Dr. Shab Krish DDS, MS

Centre Director
Board Certified:
American Board of Craniofacial Pain
American Board of Craniofacial Dental Sleep Medicine

TMJ Nutrition

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An anti-inflammatory diet is recommended for everyone but can be particularly beneficial for those with TMD.

11 Food Rules for the Ultimate Anti-Inflammatory Diet, from mindbodygreen.com by Dr. Gary Kaplan

Foods That Fight Inflammation, Harvard Women’s Health Watch

TMJ-Nutrition in Flower Mound Texas
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TMJ NutritionTerrie Cowley - President and Co-Founder

  • Without proper nutrition you increase the risk of either gaining or losing weight or suffer nutritional deficiencies leading to other health problems.

TMD Nutrition and You


Without proper nutrition you increase the risk of either gaining or losing weight or suffer nutritional deficiencies leading to other health problems. Remember the five principal food groups: fruits, vegetables, starches, protein, and dairy.

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First, the Background on TMD

Scientists now agree that Temporomandibular Disorders (TMD) are a complex and poorly understood set of conditions characterized by pain in the jaw joint and/or surrounding tissues and limitation in jaw movements. These problems can affect your ability to chew and swallow foods and limit how wide you can open your mouth.

There are genetic, hormonal, environmental and behavioral factors that may increase your risk for TMD. The immediate causes include a variety of conditions such as injury to the jaw, arthritis, muscle problems, autoimmune and connective tissue disease, developmental conditions, or movement disorders affecting the jaw. TMD also may occur following head and neck treatments for other conditions including tumors. In individuals who have had prior surgery, altered function may be due to scarring and alteration in remaining bone anatomy. In some cases, numbness and pain may persist if nerve damage has occurred.

Many patients diagnosed with TMD may also suffer one or more systemic conditions, often also characterized by pain, which include chronic fatigue, syndrome, chronic headache, endometriosis, fibromyalgia, interstitial cystitis, irritable bowel syndrome, low back pain, sleep disorders, and vulvodynia. Having more than one painful condition can further diminish ones appetite and affect food choices. Whatever your situation may be, it is clear that TMD alone can impact your quality of life and lead to poor nutrition if the jaw pain and oral disability seriously affects your diet.

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In addition, TMD patients may experience dry mouth as a side effect of chronic pain medications and other drugs. The lack of saliva to bathe the oral tissues increases the risk for dental cavities, yeast infections, and broken teeth, and adds to the difficulties in chewing and swallowing. The mouth may also become more sensitive to pain and temperature and affect taste. To avoid these problems and manage your TMD symptoms you should:

  • Brush and floss teeth after meals.
  • Get regular dental check-ups and use dentist-prescribed fluoride for dental maintenance. High-risk patients, where jaw opening is restricted, may be prescribed oral antibacterial mouth rinses that reduce cavity-causing bacteria.
  • Treat TMD symptoms of pain and limited jaw opening following principles of physical and rehabilitative medicine. Manage chronic pain by reducing inflammation and musclebased pain whenever possible.
  • Seek prescription salivary stimulants (sialogogues) if dry mouth is present.
  • Consume small meals and non-sugar-based snacks. (Limit high sugar products between meals.)

How to Manage Your Diet

Many TMD patients struggle to determine what to eat to maintain proper weight and ensure adequate protein, vitamin and mineral status. Your food choices vary depending on the amount of pain you’re experiencing and your ability to open your mouth, chew and swallow. For those who are able to adequately open their mouths and have minimal pain, a soft or easy chew diet will work well. A soft diet is defined as foods that require minimal chewing. Here is a list of foods to include as well as to avoid in such as diet.

Soft Diet

Soft Diet Foods to Include Soft Diet Foods to Avoid
Dairy/ Dairy Alternatives Smooth yogurt, soft cheeses (feta cheese, ricotta cheese, cottage cheese), milk, custard, puddings, buttermilk, soymilk, almond milk, kefir, cheese sauce Sliced hard cheese, yogurt containing chunks of fruit or seeds, coconut and nuts
Grains Soft bread (no seeds, nuts or whole grain pieces), corn bread, muffins without seeds or nuts, soft tortillas, pancakes, stuffing/dressing, matzo balls, couscous, quinoa, pasta, dumplings, gnocchi, rice, mashed potatoes, polenta, grits, hot cereals, cold cereals (crisp rice, corn flakes) Breads with seeds or nuts, pancakes and French toast without syrup, rice (Some may be able to tolerate well cooked rice, especially with gravy.)
Fruits Canned fruits, (applesauce, peaches, pears, fruit cocktail), bananas, ripe melon, baked apples, fruit juice, fruit nectars and fruit smoothies Fresh fruit with skins or seeds, whole grapes
Vegetables Cooked carrots, squash, zucchini, spinach, kale or other greens, avocados, legumes, green beans, peas, vegetable soufflé, creamed corn, asparagus tips, beets, vegetable juice, cooked pumpkin Lettuce, chopped tomatoes, fresh vegetables, such as carrots and celery
Protein Foods Soft-cooked chicken or turkey with gravy, meatloaf, fish, deli meats, meatballs, slow cooked meats, tuna, chicken/tuna/egg/seafood salad (made without onion and celery), lox, eggs, tofu, fish sticks (battered, not crunchy), legumes, refried beans, baked beans, hummus, meat and pasta containing casseroles, quiche, refried beans, liverwurst, smooth nut butters Fried eggs, fried meats with breading, hard-boiled eggs, nuts, and seeds
Soups Cream-based soups, tomato soup, broth-based soups (Avoid stringy vegetables such as celery.) Soup that contains celery, undercooked carrots, or rice (Some people can handle rice.)
Desserts Soft cakes, cobblers and pies (without the crust), soft cookies without nuts or chunks dunked in milk to soften, ice cream (without nuts or chunks), frozen yogurt, sherbet, sorbet, gelato, milkshakes, cheesecake, puddings, custard, gelatin, nutritional drinks Cakes, cookies, pies, and brownies that are hard and dry making them difficult to chew (Avoid baked goods that contains nuts, seeds, coconut, or pineapple.)

Pureed Diet

For people who are unable to tolerate a soft diet, a pureed diet may be better tolerated. Here are some examples of foods that can be included and avoided in a pureed diet.

PUREED DIET Foods to Include PUREED DIET Foods to Avoid
Dairy/ Dairy Alternatives Smooth yogurt, soft cheeses (feta cheese, ricotta cheese, cottage cheese), milk, custard, puddings, buttermilk, soymilk, almond milk, kefir, cheese sauce Sliced hard cheese, yogurt containing chunks of fruit or seeds, coconut or nuts, cottage cheese (unless pureed), feta cheese
Grains Bread (without nuts or seeds) that has been soaked into a dissolvable consistency, pureed pasta, pureed pancakes, hot cereals, grits, soft polenta, mashed potatoes (thinned as needed) Breads with or without nuts that have not been soaked, corn bread, stuffing/dressing, dry cereals, regular pasta/noodles, rice
Fruits Applesauce, mashed ripe bananas, fruit juice, fruit nectar, seedless jam/jelly, pureed fruits (strained as necessary) Canned fruit that has not been pureed, fresh fruits with skins and seeds, whole grapes
Vegetables Mashed white or sweet potatoes, pureed carrots, beets, beans, peas, creamed corn, hummus, legume pastes, vegetable juice Canned or fresh vegetables that have not been cooked or pureed into a pudding-like consistency
Protein Foods Pureed meats, pureed/scrambled eggs, crustless quiche, egg custards, liverwurst, smooth patés, smooth soufflés, pureed nuts and seeds, yogurt-based smoothies Fried meats, hard-boiled eggs, quiches and soufflés that contain crusts
Soups Soups that are smooth (like tomato) or that have been put through the blender Soups with chunks of meat, stringy vegetables, or contain rice or pasta that has not been pureed or strained
Desserts Puddings, custards, dessert soups, gelatin, cakes moistened with sauce or milk, fondue, cookies dunked in milk to soften Cakes, cookies, pies, and brownies that are hard and dry making them difficult to chew (Avoid baked goods that contain nuts, seeds, coconut, or pineapple.)
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Helpful Hints

Having a list of what foods to eat and what foods to avoid is a good starting place. However, there are many other issues that TMD sufferers cope with on a regular basis. Some of these are reflected in the questions and answers below.

Q: I’m down to 87 pounds and am concerned. I’m unable to eat because it is exhausting to eat and I don’t have much of an appetite. What should I do to prevent further weight loss?

A: Weight loss is one of the most common problems for TMD patients. Due to the elimination of certain foods in your diet, your caloric intake may decrease, resulting in weight loss. Adding calories through higher calorie foods and eating more frequently can correct calorie deficiencies. Adding energy and protein supplements should be considered if weight loss continues or is excessive. Also, you may want to consider using shakes, smoothies, or nutritional supplement drinks to add extra calories. See Tips for Adding Calories section for more information.

You can use online food tracking systems to track your calorie, protein, and fat intake. A scale should be used on a regular basis to help you keep a record of your weight gain or loss.

According to the United States Department of Agriculture, most females need between 1800 and 2200 calories per day. It is recommended that men consume between 2000 and 3000 calories per day. Use the United States Department of Agriculture’s nutrition website (http://www.choosemyplate.gov/) to find more online resources and tracking tools.

Q: My problem is whatever I eat seems to turn into extra pounds. What can I do?

A: If you notice your weight trending up, then it is important to choose the lower fat varieties of foods. Choose low fat or fat free dairy foods and limit large quantities of cheese and sour cream. Choose low fat or fat free gravy. Choose lean meats such as chicken breasts, sirloin, fish and lean ground turkey. If supplementing with shakes or smoothies: Use low-fat or fat-free yogurt and ice cream. Choose lower fat over-the-counter supplements such as Slim Fast®, or Carnation Breakfast Essentials®. Include more fruits and vegetables and look for light juices to reduce the sugar content and overall calories found in these products. If you need to lose weight, consult your physician or dietician and create a weight loss plan. Then enlist the support of a registered dietitian to help with meal planning ideas. You can find a local dietitian by contacting the Academy of Nutrition and Dietetics at http://www.eatright.org . Here you will find a list of local dietitians who may be of help for meal planning and weight loss coaching.

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Q: I used to enjoy salads. Now, salads and fresh produce are difficult to chew. As a result, I have become constipated. What foods should I be eating and which foods should I avoid?

A: There are many options to correct constipation. Dietary-wise, it is recommended to increase your fiber and drink more liquids. Stewed prunes, prune juice, and bran-based foods are helpful in stimulating a sluggish bowel. Ground flax seed can also be added to yogurt and pudding to increase fiber in the diet. Aim to eat a sizable breakfast in the morning and drink hot liquids with the meal to help stimulate the bowel. Make sure you are adequately hydrated. Most people need between six and eight cups of liquid per day. Warm liquids such as tea, coffee, and ciders often provide a stimulant effect, which is helpful in relieving constipation. If dietary measures do not resolve the constipation, speak to your health care provider for medication options.

Q: I am not able to eat every type of food anymore and worry that I may become deficient in certain vitamins and minerals. Should I take vitamin supplements?

A: For people who may not be able to tolerate foods from all food groups on a daily basis, a multivitamin may be beneficial. Assess your need by answering the following questions.

  • Do you eat at least two servings of fruit a day?
  • Do you eat at least three servings of vegetables a day?
  • Do you eat at least three different colors of fruits or vegetables per day?
  • Do you drink or eat at least two servings of dairy foods a day?
  • Can you eat breads, cereals, pasta, rice and potatoes? Do you consume at least four servings per day?
  • Are you able to eat a variety of protein foods such as lean meats, chicken, turkey, pork, fish, eggs, cheese, nuts, and legumes?

If you answered no to more than three of these questions, then you would benefit from a standard multivitamin. If you answered no to two or less of these questions, then your diet is probably adequate and you do not need a multivitamin.

If you are in need of a multivitamin, look for one that meets the daily value for most nutrients. Women of childbearing years who are planning to become or who are pregnant should look for a prenatal daily vitamin and mineral supplement. Women who have gone through menopause or people who are over 65 years of age may look for a senior formula as these formulas often contain less iron and more calcium and vitamin D.

Consider the size and shape of the vitamin pill. If you have difficulty taking pills, you may want to select a liquid form of a multivitamin. Ask your pharmacist for more information and options.

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Q: I am pregnant and having a difficult time finding foods that work for me. How much of each food group do I need to support a healthy pregnancy?

A: Adequate weight gain during pregnancy is important to your baby’s health. According to the American College of Obstetrics and Gynecology and the Institutes of Medicine, women of normal weight should aim to gain between 25 and 35 pounds during a term pregnancy. Women who are overweight should gain 15 to 20 pounds. Women who are obese should aim to gain between 11 and 20 pounds. Women who are underweight should strive to gain 28 to 40 pounds. To determine your weight category, calculate your body mass index (BMI) using this online tool: http://www.nhlbisupport.com/bmi/ . Weight gain through pregnancy is variable, with the largest gains of one to three pounds per week in the 2nd and 3rd trimester. Your physician will help you track your weight gain. Pregnant women usually need to consume an extra 300 calories per day to allow for adequate weight gain.

If you are having a difficult time gaining weight, then you may need to increase your calories by 500 to 600 a day. (See the Tips for Adding More Calories section for ways to fortify the foods you eat.) Some women may find it easiest to add smoothies or nutritious drinks to help meet their caloric goals. Adding snacks between meals such as cottage cheese and fruit, peanut butter spread over crackers, or a banana are quick and easy ways to add the additional calories needed.

For women who are breastfeeding, your calorie needs are still elevated. To prevent rapid weight loss and to allow your body to continue to lactate, you will need an additional 500 calories above your baseline daily calorie intake.

Q: I’ve stopped eating out at restaurants because I have a hard time finding foods that I can eat. Do you have suggestions?

A: Eating in a restaurant can be difficult, but still possible with a little planning. Choose a restaurant for which you can review the menu ahead of time. Many restaurants have their menus available online. Look for soups as a starter. Menus that have pasta offerings or rice and bean options will work well. Look for pasta dishes that have a red or white sauce. Ask the server to have the meats chopped fine or choose a meat sauce, and request vegetables cooked well done instead of al dente. Many TMJ patients tell us they ask the server to blend their food – including salads, soups, and pastas. After all, it’s the same food. It is your right to ask for a dish to be modified to suit your needs. Have the chef hold or substitute ingredients that do not work for you. If you have been losing weight, then indulge in dessert! Look for ice cream, custards, or soft moist cakes as suitable options.

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Q: I have a family to feed at home. How can I provide healthy balanced meals?

A: Making meals for your family can be accomplished with basic understanding of a balanced diet. A well balanced meal should contain food from the following food groups: a starch (pasta/rice/potatoes/breads), a protein (meat/cheese/vegetarian options), a vegetable, a fruit and dairy. Once you have decided what to have, then you can modify the items that need to be softer for you. For example, if the menu includes potatoes, chicken and green beans for your family, then you could modify the items by making mashed potatoes and adjusting the consistency to make them thin enough for you. If the chicken is too hard to chew, then you can chop it into smaller pieces or puree it. Adding gravy, broth, or cream soup will help with consistency and flavor. Modify green beans by either cooking to a very soft mushy form or chop into very small pieces. If unable to tolerate the fruit or vegetable at the meal, you could substitute vegetable or fruit juice to meet your nutritional needs. Another way to meet the needs of your family, as well as meeting your needs, is to consider more casserole and crock pot meals. Both cooking mechanisms yield a softer product that can either be chopped fine or pureed based on your specific needs. To balance the meal, serve a low fat milk or dairy alternative to ensure adequate calcium intake. The bottom line is that you and your family need balance in choosing foods from all food groups.

Q: I am preparing for jaw surgery. What kinds of foods should I plan to have on hand when I get home for recovery?

A: During recovery, you may be limited in your ability to open your mouth and chew and swallow comfortably. This will require more of a liquid diet. Stock up on pureed soups, puddings, gelatins, custards, and ice cream or sherbet. If you tolerate dairy products, white or flavored milk is a good choice since they’re rich in calories, protein and calcium. Consider flavoring milk with flavored syrups, Nesquick®, Ovaltine®, or Carnation Instant Breakfast® to help increase calories and protein. Using commercial nutritional beverages such as Boost®, Ensure®, Myoplex® or Muscle Milk® are sometimes necessary to meet calorie and nutrient needs. You can also make homemade shakes using milk, ice cream, and smoothies using a variety of frozen fruits or bananas.

Once you are able to open your mouth, you can advance your diet to pastas and soft finely chopped meats, cooked vegetables, and soft canned fruits. See the Soft Diet section for more ideas in each food group. You may need to continue to supplement your diet with shakes or commercial beverages if you are not eating well. Use your weight as a guide. If you are actively losing weight during your recovery, it is important to supplement your meals with liquid calories either in the form of commercial beverages, shakes, or juices.

To save time and energy, make soups, casseroles, and custards ahead of time and freeze them in single serving portions. You can also do this with shakes and malts by making a large batch and freezing in single cup servings.

Tips for Adding Calories

Preventing weight loss is difficult if you are having trouble eating regular meals. Pain with chewing may reduce your overall calorie intake and food choices, which may result in weight loss. Wise food choices can maximize caloric intake. Here are some tips to help prevent weight loss: Aim to eat six small meals throughout the day. Each meal should consist of a minimum of 300 to 500 calories.

  • Add healthy fats to increase your calories. One tablespoon of oil, butter, margarine, or nut butter contains about 100 calories.
  • Add cheese to meals and consider using full fat dairy products during this time to promote weight gain. Choose whole milk, regular or Greek yogurt, full fat cottage cheese and cream cheese instead of their low-fat counterparts.
  • Add gravy, broth, or cream soup to meats to increase calories.
  • Choose high calorie drinks. Look for full fat milk, regular juices, and shakes or smoothies. Select diet drinks or calorie free beverages less often.
  • Add cheese sauces, cream sauces, or oils to vegetables.
  • Look for canned or frozen fruits in heavy syrup.
  • Eat starchy vegetables such as regular potatoes, sweet potatoes, corn, and carrots instead of non-starchy vegetables (green beans, cucumbers, peppers, zucchini, and spinach).
  • Eat avocados! Avocados are rich in healthy fats, protein, vitamins and minerals. Add to meals, soups and dips.
  • Add eggs and eat more egg-based foods such as custard, quiche, and omelets.
  • Try mayonnaise-based foods such as ham, chicken, tuna or egg salad. You can eat these types of protein-rich foods with or without bread depending on your tolerance to chewing.

Other Helpful Tips

When dealing with jaw pain no matter the severity, keep these tips in mind.

  • Practice good oral hygiene. Brush your teeth after every meal and rinse your mouth out with water. This is especially important to reduce plaque formation after eating starchy foods such as cereals, bananas, dried fruits, and any sugary foods.
  • Try to maintain a balanced diet. Include all major food groups from grains, vegetables, fruits, milk and protein foods.
  • Maintain pain management if pain is significant. Seek help from your primary care physician and/or a pain specialist.
  • Eat fiber-rich foods with every meal to avoid constipation. Choose brown rice or whole grain pasta, bran-based cereals, fruits, vegetables, nut butters, and legumes daily for your meals.
  • Hydrate well. An easy way to figure out if you are getting enough liquid each day is to take your weight in pounds and divide it by two. This number is the amount of hydration needed per day in ounces. If you are currently losing weight, then use your usual body weight to do this calculation. Remember that all decaffeinated liquids count towards your hydration needs.
  • Monitor your weight every few days. If you are losing weight despite increasing your calories or because you are unable to eat enough during the day due to pain, then supplement with liquid calorie nutritional beverages. Speak to your physician or enlist the support of a registered dietitian for more ideas specific to your situation.

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Resources

The TMJ Association: http://www.tmj.org

The Academy of Nutrition and Dietetics: http://www.eatright.org

Department of Health and Human Services: http://www.hhs.gov/partnerships/letsmove/communities_on_the_move/healthy-eating/index.html

Pain Pathways Magazine, Integrative Therapy: Pain & Nutrition: http://www.painpathways.org/nutrition-pain/

Recipes: http://www.muschealth.org/weight-loss-surgery/nutrition/recipe-corner.html

About the Authors

Dena McDowell, MS, RD, CD, Froedtert and the Medical College of Wisconsin, Clinical Cancer Center – Oncology Outpatient Nutrition Services Department, Milwaukee, WI. Dena’s clinical practice focuses on patients undergoing chemotherapy and radiation therapy. She participates in the hospital’s community education program which teaches the public about various nutrition-related topics as well. Dena also is a frequent lecturer and writer on the topic of nutrition.

Dr. Joel Epstein, DMD, MSD, Consulting Staff, City of Hope National Medical Center, Duarte, CA, Collaborative Member, Samuel Oschin Comprehensive Cancer Institute and staff at Cedars-Sinai Health Sciences Center in Los Angeles, CA. Dr. Epstein has a long career in oral medicine, with a focus on oral oncology. Oral medicine focuses on diagnosis and management of oral mucosal conditions, salivary gland and sensory and motor disorders of the oral tissues and the jaw. Dr.Epstein has published in the area of oral medicine and oncology extensively and is active in several national and international organizations. He maintains a clinical practice in oral medicine.

The TMJ Association thanks Patti Cobb, RD, CD, Chief Clinical Dietitian, Froedtert Memorial Hospital, Food and Nutrition Services in Milwaukee, WI as well as TMD patient, Janelle Botez, for their help in us making this booklet possible.

About The TMJ Association

The mission of The TMJ Association, Ltd. (TMJA) is to improve the diagnosis, care and treatment of everyone affected by temporomandibular disorders through fostering research, education, and other activities with the ultimate goal of preventing TMJ problems.

The TMJA achieves its mission by promoting awareness of Temporomandibular Disorders among the public, research, and health care communities, connecting TMJ patients for one-on-one support, encouraging basic and clinical research, and safer and more effective methods of diagnosis and treatment, collecting and disseminating information on the advances of research and treatment, and advocating for patients’ rights by communicating with elected officials, government agencies and others in policy making capacities at the national, regional and local level.

The TMJ Association, Ltd. (TMJA) is a 501(c)(3) nonprofit organization.

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The Deflaming GuidelinesDeflame Enterprises

  • The focus of deflame.com and the Deflaming Guidelines is quite specific…to explain how to reduce a chronic inflammatory state with diet and nutritional supplements.
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The information contained in the Deflaming Guidelines is consistent with the information found at www.deflame.com, the internet’s most comprehensive website devoted to reducing inflammation with nutrition.

The focus of deflame.com and the Deflaming Guidelines is quite specific…to explain how to reduce a chronic inflammatory state with diet and nutritional supplements. This is an extremely important nutritional goal, as research now clearly demonstrates that our dietary habits can promote a state of chronic inflammation that leads to the expression of aches, pains, disability, and most chronic diseases, such as diabetes, heart disease, cancer, osteoarthritis, and neurological diseases such as Alzheimer’s disease, Parkinson’s disease and multiple sclerosis (1-7).

The Deflaming Guidelines are divided into five different sections.

Part 1: The Inflammation Checklist

Find out how many inflammatory factors are active in your life at this moment. The goal is to have as few as possible.

Part 2: Introduction to Basic Deflaming Concepts

Basic conceptual issues are discussed and simple steps to reducing inflammatory food consumption are introduced.

Part 3: Why Grains Inflame

The truth we must all deal with is that grains are simply not the appropriate food to eat as a staple food. Grains are best in condiment portions or not at all.

Part 4: Foods and Dietary Suggestions to Fight Inflammation

Provided is a thorough list of the foods that are anti-inflammatory, as well as suggestions regarding meals.

Part 5: Nutritional Supplements to Help Fight Inflammation

simple and clear approach to supplementation is outlined, and supplement programs are presented.

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The Deflaming Guidelines work best when coupled with regular exercise.

Walking 1/2 hour to 1 hour a day is sufficient for many,

while more intense exercise is preferred by others.
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** An MP3 audio version of these guidelines is available at www.deflame.com, in which key highlights are discussed.

Deflame Enterprises • Copyright 2009 • All Rights Reserved

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Part 1: The Inflammation Checklist How many inflammation factors apply to you?

I have chronic aches and pains, such as back pain, neck pain, headaches, or general muscle and/or joint soreness.

I regularly take anti-inflammatory or anti-pain medications, such as ibuprofen, aspirin, or Tylenol®, or a similar prescription drug.

I regularly eat grains and grain products, such as white bread, whole wheat bread, pasta, cereal, pretzels crackers, and any other product made with grains or flours from grains, which includes most desserts and packaged snacks.

I regularly eat refined sugar (including desserts, sodas, sweetened drinks, etc.).

I regularly eat partially hydrogenated oils (trans fats) found in most margarines, deep fried foods (French fries, etc.) and most all packaged foods.

I regularly eat corn oil, safflower oil, sunflower oil, cottonseed oil, soybean oil, and foods made with these oils such as mayonnaise, tarter sauce, margarine, and nearly all salad dressings.

I regularly eat cheese in more than condiment size portions.

I regularly drink or eat dairy products in more than condiment size portions, or drink/eat in the place of fruits and vegetables.

I regularly consume soy or soy products, or eat them in place of fruits and vegetables.

I regularly eat meat and eggs from grain-fed animals (regular supermarket brands).

I am overweight and/or it is hard for me to lose weight/fat.

I can grab too much fat around my waist.

I am physically lethargic.

I do not exercise regularly.

I do not feel well when I exercise or if I exercise a little more than I should, it is hard to recover.

I am mentally lethargic and feel rundown and depressed more than I would like.

I look old and/or feel old for my age.

My skin looks old and is sagging.

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I am prone to cold, allergy, and flu symptoms.

I am a smoker.

I suffer from one or more of the following: arthritis, fibromyalgia, chronic fatigue syndrome, sinusitis, allergies, acne, asthma, digestive conditions, flu symptoms, dysmenorrhea, endometriosis, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, cancer, heart disease, osteoporosis, hypertension, depression, the insulin resistance syndrome (pre-diabetes), or diabetes.

BMI (Body Mass Index) [Determine BMI at http://www.nhlbisupport.com/bmi/] Underweight = <18.5; normal weight=18.5-24.9; overweight=25-29.9; obesity=30 or greater

Deflame Enterprises • Copyright 2009 • All Rights Reserved

Part 2: Introduction to Basic Deflaming Concepts

As you just discovered, we all suffer from inflammation issues to varying degrees. Therefore, each of us needs to focus on reducing our individual inflammation issues, and diet is the key to realizing this goal. The following foods cause inflammation; that is, they are pro-inflammatory and therefore, should be avoided (1-7).

  • All grains and grain products, including white bread, whole wheat bread, pasta, cereal, pretzels, crackers, and any other product made with grains or flours from grains, which includes most desserts and packaged snacks.
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  • Partially hydrogenated oils trans fats) found in margarine, deep fried foods (French fries, etc.) and most all packaged foods.
  • Corn oil, safflower oil, sunflower oil, cottonseed oil, peanut oil, soybean oil, and foods made with these oils such as mayonnaise, tartar sauce, margarine, salad dressings, and many packaged foods.
  • Soda and sugar are inflammatory. If you eat dairy or soy, they should be consumed as condiments, not staples.
  • Meat and eggs from grain-fed animals (domesticated animal products). Modern meat is problematic because the animals are obese and unhealthy; they are loaded with saturated fats and contain too many proinflammatory omega-6 fatty acids. Grass-fed meat or wild game are our best choices. Otherwise, we should eat lean meat, skinless chicken, omega-3 eggs and fish (4). Lean cuts of meat and lean hamburger meat are available at most grocery stores, and even extra-lean is sometimes available.

Most of us find it somewhat distressing and/or depressing that so many foods are pro-inflammatory, and wonder what there is left to eat. However, far more depressing than making basic dietary changes is suffering from any of the numerous diseases and conditions caused by inflammation: chronic pain, arthritis, fibromyalgia, chronic fatigue syndrome, sinusitis, allergies, acne, asthma, digestive conditions, flu symptoms, dysmenorrhea, endometriosis, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, cancer, heart disease, osteoporosis, hypertension, depression, the insulin resistance syndrome or syndrome X (pre-diabetes), and diabetes (1-7).

You need to decide how much pain and suffering you are willing to live with, and then, eat and exercise accordingly. The fewer inflammatory foods you eat, the less inflammation you will have and feel. No one will be perfect with their eating...we all just need to do your best. If you have a few weak moments or longer periods of time where you dine excessively on inflammatory foods, do not beat yourself up or become depressed. This happens to everyone, so simply re-commit yourself to the deflaming process.

The best eating thought to embrace is that, with every bite we take, we are either deflaming or inflaming. This is a fact we all must accept, so we should all do our best to eat mostly anti-inflammatory foods.

If you are fortunate and have “good” genes, you may be able to handle more inflammatory foods than some of your family members or friends. The problem is that most inflammatory diseases develop slowly and without symptoms...until it is far too late. Therefore, we all need to be careful about consuming pro inflammatory foods and not take for granted what appears to be good health.

In a nutshell, all you need to do is eat mostly fruits, vegetables, nuts, fish, chicken, and lean meat. Eat until you begin to feel full and then stop. Take the key supplements and exercise more. There is no need to make deflaming a complicated or negative process, and this is illustrated by the many examples found in the Success Stories section at deflame.com.

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The next two pages discuss the problems with grains in more detail. Key issues will be addressed and common objections will be answered.

Deflame Enterprises • Copyright 2009 • All Rights Reserved

Part 3: Why Grains Inflame

Grain consumption is a sensitive subject for many individuals, which is why additional information is being provided. Most people have eaten bread, pasta, and cereals their entire lives, and giving up this food can be psychologically traumatic for some, which illustrates the strong and often inappropriate emotional connection that we have with food.

Why-Grains-Inflame

A goal should be to view eating as a mechanism to fuel the precious vehicle (your body) that conveys you throughout life. Remember, you can only trade in your motor vehicle, not your body vehicle. With this mindset, we are less likely to be opposed to making any changes that would benefit our body vehicle.

Many find it surprising that grains are a relatively new food from a historical perspective. The following foods were never consumed prior to 5,000-10,000 years ago: grains, pasta, cereal, soy, beans, dairy, refined sugar, partially hydrogenated fats, and seed oils, such as corn, safflower, cottonseed, sunflower, peanut, canola, and soybean oil (4,7). Mammals with a similar genetic code to ours inhabited the earth for 1,990,000 years before man appeared on earth. We must appreciate that our genes are not dissimilar from those that came before us; modern science has demonstrated this fact.

This means that humans are genetically adapted to eat fruits, vegetables, fish, fowl, meat, roots, tubers, and nuts. Consider also that there are no chronic diseases caused by eating these foods. No matter what disease you may suffer from, none of these foods must be eliminated from the diet. The same cannot be said for grains in particular. In a nutshell, grains contain several problematic substances including gluten, lectin, and phytates, and grains also promote inflammation by promoting body acidity, and disrupting proper blood sugar regulation.

Gluten

Celiac disease is a disabling digestive condition that is caused by the gluten found in certain grains. Most notorious on the list of gluten grains is wheat; others include couscous, spelt, kamut, rye, and barley. Among the non-gluten grains are rice, wild rice, millet, and corn. A detailed list of gluten foods can be found at the Celiac Sprue Association’s website (www.csaceliacs.org).

It is not only those suffering from celiac disease that need to avoid grains. Gluten can promote many other symptoms and conditions, ranging from schizophrenia (7) to more common conditions such as headaches (8). For certain individuals, gluten sensitivity can present exclusively as a neurologic disease, and not with classic digestive problems. The most common symptoms include headache and nervous system symptoms such as numbness, tingling, and weakness (8-10).

In one study (11), researchers randomly selected 200 disease-free individuals for the purpose of assessing antigluten antibody levels, which is a way to measure gluten sensitivity. Health complaints of the 15% of subjects with the highest antibody levels were compared with the 15% of subjects with the lowest levels. Interestingly, those with the highest antibody levels suffered from headaches, chronic fatigue, regular digestive complaints, subtle anemic changes, and NO signs of celiac disease, while those with the lowest levels were symptom-free. In another report, 3 cases of gluten sensitivity were discussed. All patients were women in their mid 40’s and each suffered from digestive bloating, gas, abdominal pain, and fatigue. Symptoms resolved after going on gluten-free diet (12).

Lectins

All grains and legumes (beans, lentils, soy) also contain sugar-proteins known as lectins, which resist digestion and cooking. Before absorption, lectins are known to cause digestive system inflammation, which may or may not cause obviously linked symptoms (13). After lectins are absorbed into circulation from the digestive tract, they bind the surface of cells throughout the body. While all the details are not known, researchers state that, “there is now abundant evidence that lectins can cause disease in man and animals” (14). Research suggests that lectins may play a role in promoting the following conditions: inflammatory bowel disease, diabetes mellitus, rheumatoid arthritis, glomerulonephritis, psoriasis, multiple sclerosis, retinitis and cataracts, as well as congenital malformations, infertility, allergies and autoimmune problems (14).

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Other problems with grains

Grains contain a substance called phytic acid, which is known to reduce the absorption of calcium, magnesium and zinc from grains (7). Grains also promote an acidic body pH, which is known to be inflammatory. Research has now demonstrated that a diet-induced acidic state helps to promote the loss of bone and muscle that occurs as we get older (4). Finally, while grains are a low-fat food, they contain an elevated ratio of omega-6 to omega-3 fatty acids (7). Omega-6 fatty acids are converted into chemicals the cause inflammation, chronic disease, and pain (1,2,5,6).

other-problmes

With the above in mind, you may be wondering why we have been told that grains are so good for us? First, whole grains do contain nutrients and fiber, both of which are healthy and anti-inflammatory. However, we get more nutrients and fiber from fruits and vegetables. Second, grains are inexpensive and can be stored easily, so they are profitable for food manufacturers. We are never told that we can get all the nutrients and fiber we require by eating fruits, vegetables, and nuts, and that there is no need to consume grains.

It is important to understand that the health conditions discussed above have only been associated with the consumption of grains and legumes (beans) and have never ever been associated with the consumption of fruits, vegetables, nuts, and healthy animal products. Therefore, try to avoid grains, flours, bread, pasta, etc., and try to replace these foods with fruits and vegetables. Sprouted grains are somehow seen as a loophole to refined and whole grains, but this seems unlikely.

What about fiber?

A great misconception is the notion that we cannot get adequate fiber unless we eat whole grains. In fact, whole grains are a poor source of fiber when compared to fruits and vegetables on a calorie basis. When we compare foods based on calories, fresh fruit typically contains twice the amount of fiber found in whole grains, and nonstarchy vegetables, such as broccoli and lettuce, contain almost 8 times the amount of fiber found in whole grains (4).

In addition to being low in fiber, grains are also low in potassium when compared to fruits and vegetables. Research has demonstrated that diets low in potassium predispose one to numerous diseases such as chronic pain, osteoporosis, age-related muscle wasting, calcium kidney stones, high blood pressure, stroke, asthma, exercise-induced asthma, insomnia, air sickness, high-altitude sickness, Meniere’s Syndrome (ear ringing), and age and disease related chronic kidney insufficiency (2,4).

Unlike other minerals, it is important that we get potassium from food, NOT supplements. Supplementing with potassium can lead to inappropriately high levels of potassium in the blood, called hyperkalemia, which can lead to muscle weakness, numbness and tingling, abnormal heart rhythm, muscle paralysis, troubled breathing, and even heart failure and death.

Notice the difference in the fiber and potassium (K+) content in grains versus fruits and vegetables.

food-portion

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Part 4: Foods and Dietary Suggestions to Fight Inflammation

  • All fruits and vegetables. Eat fruits raw and vegetables raw or lightly cooked. Red and sweet potatoes are acceptable as long as they are consumed with a protein, such as eggs, fish, meat, or fowl.
    Fight-Inflammation
  • Fresh or frozen fish. A recent study indicated that farmed-raised tilapia, catfish and bronzini had unacceptable omega-6 to omega-3 ratios, while all other fish had appropriate ratios (17). Shell fish are also a good option.
  • Meat, chicken, eggs from grass-fed animals. Go to www.eatwild.com to find producers of grass-fed animal products. If you cannot acquire grass-fed products, do the best you can to get lean cuts of regular meats, which are available at all supermarkets.
  • Omega-3 eggs. Common supermarket brands of anti-inflammatory omega-3 (n-3) eggs are Christopher Eggs (600mg n-3 per egg yolk), followed by 4-Grain Vegetarian omega-3 Eggs (300mg n-3 per yolk), Sparboe Farms omega-3 eggs (250mg n-3 per yolk), and Eggland’s Best (110mg n-3 per yolk). Egg whites are also a good choice.
  • Wild game (deer, elk, etc.)
  • Nuts: raw almonds, cashews, walnuts, hazelnuts, macadamia nuts, etc. As nuts are high in calories, be sure to temper your nut consumption if your goal is to lose weight. For example, 1/4 cup of nuts provides about 170-225 calories.
  • Spices like ginger, turmeric, garlic, dill, oregano, coriander, fennel, red chili pepper, basil, rosemary, kelp, etc. (sea salt is okay if you wish to add a little salt).
  • Oils and fats: It is best to use organic oils, as it is thought that nonorganic oils may contain pesticides. Use organic extra virgin olive oil and coconut oil. Butter is also a healthy choice and the best butter comes from grass fed cows. You will get the best available butter if you buy organic butter (Organic Valley indicates that their butter and heavy cream are from grass-fed cows).
  • Salad dressing: extra virgin olive oil, balsamic vinegar (or lemon juice), mustard if you like, and spices (Greek, Italian, ginger, dill, oregano, etc.; whatever suits your taste). When eating in a restaurant, use dressings sparingly, as most are made with soybean oil or worse, and most are rich in sugar.
  • Whenever you are thirsty, drink water or organic green tea (non-organic green tea may contain pesticides and should be avoided).
  • Alcohol: Red wine and stout beer are the best choices.
  • Candy: Dark chocolate. Be sure to temper your consumption as dark chocolate is high in calories. Try to eat no more than 50-100 calories per day.

We clearly have many anti-inflammatory food options and so should not think that there will be nothing to eat if we do not eat breads, pasta, grains, cereal, and pastries.

Eating anti-inflammatory need not be complicated. Most meals can be prepared the same way as always - just eat as little grain products as possible. Instead of rice, past or other grain product, have more vegetables and a modest potato portion with whatever protein dish is being served. The following page offers a few meal options that can be used as templates.

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Meal Suggestions

Breakfast Options

  • Soft boiled, poached or gently fried omega-3 eggs and favorite vegetables and spices (a small serving of sautéed potatoes is okay if you are not carbohydrate sensitive). It is best to use organic virgin coconut oil for cooking eggs and potatoes. Olive oil would be the next best option.
  • Omega-3 egg or egg white omelet with favorite vegetables and spices. You can pour marinara or pasta sauce over the omelet. Lightly dust the omelet with your favorite cheese - when you add the sauce, it tastes like a pizza.
  • If you wish to have oatmeal or grits, add a couple tablespoons of ground up chia/flax seeds, whole hemp seeds, and some raisins, berries or favorite fruit. You can also use chia seeds after they have been soaked for about 10 minutes. Chia seeds can be ordered from www.sunorganicfarms.com. To avoid excess calories, use water instead of milk [or soy/rice milk] and let the fruit be your sweetener.
  • Favorite fruit topped with hulled hemp seeds and/or soaked/ground chia seeds. Instead of the abovementioned seeds, you can also use a quarter cup of your favorite nut that has been previously soaked in water. Blend the soaked nut with water and pour over the fruit.
  • Meal Shake (See Below)

Lunch and Dinner Options

Breakfast-Options
  • A chicken, fish, or steak Caesar salad without croutons is an example of a meal that contains appropriate portions of vegetables and protein; it is a model meal that can be applied to all other meals when determining your vegetable and protein portions.
  • Chicken, fish, steak (or favorite lean meat) and steamed/sautéed vegetables with favorite spices. You can have a small portion of sautéed or baked potato. Have as much salad as you like.
  • Marinara or pasta sauce poured over vegetables and meatballs from lean chop meat (or animal protein sources of your choice).
  • Have as much salad as you like with lunch and dinner.

When you feel like you have room for dessert, eat more vegetables, or wait an hour to see if you are indeed still hungry.

Meal-shake

Meal shake

  • Blend favorite frozen fruit (bananas, blueberries, cherries, strawberries, etc.) and egg white protein powder (or protein powder of choice). You can also add some coconut or your favorite raw nut. Make sure to always use water for blending to avoid excess calories. This shake is not only highly nutritious and filling, but easy and quick to prepare.
Snack-Options

Snack Options

  • Any combination of your favorite fresh fruits.
  • 1-2 Tbsp of organic heavy cream over frozen cherries, blueberries, or favorite fruit.
  • Dark chocolate, raisins, and raw almonds or favorite raw nut**.

**Nuts are high in calories, so be sure to temper your nut consumption if your goal is to lose weight. For example, 1/4 cup of nuts provides about 170-240 calories. When eating dark chocolate, try to use 50 calorie pieces, as chocolate is also high in calories.

Please realize that you may not have to significantly alter the meals you currently prepare. Simply substitute vegetables for grains, bread, and pasta, and eat more fruit (or healthy dessert/snack options) between meals.Clearly, there is no need to make deflaming a complicated or negative process.

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Meal Preparation

For some, meal preparation becomes an obstacle to healthy, anti -inflammatory eating. Have no fear, several books are available that contain many anti inflammatory recipes. For example, The Paleodiet (3), The Paleodiet for Athletes (15), and Nourishing Traditions (16) are excellent books that provide antiinflammatory nutritional advice and offer a wide variety of recipes for meal preparation.

When healthy eating is a goal, many feel that they can never eat out in a restaurant, as no anti-inflammatory meals are available. It is important to understand that our favorite ethnic restaurants offer a wide range of antiinflammatory meals. Since traditional Indian, Asian, Hispanic, Greek, and Italian meals focus on vegetables, animal products, and anti-inflammatory spices, they can all be considered anti-inflammatory...just try and avoid the grains, bread and pasta, which represent modern pro-inflammatory additions to these meals. You can also prepare various ethnic foods at home, so acquiring ethnic cookbooks can be very helpful.

Meal-Preparation

Making a Decision

You need to make a choice regarding the foods you eat: will they be pro-inflammatory foods or anti-inflammatory foods? If you have no symptoms and feel wonderful, you need to decide if you want to risk regularly consuming pro-inflammatory foods that are known to cause significant health problems and disease in many humans. If you do suffer from any of the conditions previously mentioned, you may wish to see if grains/legumes and the other pro-inflammatory foods are a cause. If you make the decision to deflame, you need to first visualize and consider what might be a reasonable deflaming lifestyle for you on a long-term basis.

You need to make sure that this decision is commensurate with how well you wish to feel. For example, if you discover that grains give you headaches, you need to decide how much headache pain you can handle. If you want to be headache free, then you may need to absolutely eliminate grains from your diet. Be aware that there are case reports in the scientific literature that describe patients who can maintain a headache-free state, only if they avoid the gluten grains (8).

After coming to a decision in your mind, you need to commit to discovering how your health is influenced by the consumption of pro-inflammatory foods. You need to commit for at least 1 month to a near perfect deflaming diet. Within a week, you are likely to feel a difference and by the end of 1 month you will know for sure how food affects your health (some people who are significantly inflamed may need 2-3 months).

If you want to cheat and maintain your new-found feelings of wellness, you will need to determine what level of pro-inflammatory foods you can consume. When you find the level that suits you best, stick with it. You also need to decide whether you wish to take supplements.

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Part 5: Nutritional Supplements to Help Fight Inflammation

More and more research suggests that supplements can help promote health and prevent disease. Interestingly, inflammation reduction seems to be a likely mechanism of action for many supplements. Thus, each of the suggested supplements has been selected due to its ability to promote health and/or reduce inflammation.

To date, we do not know precisely which supplements we need or the exact amounts. Accordingly, Deflame.com advocates a general approach for inflammation reduction, which is reflected in the Basic Program that includes 4 different supplements. If you wish to take less than the Basic 4, options are listed below.

Supplement Options

  1. supplement: Mega D-1000 (78 cents/day).
  2. supplements: Mega-D 1000 and Aved-Multi (1.65 cents/day).
  3. supplements: Mega-D 1000, Aved-Multi and Mega Magnesium (about $2.40/day).
  4. supplements: vitamin D, multivitamin/mineral, magnesium and fish oil (about $3.10/day).

The Basic Program is a reasonable $93.50 per month (about $3.00 per day, which is less than what many people spend everyday on coffee/soda and a snack).

The Advanced Program includes the 4 supplements in the Basic Program, with three additional supplements (Probiotic Complete, Coenzyme Q10, and Pro-Enz). The cost for the Advanced Program is about $6.00 per day.

Most importantly, you need to feel good about whatever supplements you wish to take, whether it be just vitamin D, the Basic Program, or the Advanced Program. It is important to make a decision and stick to your decision. Over time, you may find that you want to take less or more supplements - not a problem. Find what suits you best and stick with it. Please visit www.deflame.com for a detailed explanation of each supplement. And make sure to sign up for our free newsletter so you can be kept up to date with new information.

basic-health
advance-health

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Why Anabolic Laboratories supplements are the best choice

Currently, there are no government standards specific to supplement manufacturing. This lack of regulation creates a confusing environment for individuals who desire the highest quality nutritional supplements. The vast majority of manufacturers set their own standards, and these are typically characterized in an extremely positive fashion. However, since supplement manufacturing is a generally unregulated industry, there is no authorized agency that verifies manufacturing claims. Third party audits of a supplement manufacturer’s facility is voluntary, and most do not volunteer.

Currently, our main method of comparing supplement brands is to use the nutritional supplement manufacturer’s yardstick of quality - the Good Manufacturing Practices, or GMPs. The GMP seal is awarded to companies by the National Products Association (NPA). Their GMP Certification Program “is designed to verify compliance of member suppliers of dietary supplements with a standardized set of good manufacturing practices”, and is based upon third party inspections. Less than 50 manufacturers (which includes Anabolic Laboratories) meet NPA/ GMP standards.

However, there is an even stricter regulation program than the NPA/GMPs, and that program is the Pharmaceutical cGMPs, which is regulated by the Food & Drug Administration. Because of Anabolic Laboratories’ status as a licensed manufacturer of pharmaceuticals, Anabolic Laboratories is the only manufacturer of nutritional supplements that operates a facility meeting the FDA’s stringent pharmaceutical standards.

The pharmaceutical standards are orders of magnitude more demanding than the NPA/GMPs. Therefore, by choosing Anabolic Laboratories nutritional supplements, you are choosing supplements manufactured to a higher standard. Literally speaking, no other company compares.

Deflame Enterprises • Copyright 2009 • All Rights Reserved

References

  1. Seaman DR. The diet-induced pro-inflammatory state: a cause of chronic pain and other degenerative diseases? J Manipulative Physiol Ther. 2002; 25(3):168-79.
  2. Seaman DR. Nutritional considerations for inflammation and pain. In: Liebenson CL. Editor. Rehabilitation of the spine: a practitioners manual. 2nd ed. Philadelphia: Lippincott Williams & Wilkins; 2006: p.728-740.
  3. Cordain L. The paleodiet. New York: John Wiley & Sons; 2002.
  4. Cordain L, Eaton SB, Sebastian A et al. Origins and evolution of the western diet: Health implications for the 21st century. Am J Clin Nutr. 2005;81:341-54.
  5. Simopoulos AP. Essential fatty acids in health and chronic disease. Am J Clin Nutr. 1999; 70(3 Suppl):560S-569S.
  6. Simopoulos AP. Omega-3 fatty acids in inflammation and autoimmune diseases. J Am Coll Nutr. 2002; 21(6):495-505.
  7. Cordain L. Cereal grains: humanity’s double-edged sword. World Rev Nutr Diet. 1999; 84:19–73.
  8. Hadjivassiliou M et al.Headache and CNS white matter abnormalities associated with gluten sensitivity. Neurology. 2001; 56:385–388.
  9. Hadjivassiliou M et al. Gluten sensitivity as a neurological illness. J Neurol Neurosurg Psychiatry. 2002; 72:560-63.
  10. Hadjivassiliou M et al. Neuropathy associated with gluten sensitivity. J Neurol Neurosurg Psych. 2006; 77:1262-66.
  11. Arnason JA et al. Do adults with high gliadin antibody concentrations have subclinical gluten intolerance? Gut. 1992; 33:194-197.
  12. van Heel DA et. Novel presentation of coeliac disease after following the Atkins’ low carbohydrate diet. Gut. 2005; 54:1342.
  13. Cordain L, Toohey L, Smith MJ, Hickey MS. Modulation of immune function by dietary lectins in rheumatoid arthritis. Brit J Nutr. 2000; 83:207-17.
  14. Freed DLJ. Lectins in food: their importance in health and disease. J Nutr Med. 1991; 2:45-64.
  15. Cordain L, Friel J. The paleodiet for athletes. New York: Rodale; 2005.
  16. Fallon S, Enig M. Nourishing traditions. 2nd ed. Washington, DC: New Trends Publishing; 2001.
  17. Weaver KL et al. The content of favorable and unfavorable polyunsaturated fatty acids found in commonly eaten fish. J Am Diet Assoc. 2008; 108(7):1178-85.
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