speak to that connection or again, you more interested in the practical application of that, which is totally, totally fair? I i can relate to that. Yes. Have you read across that research um and what seems to be emerging? Yes.
00:46:08
Speaker
Nutrition and fibro that is just so fascinating. And again, there's it's one of those areas where there is more and more research emerging. I think looking at it from that sort of practicality perspective, so it's like you know the the base level, it's really looking at that more sort of anti-inflammatory style diet. Mediterranean style diet, but and like building in the plants and omega-3s and all that sort of thing.
00:46:34
Speaker
But then there's like the other tools in the toolbox. So maybe it is removing dairy or maybe it's not. Maybe it's removing gluten or maybe it's not. and vitamin d is something which i think needs to be focused on as well and ensuring that that's been optimized same deal with with iron levels ensuring that that's regularly checked and optimized and in this population i'd much prefer someone go and get an iron infusion than going and taking supplements because of absorption and impact on gut and all that sort of thing so
00:47:10
Speaker
That would then sometimes depend on the doctors, on the person's GP if they would do a script for that or not. Again, a bit of a sidebar. Yeah, fascinating. But then there's also some really interesting research with fibros specifically around things called excitotoxins. I'm not sure if you've read about these, but they're more of your like artificial sweeteners, MSG, things that sort of morph fit into more that category, which...
00:47:36
Speaker
Again, we can discuss if those are good for us or not anyway. But in people with fibro, they've been shown to specifically worsen symptoms. So if there's something which someone is including, then my advice would be, well, let's not, let's bring them back out. and Then there's further further research around other specific nutrients with fibro as well. So looking at things like magnesium um in particularly um and then some of the other the nutrients that I've already mentioned too. so it's a really interesting area and there's' I feel like there's just more research coming out in this space more and more. yeah
00:48:13
Speaker
But I think one one thing that i' probably sways me a little bit in my practice probably because of when I will end up seeing people is often... they will have already removed something from their diet before they come to see me. And my suggestion for anyone listening is like before you go and start removing things from your diet, go and go and see a dietitian first because you might not need to remove it. yeah,
00:48:40
Speaker
particularly if you removed it some time ago, that we don't, like I don't want you to have fear around food and, or unnecessary fear around food, I should say. And i think trying to look at it holistically and as I said, restricting restriction as much as possible is, is I think really, really helpful and really, really important.
00:49:05
Speaker
For sure. I, well, want to touch on supplements a little bit. yeah Um, and now obviously everyone's keen on supplements because you don't have to really do much. it's It's an easy habit. It's easy, an easy habit to change. And I'm obviously big on habit changes. And I think we've discussed those a little bit in terms of these small, inc um, incremental changes make a huge difference over time.
00:49:30
Speaker
Um, it's the results aren't often immediate, yeah but there, there is results over time. what What role does supplements have in, because again, it it would be a lot easier for me to not change anything about my diet and add just a supplement.
Role of Supplements in Nutrition
00:49:46
Speaker
yeah So what what's the go with supplements? So I guess a few things here, part of it is meeting people where they're at and if they don't want to change their diet and, but we can get them to take a supplement.
00:49:58
Speaker
Cool. It's not, it's not the best thing, but it's better than nothing. That said, the way that I view supplements and probably one of Australia's best sports nutrition researchers, Louise Burke, was talking at a conference that I was at.
00:50:14
Speaker
like quite early in my career. And she spoke about supplements um like sprinkles on the icing on the cake. And so since then, I have been borrowing that from her because it's, I just think it's one of the best analogies I've ever heard.
00:50:26
Speaker
So if we think about management of chronic pain, like a cupcake, so the cake, and I appreciate the irony being a dietitian and using this analogy, but here we are.
00:50:38
Speaker
So if we think about it, we've got that the exercises that you're working on and the you know person's habit changes and everything, they're they're the cake. So they're like like a really, really big rock. That's really, really important one.
00:50:52
Speaker
But a cake is always better with icing, right? And that's where the nutrition comes in. So the nutrition really complements it and makes it better. And, you know, how great is a cake with incredible icing and in Like, you know, the better the icing, the better the cake, right?
00:51:08
Speaker
Same sort of deal with your nutrition. But then you've got the sprinkles and the icing on the cake and they're your supplements. So you're not going to go and have your supplements alone and expect like gold star results. and You're not going to get sprinkles and just put them on the top of the cake and expect it to be the best cake in the world. You need all three together for it to be absolutely incredible.
00:51:30
Speaker
And that's where I think what we're talking about here today is why it's so important is because supplements, they can make it better. Don't get me wrong. They can fill gaps.
00:51:40
Speaker
which can be great, but trying to use them on their own, like you can, but you're not gonna get as good at outcomes. As I said though, let's meet people where they are and if that's all they've got the capacity to do, cool, let's do that.
00:51:53
Speaker
But over time, hopefully we can influence them to make some further behavioral changes and habit changes to to get even better outcomes. sorry it's a yes, but it's, you know, let's do the other stuff too. so That's yeah it's a great analogy. So, okay, so say we've got the the cake and the icing and we do want the sprinkles. Yeah. what are What are the sprinkles that seem to be helpful for um people with persistent pain?
00:52:23
Speaker
Yeah, so and few things. So omega-3s would be probably the top of my list, and particularly if somebody really struggles to get enough in their diet, and and most people do, if we're honest.
00:52:37
Speaker
um So a really good quality omega-3 supplement, and and I'm not meaning going and I'm not going to not going to shame any brands, but something which you can buy from the supermarket, yeah. probably not going to be best quality. So i'm getting something which is is a better quality is is really advisable.
00:52:57
Speaker
So fish oil, and I really like collagen supplements. So that's looking and that's probably more from an osteoarthritis perspective. So some some really cool research that's come out around collagen and its ability to help with and cartilage reformation. and in particularly in people with osteoarthritis. So and a really helpful one, which can then indirectly help with with managing some of that pain.
00:53:25
Speaker
um I think magnesium is is one which I think most people are are aware of. How efficacious is it? Questionable.
00:53:36
Speaker
But if it's even if it's being a bit of a placebo, there's no harm, so might why not? I do think that the form matters though. So something like Magnesium citrate is more likely to cause diarrhea because of it bringing water into the bowel. So I generally suggest people minimize use of that or avoid that and having having a different type. So I'd be more likely to be suggesting something like magnesium glycinate.
00:54:03
Speaker
Then it would then depend on what else is going on for that individual and like where some of the gaps in their diet might be. So for example, if there's somebody who is traveling lots, they've got a lot of meals which are out, they're doing their best with their nutrition, I'm more likely to be suggesting a multi for somebody who's in that sort of situation because it's just harder to get the nutrition right when you're not in control of what you're eating all the time. and Or if you're going on holidays, take it with you, use it as a top-up. That's where, you know, it can fill the gaps, but it's not something I'd be suggesting you rely on as the way that you get your nutrients in.
00:54:40
Speaker
I'd say then there's sort of like a bunch of others which I'd say I might the sort of next tier down. So they like things like curcumin supplements, um so like turmeric, some probiotics, things like your glucosamine and chondroitin, really mixed stuff around that. Again, probably more placebo, but no harm. so if you want to spend your money.
00:55:03
Speaker
And then like some of your more like very specific nutrients. So, you know, if you're needing vitamin D, if you're needing iron, if you're needing zinc and so on, I think that can be quite helpful too. So that'd be some of my more go-tos, but to be really clear, like please don't go and start taking all of those without getting some advice because... You know, as an example, and fish oil supplements can thin your blood.
00:55:28
Speaker
And so and if you're someone who's also taking water, warfarin or or some other blood thinner, you could actually have some really negative outcomes if that was something that you were to go and do. So, yeah.
00:55:40
Speaker
Yeah, great advice. No, that's fascinating. It's interesting to to see some of those, at least the big ticket item ones that you think are important. And from the little research that I've done around it, um yeah, it's interesting to see some of those overlap. Some of them probably fall further down the list than I thought would. Tumorink was one of those ones that I thought might be higher on the list. but um And it's really, it's funny. So going back a few years, that probably would have been a bit higher on the list. But I think...
00:56:12
Speaker
It's probably dropped down a little bit for me because I've been trying to get people to a include it a bit more in their diet, but there hasn't been further research to support that initial research or or or that I've seen. So yeah it is still one that I will very frequently recommend, but.
00:56:32
Speaker
that I think the fish oil is better. I trust i trust your your take on that well, well, more than because it's impossible to keep across it. ah and there's I think that's the other part of it. there's There's so many different ones on the market now as well.
00:56:49
Speaker
I think probably something else that I do think is important to add is there's, that they and I touched on it, but like the quality is really, really important. And If you were to go and look in my supplement cupboard, you'd see that like basically everything is like single nutrients rather than you get like you can go and get like things which are like a whole ton of different things all combined together.
00:57:14
Speaker
And the reason for that for myself and and my family and how I talk about it with my clients as well is once once it becomes a mix of different things, the risk of contamination and of unwanted substances goes up quite considerably. Yeah.
00:57:30
Speaker
and quality really matters. So spending that little bit extra and, yes, you might end up with a few more things, but like you don't want to make sure that it doesn't have unwanted things in there. And, you know, that could be things from, like, you know, illegal drugs to rat poison to, you know, all sorts of things. So, like, the...
00:57:52
Speaker
but There's been some some different analyses done on supplements, both made here and and internationally. and Internationally is worse than here, but there's still some questionable things on shelves here too. So I'm not trying to be i'm not trying to scare anyone, but also just be really mindful of um what you're choosing and and where it's been formulated and and by who.
00:58:13
Speaker
sorry Yeah. How do you screen for that? Like, obviously, you just kind of mentioned that. But if you're a layperson that doesn't, you know, look at this stuff often, how do you quickly screen for that's the good supplement? Say a GP is recommended, oh, go and get, you know, omega-3s. How would you know whether you were getting quality omega-3s?
00:58:33
Speaker
I think choosing like really strongly reputable brands that you can't buy at the supermarket and you can read between the lines there of which companies I'm talking about. said I don't want to name it shame. and But I think something that you're more likely to buy at the pharmacy or or is has been third-party batch tested. So what I mean by that is there's a company called Informed Sport and there's a company called Hasta.
00:59:02
Speaker
And both of those big companies, they test for... things that we don't want in supplements from a general perspective, but also from a sports perspective. So like elite athletes, you know, if you're working with a sports team, they have to have one of those ticks on there to make sure that they're safe.
00:59:18
Speaker
I actually often extend that to general population as well. Like there's just from a, if the person can afford to spend the extra bit, then do it because, because you know that the quality of what you're having is, is a little bit better.
00:59:31
Speaker
It's a, it's a really good way to think about it. Again, like I know I've said a few times but about, you know potentially working with a dietitian, but my suggestion would be get some advice so that you don't end up taking a million different things. And then the dietitian will be able to recommend what the best one it actually is for you rather than being like, oh, i think this one looks all right. It's...
00:59:52
Speaker
you know I've got probably four different omega-3 supplements that I would recommend to people depending on who they are, what their price point is. like And I say who they are, like what their requirements are, what their price point is and and so on and so forth. So it's not like a one-size-fits-all thing. it's you know there's There's a number of different reasons you'd suggest a certain supplement.
Conclusion and Gratitude
01:00:14
Speaker
Yeah.
01:00:15
Speaker
yeah absolutely go and moral of the story go and see chloe and you'll get but better bang for your buck that's very kind but yeah whether i i think you know i'm really lucky i've got a really great team of dietitians that i get to work with someone said to me recently like you really do have the best team i'm like i really do i think that they are absolutely amazing so anduts yeah i'm very very lucky so yeah Awesome. Awesome. Well, i'll definitely put your details or your business details in the show notes so people can go and book in. i have a question that I ask pretty frequently and it'll be interesting to hear the answer for it from a dietician. But if if someone's listening to this and they're really struggling with pain, they're like, what can I do? i don't seem to be getting any better. What would your advice be to them?
01:01:07
Speaker
um Probably go see doctor first. Okay, okay that good point, but they've seen the doctor. They've been ticked off. So they've come to see me. i think yeah the first thing that I would be, like as a general thing, that I'd probably be suggesting to most people is like let's let's reflect on what the quality of your diet is like and how how can we optimise it, again, based on where that person is at. So how can we include... some extra plants some extra fiber in how can we get some extra water in and is there anything that we can do from a nutrition perspective that will help with managing stress and improving sleep because of the role that those things have yeah that's that's where I'd be starting with them
01:02:01
Speaker
Yeah, awesome. Awesome. Well, thank you so much. i I found this conversation fascinating and very informative. So I appreciate it. And I'm sure many people listening feel the same way. So thank you so much, Chloe, for coming on the show. Thanks so much for having me, Lachlan. It's been a really fun chat. And yeah, thanks so much again for having me.