Peripheral Neuropathy Nutrition

Good nutrition is often the first line of defense to avoid many diseases, including peripheral neuropathy. The best way to prevent peripheral neuropathy is to carefully manage any medical condition that puts you at risk. That means controlling your blood sugar level if you have diabetes or talking to your doctor about safe and effective treatments if you think you may have a problem with alcohol. Whether or not you have a medical condition, eat a healthy diet rich in fruits, vegetables, whole grains and lean protein. Keep a food diary so you are aware of what you’re eating and to make sure you get all the nutrients you need each day to stay as healthy as possible.

Disclaimer: Please check with your doctor before beginning any diet or supplement regimens.

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Healthy Diet Basics for Nerve Health

If you have a nerve disorder, a diet rich in certain nutrients can help. The food you eat can improve your nervous system’s functioning. Knowing which nutrients nourish your nervous system can help you lead a healthier life and reduce your chances of nerve-related problems.

  • Establish your diet around vegetables, fruits, whole grains, legumes, omega-3 rich foods and lean protein sources
  • Aim for 5-10 servings of colorful fruits and/or vegetables daily (phytonutrients). 1 serving = 1/2 cup for all other fruits and vegetables
    • 1 medium fruit or vegetable, example apple, orange
    • 1/4 cup dried fruit
    • 3/4 cup juice
  • Limit/avoid alcohol
    • Toxic effect on nerve tissue
  • Be aware of sodium; use <2,300 mg per day
  • Lower saturated fats and trans fatty acids by choosing lean meats and poultry, and low-fat or non-fat dairy products
  • Choose monounsaturated fats and polyunsaturated fats (from fish, nuts, and vegetable oils) in lieu of saturated and trans fats
  • Choose/prepare foods and beverages with little added sugars/caloric sweeteners

Anti-Inflammatory Eating

Low-level, chronic inflammation lies so far below the skin’s surface that you can’t see it or feel it. It’s the result of an immune system in overdrive, damaging healthy tissue and leading to chronic illnesses. Modifying your diet is one of the best things (if not the best) you can do to reduce your body’s inflammation, which can result in decreased neuropathic symptoms. If possible, always try to consume organic foods.

Follow these tips to help keep inflammation as low as possible:

  1. Eliminate Sources of Gluten

Gluten is a general name for proteins found in wheat, barley and rye, and is linked to inflammation. It can adversely impact the intestinal wall – particles can break through the wall and enter the bloodstream where they don’t belong, leading to an immune response (i.e., inflammation). Gluten has become quite a controversial topic in recent years, with many experts claiming that only those with celiac disease benefit from avoiding and eliminating gluten. However, there are many inflammatory conditions that can benefit from a gluten-free diet, especially those that are autoimmune in nature.

Here, we will try to break down some of the confusion regarding gluten, celiac disease and non-celiac gluten sensitivity and their relation to peripheral neuropathy:

Celiac disease: A disease in which the small intestine is hypersensitive to gluten, leading to difficulty in digesting food. Classic celiac disease presents with signs and symptoms of malabsorption such as diarrhea, weight loss and anemia. Individuals with celiac disease have reported neuropathic symptoms even before being diagnosed with celiac: https://www.foundationforpn.org/what-is-peripheral-neuropathy/causes/autoimmune-disease/celiac-disease/

Non-Celiac Gluten Sensitivity (NCGS): A non-specific immune response to gluten that has been clinically recognized as less severe than celiac disease. Symptoms include abdominal pain, fatigue, headaches, tingling/numbness and foggy brain, and typically appear hours or days after gluten has been ingested.

Peripheral neuropathy is common in non-celiac gluten sensitivity: research shows that up to 57% of people who have some form of neurological symptoms test positive for anti-gliadin (anti-gluten) antibodies, meaning that they’re likely sensitive to gluten even though they don’t have celiac. R

There is no nutrient found in gluten-containing foods that we can’t find elsewhere in our diet, and in many cases, eliminating gluten involves cutting out processed food like white bread, pizza, pastries, etc. (And, sorry, gluten-free processed foods are not a substitute for a gluten-free nutrient dense diet.) We recommend trying a whole food, gluten-free diet for at least two weeks to see how you feel, then adjust accordingly.

  1. Avoid Processed Foods

Per the above guidelines surrounding gluten, it is recommended that you avoid processed foods altogether to achieve optimal health. Even opting for gluten-free bagels and pastries is contraindicated as these foods are still highly-processed. So why avoid processed foods? Processed foods contain some combination of preservatives other than salt (e.g., nitrites), hydrogenated oils, modified starches, protein isolates, flavoring agents, artificial colors, emulsifiers, humectants, non-sugar sweeteners, and/or other cosmetic additives, etc. Examples of processed foods include (but are not limited to) breads, cereals, instant noodles and soups, frozen or shelf-stable ready meals, commercial desserts, salad dressings, soda and other sweetened beverages, reconstituted meat products, etc. Research has shown that these foods are linked to inflammation and heart disease. In a 2019 study in BMJ, researchers tracked more than 105,100 adults for a median follow-up period of five years. They found that there was a 12 percent increase in the risk of cardiovascular disease for every 10 percent increase in the amount of ultra-processed food consumed.

The best advice we can give you is that when shopping for groceries, only choose whole foods (fruits, vegetables, meats) from the perimeter and to avoid most processed food items in the aisles. Unprocessed frozen fruit, vegetables and animal proteins are perfectly fine.

  1. Ditch the Dairy

Dairy products, especially those made from cow’s milk, can be difficult to digest. About 65% of the human population is lactose intolerant; so it is highly likely that you may be lactose intolerant and not even aware of it. When you’re lactose intolerant, it means you don’t produce the lactase enzyme needed to digest the lactose in milk, which can lead to poor digestion and bloating, gas or cramps. Some people react to the proteins in milk like whey and casein; research has demonstrated that celiacs can exhibit an inflammatory response to casein much like they do to gluten.

Milk and other dairy products can aggravate skin conditions like eczema, atopic dermatitis and acne. It can also be a trigger for asthma and rhinitis in children.

Evidence indicates that milk can trigger an immune response and lead to autoimmune diseases. High amounts of dairy consumption have also been associated with greater levels of inflammatory biomarkers, higher fracture rates, and a higher risk of mortality. Just one cup of milk daily is linked to a 50% increased risk of developing breast cancer.

While we couldn’t find any studies directly linking neuropathic pain to dairy consumption, as stated above, dairy consumption has been linked to inflammation, and chronic inflammation is involved in the pathophysiology of peripheral neuropathy.

Our recommendation is if after getting rid of gluten and processed foods for a couple of weeks and you’re still not seeing improvement, try taking the dairy out of your diet as well for a couple more weeks and wait to see what happens.

  1. Avoid White, Refined Sugar

It’s no surprise to you that refined sugars are damaging to our health. Excess sugar and refined starches spike insulin levels, can increase our body’s production of inflammatory cytokines, not to mention that sugar is linked to obesity, diabetes, metabolic syndrome, tooth decay, and mood swings.

Thankfully, there are many natural sweeteners available like dates, raw honey, coconut sugar, coconut syrup, maple syrup, etc. And don’t forget about the natural sugars found in fruit, which can be the best dessert of all.

  1. Mind the Nightshade Family

The nightshade family includes tomatoes, eggplant, peppers, white potatoes, goji berries and tobacco. Nightshades can impact inflammation, particularly arthritis.

If you’re still experiencing neuropathic pain even after having eliminated gluten, processed foods, dairy and refined sugar, try cutting nightshades out for one month and see if it makes a difference.

  1. Questionable Foods

Everyone’s body is different and how everyone’s body reacts to certain foods is not a black and white answer. The aforementioned recommendations regarding food elimination are more or less universal for those dealing with chronic inflammation. However, when it comes to individual food sensitivities/intolerances, there is great variation, and your specific food intolerances may still be driving your chronic inflammation, even after you have eliminated all the foods above.

Let’s first start with explaining the difference between food allergies and sensitivities/intolerances:

Food Allergy vs. Intolerance

Food Allergy: A food allergy is an immune system reaction that occurs soon after eating a certain food. Even a tiny amount of the allergy-causing food can trigger signs and symptoms such as digestive problems, hives or swollen airways. In some people, a food allergy can cause severe symptoms or even a life-threatening reaction known as anaphylaxis. R

Food Intolerance: Food intolerance (also known as food sensitivity) isn’t like a traditional food allergy—instead, it’s a delayed, unpleasant reaction to food that doesn’t involve anaphylaxis. R

Food intolerances may cause digestive symptoms such as bloating, diarrhea and gas. Although we couldn’t find any studies that link food intolerances with neuropathic pain, research has shown that intolerances to certain foods do also manifest as neurological symptoms, such as migraine headaches. R

Even though food intolerances can cause problematic symptoms, they are generally not considered dangerous. Still, those who have food intolerances may need to avoid the foods that trigger their symptoms.

How to determine if you have an intolerance to a certain food:

  • Please refer to this comprehensive online handout from the University of Wisconsin on using food elimination strategies to determine food intolerances.
  • Alternatively, you may order an IgG food intolerance/sensitivity test which will test a sample of your blood against common food intolerances. These test kits are now available for at-home use, or you may ask your physician to refer you to a practitioner who can perform this type of testing.
  1. Load Up on Anti-Inflammatory Foods!

Food elimination doesn’t need to be all gloom and doom; there are plenty of delicious foods out there that not only don’t cause inflammation – they actually fight inflammation!

An anti-inflammatory diet should include these foods:

  • Avoid hydrogenated oils and opt for oils like olive and avocado instead. (note: do not cook/stir-fry with olive oil at high temperatures – it oxidizes the food – which creates more inflammation).
  • Increase your fiber and antioxidants:
    • with green leafy vegetables, such as spinach, kale, and collards
    • fruits such as strawberries, blueberries, cherries, and oranges*
  • Increase Omega-3 fatty acids:
    • from foods such as fatty fish like salmon, mackerel, tuna, and sardines
    • seeds (such as ground flax) and nuts like almonds and walnuts*

*If you test or discover that you have an allergy or intolerance to these foods, please avoid for the time being.

Hippocrates, the Greek founder of Western medicine (and whom the Hippocratic Oath that physicians take upon medical school graduation is based upon), once said “Let food be thy medicine and medicine be thy food.” He knew early on that food was the best medicine, and when it comes to dealing with the symptoms of peripheral neuropathy, his wisdom is no exception.

Source: Academy of Culinary Nutrition

Optimal Diet for Blood Sugar Control

Elevated blood sugar levels contribute to many chronic health conditions, including diabetic peripheral neuropathy. To help you maintain the best blood sugar level and manage your diabetes –

Know Your Carbohydrates!
Bread, cereal, pasta; starchy vegetables, like corn, peas, potatoes; dried beans, lentils, rice; fruits and fruit juices; milk, yogurt and other dairy foods; sweets, like cookies, candy, regular soda, sugar, syrup

Quality:
High fiber/whole grains, fruits, beans/lentils, low-fat dairy

Quantity:
Count your carbohydrates, label reading for serving size AND total carbohydrate
Plate method (1/2 plate veg, ¼ starch, ¼ lean protein)

Timing:
Spread out carbohydrate servings (3 small meals, 2-3 small snacks)

Managing Side Effects of Treatments or Medications

Often the medications and treatments that are used to fight chronic or life-threatening conditions, have a tendency for healthy cells to be affected, too, which may cause side effects. Some side effects may result to eating problems.

Nausea: 6-8 small meals, bland foods
Lack of appetite: Eat every few hours, fluids between meals
Unwanted weight loss: Add healthy fats (olive oil, nuts/seeds, avocado, olive)
Constipation: Increase fiber/fluids, regular meal times
Diarrhea: Limit milk products, small/bland/low-fat meals – easily digestible

Foods That Aggravate Peripheral Neuropathy

Contributing factors to PN include vitamin deficiencies, traumautic injuries, diabetes, alcoholism, and others. Treatment may include managing underlying causes, physical therapy, medications and dietary changes. For best results seek guidance from your doctor.

Gluten: If you have a gluten allergy, celiac disease, consuming gluten can trigger and worsen your symptoms. Common sources include all food containing white, wheat, cake or baking flour. Look for products labeled ‘gluten free’.

Refined grains are highly glycemic meaning they have a dramatic impact on your blood sugar. Being able to control your blood sugar is the number one strategy to prevent neuropathy associated with diabetes. To improve the glyceminc impact of your diet, replace refined grains with whole grains.

Added sugars add flavor but few nutrients. Nutritional deficiencies can lead to neuropathy symptoms. Choose nutritious foods like fruits, vegetables and whole grains.

Saturated fat, prevalent in fatty meats and dairy products, can cause inflammation and an increased risk for type 2 diabetes. For enhanced wellness, replace fatty protein sources with lean alternatives and eat moderate amounts of healthy fat sources.

Source: LiveStrong.com

Healthy Eating and Shopping

To help you keep track of your food and water intake, plus your activity levels, we have created a food and activity log for you. Download a printable copy of a weekly food diary.

A shopping guide may help you plan your meals and make good selections at the grocery store. Plan ahead and buy only what’s on your list to avoid impulse buying. Download a printable copy of a shopping list.

Supplements

The first group of vitamins that may help people with peripheral neuropathy are the B group of vitamins. One common cause of PN is deficiency of B vitamins, particularly B-12. And, if a B-12 deficiency isn’t treated in a timely manner, the nerve damage can be permanent. The best food sources of vitamin B-12 are meats, fish, eggs, low-fat dairy foods and fortified cereals. If you’re a strict vegetarian, fortified cereals are a good source of vitamin B-12 for you, but you may also want to talk to your doctor about B-12 supplements.

Another vitamin that may be helpful for PN is vitamin E though a deficiency is uncommon except in cases of intestinal malabsorption or malnutrition.

Click here for a list of other natural supplements that can be beneficial.

Source: Neurology.com

Please also have a look at this blog post about Healthy Eating for Peripheral Neuropathy by Shanna Patterson, M.D.