Mark Gostine MD, age 54,
at the finish of the
2005 Boston Marathon

Many patients wish to help themselves and change the course of chronic musculoskeletal pain. Frequently, this means working with doctors, nurses, and therapists using medications, injections, physical and behavioral therapy.  However, patients also want to know “what can I do on my own to help this pain problem?”

In 2002, at the age of 51, I decided to run the Detroit Marathon, a 26 mile race. For the four years prior I had seriously cut back my running because of a hip problem.  Nonetheless determined, I intensified my program of diet, vitamins and other supplements to see if I could conquer the hip pain in a natural fashion without the use of drugs.  Well something worked and I ran the race to completion in October of 2002. In April of 2005 and again in April of 2007 I ran the 26.2 mile Boston Marathon.  In between the marathons I have run the 15.5 mile River Bank run in Grand Rapids. To run the races properly I train regularly and this puts a great deal of stress on my joints. I have constructed a nutritional program to protect my joints and prevent musculoskeletal pain from inflammation associated with arthritis. In my case, it has evidently been successful.

In addition, inflammation seems to be a common link to many disease states, such as arthritis, cancer and heart problems, including heart failure and coronary artery obstruction. The diet below represents the best foods and supplements I know of that help reduce inflammation.

• Take 4 grams of fish oil per day. This is the single most important recommendation. Get a brand that is high in EPA and DHA.  The EPA and DHA should total at least 500mg per capsule.  Ask your health food store sales person for help here.  If you can’t take fish oil capsules, try flax seed oil, liquid form – 2 teaspoons per day.  Keep it refrigerated, and buy it new every six weeks.  It oxidizes easily.
• Eat dairy, especially kefir and yogurt, which are very healthy. Kefir is a highly concentrated liquid yogurt and the composition of the various strains of beneficial bacteria is outstanding. I buy Lifeway brand from Forest Hills Foods or Harvest Health in the dairy section. Plain yogurt like Stoneyfield and Dannon’s new product Dan Active are also good choices.   Buy them all and eat a helping of at least two of them throughout the day.   Sweeten the plain yogurt with a little jelly or jam if it is too sour for your taste. Don’t buy already sweetened or artificially flavored yogurt.  It is overly processed and not as effective.
• Kefir and yogurt contain the bacteria acidophilus which helps protect your intestines from other bad bacteria that cause stomach ulcers and acid reflux.  Acidophilus bacteria also helps break down your food properly; reducing the incidence of food allergies.  A lot of musculoskeletal pain is related to food allergies that are hard to diagnose.
• Season your food liberally with the herb Tumeric.  This is a yellow spice found in mustard. It has an earthy flavor like cumin and is used in curry, an Indian spice mixture. It has potent anti-inflammatory qualities, with over 1,000 articles in the Medline Internet database that have studied its effectiveness.  A recent editorial in the New England Journal of Medicine even suggested it could cure Cystic Fibrosis!!!  Another recent article in the Journal of Biological Chemistry indicated that it may prevent Alzheimer’s Disease, a common form of dementia.
• I sprinkle tumeric on cooked fish, eggs and soups.  It seems to work at least as well as anti-inflammatory drugs, doesn’t irritate the stomach, and costs only a few dollars at any grocery store.  Look for it in the spice aisle.  I also take turmeric extract in capsules.  The extract is much higher in curcumin, the active ingredient that protects your joints and general health.
• Drink cherry juice, dark purple grape juice and pomegranate juice daily.  Mix them up  drinking a helping of one or two of them daily.   Better yet, eat fresh or dried cherries and blueberries. Colorful fruits help protect your brain and heart.
• A little bit of alcohol each day is good for your cholesterol.  No more than one drink a day.
• Take Metamucil® once a day because increasing the fiber content in your diet reduces:
  • risk of colon cancer
  • risk of heart disease
    By binding the cholesterol in your stool and preventing the re-absorption in the small intestine.
• Get your protein from multiple sources:
  • Lean cuts of red meat, trimming all visible signs of fat
  • chicken
  • seafood
  • new eggs high in Omega 3 oils.  These eggs are available in the grocery stores.
• Use only olive oil for cooking. Try to substitute olive oil for butter.
• Drink 2 glasses of soy milk per day. I think Silk brands taste the best.
• Eat 7 helpings of fruits and vegetables because they are high in antioxidants that help relieve inflammation.  Apples, berries and dark greens are very beneficial.
• Drink green tea instead of coffee. It helps unlock your metabolism. Jasmine green tea lightly sweetened with honey is less bitter than traditional green tea.  I drink a couple  8 ounce glasses  per day.

• Take 4 Fish Oil capsules containing  300mg of DHA and 200mg of EPA per capsule
• Turmeric extract
• Take a high potency multi-B vitamin (heart and brain function)
• Take 1000mg of calcium per day (bone protection)
• Take 2000 units of vitamin D per day. Vitamin D is developing an amazing reputation for preventing multiple sclerosis, cancer, and musculoskeletal pain
• Selenium 200 micrograms per day
• Zinc 20 mg and Vitamin C 250 mg may protect the lungs to a limited degree from the ravages of smoking.   It is far better to stop smoking. 
• Eat a low Glycemic diet. The glycemic index is a rating system for foods and essentially ranks them according to the amount of sugar or simple carbohydrates each foodstuff contains. Example of high glycemic foods are candy, mashed potatoes and cookies. Low glycemic food categories are meats, eggs, dairy, whole grains, certain fruits and vegetables.
• High glycemic foods raise insulin which makes your body store fat.   The fat cells make chemicals that cause inflammation so you are more prone to cancer, heart disease and arthritis.  By eliminating high glycemic foods that release insulin you can lose weight and reduce inflammation.
  DON’T BUY HIGH GLYCEMIC FOODS OR KEEP THEM IN THE HOUSE. YOU CAN’T EAT THEM IF YOU DON’T HAVE THEM.

• Fruits:
  Apples, oranges, grapefruit, tangerines, pears, apricots, strawberries, raspberries, blackberries, blueberries, prunes, and plums are the lowest glycemic fruits. Bananas and fruit juices are high glycemic fruits, avoid them.
• Vegetables:
  All lettuce, spinach, fresh corn, green or yellow string beans, raw carrots, tomatoes, cabbage, broccoli, cauliflower, peas, and beets are very good food choices. Avoid fried vegetables, especially potatoes.
• Dairy:
  Plain yogurt that says “contains live culture” is very good for you, especially women who need the calcium and protein for their bones. Cow’s milk is a good choice and for whatever reason, high consumption of dairy milk seems to be associated with a lower risk of breast cancer. Drink away.
• Beans:
  Lentils, beans of any variety, and peas are all great choices. They increase the fiber in your diet and are a good source of protein. Humus is a bean dip from the Middle East and makes a great dip for vegetables.
• Nuts and Seeds:
  Pecans, walnuts, almonds, sunflower seeds, pumpkin seeds are good sources of protein and fiber and reduce the risk of heart disease. Eat a handful at least every other day.
• Fish, Chicken and lean Red Meat:
  Farm raised tilapia, catfish and trout are excellent choices. Atlantic salmon is very good if you can find it. Most salmon today is farm raised and not wild. Perch, bluegills, walleye are great food choices as well. I always enjoy them whenever my patients, who are fishermen, bring them in.   Lean red meat like cube steak, sirloin trimmed of fat and round steak are high in protein and low in fat. 

Don’t eat bread, pasta, potatoes, cereal (except high fiber cereals like All Bran), soda pop, chips, candy, donuts, ice cream, cake, pie or sugar. Drink unsweetened ice tea instead of diet pop. NutraSweet may be linked to brain cancer.

Lastly, you may never run a marathon, but get out and walk 2 miles a day. You will feel better.