[music playing] Lacey: The saying goes, you are what you eat, and as it turns out, inflammation can come right from your food choices.

Horizon Health nurse practitioner Kacy Jo Rogers points out sources of inflammation that may have crept into your diet and how to relieve this pain.

Lori: They're the ones who raise the bar, the ones dedicated to providing care in the most demanding of circumstances, the ones that understand the healing benefits of kindness and compassion.

They're the people of Sarah Bush Lincoln, and they set the bar high.

Sarah Bush Lincoln, trusted compassionate care right here, close to home.

Speaker 2: For over 50 years, Horizon Health has been keeping you and your family healthy, and although some things have changed, Horizon Health's commitment to meet the ever-changing needs of our community has remained the same.

Horizon Health, 50 years strong.

Speaker 3: Carle is redefining healthcare around you, innovating new solutions and offering all levels of care when and where you need it.

Investing in technology and research to optimize health care, Carle, with Health Alliance, is always at the forefront to help you thrive.

[music playing] Lacey: Thank you for joining us for this episode of Being Well.

I'm your host, Lacey Spence, and today we've got a new guest to the show coming to use from Horizon Health.

We have Nurse Practitioner Kacy Jo Rogers.

Welcome to the show.

It's good to have you.

Kacy Jo: Thank you.

Thank you, it's good to be here.

Lacey: We like to get to know our new guests who haven't been on before, so can you please give us a little bit of background about you and how you ended up with Horizon?

Kacy Jo: Yeah.

I started as a registered nurse back in 2008, and I worked at a surgical center in Terre Haute and then went on to get my advanced practice degree, graduated in 2018, worked with Dr. Pendergast at the surgery center as an RN, and then kind of jumped into the pain clinic into a new role as a, kind of trying to incorporate nutrition into their pain management treatment plans.

And so I went on to get a certification in certified nutritional pain management, is what it's called.

I did that in November of 2019, shortly after I started in the clinic.

And then it's kind of just expanded from there, but we really saw early on a need for additional options for these patients that deal with chronic pain every day, and we found that our lifestyle and nutrition, it plays a big role in how they feel every day and their pain.

So that's kind of where it started, and it's just really kind of blossomed from there.

We joined Horizon in December of 2021, so we've been just a few short months with them, but it's been great so far and we are really excited to see where it takes us.

Lacey: Yeah.

And before we jump into our topic today, which is food and inflammation, just generally, if folks are trying to find you, you are not located in Illinois, are you?

Kacy Jo: We are not, no.

We are actually in Terre Haute.

We have a clinic in Terre Haute.

Lacey: Gotcha.

So if you're looking to connect, make sure you get those time zones straight.

Kacy Jo: Yes, it is Eastern time, so yes.

Lacey: Wonderful.

So today, we're talking about food and inflammation.

So if you could start by explaining your specialty a little bit when it comes to pain management.

Kacy Jo: Yeah.

I do a little bit of, I guess I could say everything, but my primary focuses are bone health and osteoporosis, and then nutrition.

So, nutrition can be such a broad word that we use and it can involve diet and lifestyle changes, but it can involve weight loss.

It can involve smoking cessation.

It can involve sleeping optimization and all of that.

So it's a pretty broad term when we use it, but it's just about meeting the patient's needs, seeing what they need.

And my colleagues are amazing at figuring out this specific patient may need smoking cessation or maybe they need to just clean up their diet a little bit, or maybe they just need motivation to move more or weight loss and all of that.

So like I said, it's a pretty broad term, but we can utilize it in many different ways.

Lacey: So there's pain management and then nutritional pain management.

Kacy Jo: Yes.

Lacey: Which I believe is probably what we're going to dive into a little bit more today.

So what causes this pain or this inflammation?

Kacy Jo: Inflammation in itself can cause pain.

I mean, as we know it, I usually use the analogy of if you twist your ankle, it swells up and it hurts and your body, that's your immune system's kind of reaction to create that inflammation for protection, but it does cause pain.

And so when we have chronic pain on a daily basis, whether it's from an extensive back surgery we had years ago, a traumatic injury, inflammatory diseases like fibromyalgia or all the arthritic conditions, those are all inflammatory conditions and so we try to utilize food to decrease as much, if we want to say natural inflammation in our body to decrease the pain and not have to rely so much on medications that can only do so much because there's a lot of people that can't take certain medications for certain reasons.

And so if we can try and make their pain better by improving their lifestyle and their diet, then that's really going to overall improve their health.

Lacey: What is the relationship between nutrition and then this chronic pain?

Kacy Jo: So, there's a lot of foods that we can eat that make our pain worse by creating inflammation.

There's a lot of foods that we can eat that can decrease it, too.

So if we think about how our gut works, our modern American diet, and I call it the MAD diet, so it's- Lacey: That sounds great.

Kacy Jo: Yeah.

Lacey: Way to go, America.

Kacy Jo: Yes.

Or SAD, you can say the standard American diet.

The MAD or the SAD diet, it disrupts our homeostasis in our gut and the equilibrium.

So we're supposed to have a lot of healthy bacteria in our gut, but when we eat junky foods, like we're accustomed to in our standard diet as Americans, that can disrupt that normal bacteria, create inflammation, cause more widespread pain and contribute to one's chronic pain.

So it's kind of trying to determine, we can be intolerant to certain foods or sensitive to certain foods and not necessarily have an allergy to foods.

We know there's some people that are gluten free and they can't eat gluten because they have essentially an allergy to it, but we can be sensitive to foods and not even know it, but by eliminating those foods, we realize how much better we feel.

And so it's kind of just trying to sit down and figure out what are you eating on a daily basis and trying to go through that and eliminate or try to remove certain things from our diet, like a lot of processed foods that are high in sugar, high in saturated fats, high in just those yucky chemicals can really cause us to feel yucky.

We don't realize it until we eliminate those how much better we do feel.

It's really kind of cool to see when patients do comply really strictly or really well for them to come back and see just how much better they feel overall.

It's not going to take all of their pain away, but it can just optimize their plan that they have in place and help to, if we can eliminate certain medications or they're moving more or they're being more functional, and that's what it's really about.

Lacey: Now, there's me who hears talking about allergies, and I always think of going through the whole panel of testing for things that you're allergic to.

Is there a similar process for this, or is it really just removing one element at a time from your diet?

Kacy Jo: Really, those allergy tests, you can get those done, but they can tend to be very expensive and hard to find a place that would do it, so I oftentimes just use certain elimination diets sometimes, and we start with the specific food group, that's usually one of the more problematic ones or troublesome ones, and those tend to be our dairy and our gluten, our grains, and all of that.

So usually I start with dairy, have them eliminate dairy at least for seven days to see how they feel and then sometimes with that, if they feel a hundred percent better or whatever, I wouldn't say a hundred percent, but significantly better, then we can try to introduce dairy foods back in one by one to see if we can find the one that is the more problematic one, or it's just sometimes they have to eliminate the whole category itself.

I usually just use an elimination diet and more like a, I guess you can say a trial and error, but oftentimes we find it pretty early in those first three groups.

Lacey: Well, do you mind going through that just a little bit more?

Because I think it would be interesting for folks at home.

Not that this isn't something you definitely should go see a doctor for to go through this process, but just if they're able to maybe try a little bit at home just to see if they can get just some relief.

Kacy Jo: Sure.

Lacey: So you said dairy, some sugary things.

Kacy Jo: Dairy, sugar, gluten, meats sometimes.

Those are the three.

And eggs.

I kind of incorporate eggs into the dairy category, and then that's usually one of the ones we introduce back first because it's not necessarily a dairy, but it's similar to that food group.

I usually have them write down what they eat every, single day, like breakfast, lunch dinner, and then how they feel.

Say the first week we're eliminating dairy, so no dairy for breakfast, lunch, or dinner, and then you kind of see how they feel.

If they're like, "Wow, I noticed that, I never really noticed that I had a lot of bloating," or something like that.

That in itself can, like I said earlier, if we're disrupting that equilibrium in our gut, that can create a whole systematic effect.

And so by eliminating something like dairy and seeing that they're not having the bloating or they're not feeling as tired, that can be another symptom of an irritable food or a food sensitivity to us.

So just writing down, I give them usually a food diary or they can do a journal, whatever they prefer to do, and just writing down maybe, say they had oatmeal for breakfast.

"How did you feel?"

"Well, I had a headache."

We focus on where their pain is, also.

So if they have chronic back pain, "How did your back feel?

Did your back feel the same or better, or even worse?"

And so just by doing that, and then I think that helps them see it day to day, too, and then by that, they can figure out, "Well, on Monday and Wednesday I had oatmeal and an apple for breakfast, but on Tuesday I had eggs and toast with butter.

But Monday and Wednesday, I felt fine in the morning after I ate, or midway through the day, but Tuesday I did kind of feel like I was bloated," or I keep using that as an example, but or, "Maybe I had a headache or I felt fatigued."

Lacey: Something we might attribute to literally anything else.

Kacy Jo: Absolutely.

Yeah.

And that's one of the things.

They don't realize how bad they were feeling before until they just cut out certain foods sometimes.

Lacey: Well, as we're talking about this, I don't know if it's too technical to go into or if there is a blanket answer, but these certain foods, why is it causing this reaction in your body?

Is it just the bacteria?

Is there something that, for each different one between dairy and between gluten?

What's happening?

Kacy Jo: Well, if it's truly a sensitivity or even an allergy, our immune system kind of reacts to it.

And I always explain it, the best thing that our immune system does is create inflammation.

And so if we're eating foods that we're intolerant to or sensitive to, our immune system's going to react.

And so it's going to create the inflammation.

But also, if we're eating yucky foods that are disrupting that normal flora and the equilibrium in our gut, that is there for a reason, and it's kind of like a protection and a barrier for us.

And if we're disrupting that and removing that, that can start to create gut inflammation and other problems that just can kind of be a snowball effect.

Lacey: Now, is this, talking about like the gut microbiome things, is this newer or is it more like a health fad?

I feel like in the last couple of years, I've been hearing more about it, and so I didn't know if we were just learning about how food can really disrupt all the little critters that we're carrying with us or what.

Kacy Jo: It's always been there, we'll be honest, but I think there's just more focus on it now.

There's more research that, I keep seeing new studies out every week almost as far as they're trying this.

I just read one last week on how our diet can really affect our mental health and I'm like, as nalïve as I can be, I never would have thought that it could, but it makes sense.

If we're eating these foods that yeah, they can cause us physical pain, they can also cause us psychological pain.

It's really neat to see all these different studies just start to evolve, but I think there's just more attention on it now and so there's more awareness.

Lacey: Which, as much as it's connecting to different things, it sounds like, thank goodness we're finally really looking into it.

Kacy Jo: Yes.

Yes.

Lacey: And giving it that attention.

So, we've talked a lot about foods that are bad and we've talked a lot about foods that we can remove.

Are there any foods that are particularly good?

Kacy Jo: Absolutely.

Lacey: Let's run through some of those, please.

Kacy Jo: Fruits, vegetables, healthy fats.

Healthy fats, what is a healthy fat?

Olive oil, that's really big.

I usually try to guide people to follow more of a Mediterranean lifestyle or diet, and that is a lot of healthy fats.

So fish, fish oil, like I said, olive oil, virgin olive oil, fruits, and vegetables, and making sure that you're getting a vegetable serving with every meal.

And even breakfast, people are like, "How can I eat vegetables for breakfast?"

You can put it in your eggs or you can chop them up and saute them or however you want.

Lacey: Some peppers or some spinach in your smoothie.

Kacy Jo: Yes, yes.

Lacey: There's ways, we're just a little bit in denial.

Kacy Jo: Yes.

Lacey: They might not be as, I say tasty, as the sugar and stuff, but it's tricking our brain to thinking it's good and it's really, really kind of hurting us.

Kacy Jo: I know, I know.

And there's a lot of ways you can get sweetness from good things, too, like Stevia, Stevia plant, monk fruit.

Even just a small amount of natural sugar or real sugar is fine, as long as we're not going over, I usually recommend a six teaspoon a day limit.

Lacey: I find it really interesting that you bring up only six teaspoons of sugar a day.

Looking at all of the packaging for, I mean, trying to find, where's the gluten, where's the best, cleanest ingredients that we can have.

So do you have any advice for folks who are maybe trying to scope out their nutrition labels?

I mean, sometimes the packaging can be a little misleading.

Kacy Jo: Absolutely, and I think so much we've been focused on calorie, calorie, calories, but it's not so much about the caloric intake as it is about what type of calories we're bringing in.

We can eat a lot of what I call discretionary calories, so junk calories, and we're going to feel yucky, but so not to focus on calories, but focus on the added fruits or sugars and focus on the saturated fats.

Those are really the only two things that I encourage my patients to look at when they're looking at the labels.

Anything that has a label on it should not have more than six grams of sugar in it per serving.

Anything less, that's great, but if you're getting something and you look at that label and it's got 12 grams of sugar in it, no, put it back.

There's a better option.

And not necessarily sugar-free things either, because those can contribute to messing up that equilibrium in our gut and those chemicals, all those ones that we can't pronounce.

Those weird-looking names.

If it's on there, it's not good.

Lacey: So our body gets confused kind of on what to do with those?

Kacy Jo: It does, and it can mess up your metabolism.

Our brain doesn't recognize artificial sweeteners, so those things that we find in Diet Coke or Diet Pepsi, our brain doesn't recognize them.

So the only thing our brain knows what to tell our body to do is metabolize them to fat.

Lacey: And it's not a healthy fat.

Kacy Jo: Yeah.

You're better off, as crazy as it sounds, to drink regular soda, but I always encourage patients not to, but just trying to find... we've been tricked for so long that sugar-free things are good for you or they're better for you, or low fat things are better for you, but oftentimes, we find that they remove those, but they have to put something in to replace that, and oftentimes what they put in is worse.

Lacey: There's usually a consequence.

Kind of a too good to be true sort of thing.

Kacy Jo: Yes.

Lacey: Well, we've been talking a lot about food to manage the pain and inflammation.

If removing things from your diet, adding in healthy things isn't quite enough, what other ways can we remove inflammation?

Kacy Jo: Activity.

Lacey: Okay.

Kacy Jo: Even just going for a 10-minute walk after a dinner or after a lunch.

You don't have to go outside or you don't have to go to the gym for hours on end, but if you can just go for a 10-minute walk after your dinner, that can help improve or increase your metabolism, but also kind of help your body kind of absorb and digest everything properly.

But sleep optimization, too.

There are studies out there that show that if we can get at least seven to eight hours of sleep a night, that can improve our just overall how we feel, but also how our body's health and our weight and everything like that.

We're not going to lose weight or we're not going to metabolize things appropriately if we're running on very minimum sleep.

So sleep, like I said, physical activity, smoking cessation, eliminating things that are bad habits.

Bad habits can be more than just our food habits.

Lacey: Well, there's a lot of similarities that I'm hearing from a lot of our health experts who are coming on this season, definitely talking about doing things in moderation.

How important is it to not just try and go full force into, "I'm going to drop all dairy just this week and bam, here we go.

I'm going to run six miles," or whatever.

That seems to backfire a lot.

Kacy Jo: Absolutely, and it oftentimes has negative effects.

Yes, you're right.

So moderation.

I always tell, whenever there's a lot of things that need to be changed with patients, I always say, "We're going to start with one thing for month one, and we're going to focus on that.

We're going to get good at that and then we're going to move forward month two, find something else."

So usually month one, and people are different so they can choose to do different things, but month one example, we're going to eliminate a lot of discretionary calories.

We're going to try to eliminate all those added sugar products from our diet, get really good at that.

Then, month two, we're going to start to do healthy replacements, try and replace our starches for more green and colorful vegetables.

And it's all about getting accustomed to it and creating it a lifestyle.

And then maybe you need to start with the physical activity after you get good with the diet.

Definitely in moderation.

Lacey: That's a key to success.

Kacy Jo: Yes.

Lacey: So if you could, could you take a few moments to tell us about maybe a few success stories that you've had with- Kacy Jo: Sure.

Lacey: how big of a deal that the food-related inflammation can be?

Kacy Jo: One of the biggest things that we see in chronic pain is fibromyalgia, and those patients unfortunately have suffered for years, most of the time, with just this widespread diffused pain that just has been unexplainable for so long.

And for so long, we kind of just reverted to medications to try to treat the symptoms, and they work very well most of the time, but I've worked with those patients probably the most with their diet and everything, and I have seen some of them be on four or five different medications at high doses just for their fibromyalgia symptoms, really focused on their diet, really focused on their physical activity.

I had a patient that was on four different medications and I worked with them for probably a little over a year and came back to me, was not taking any medications anymore, was getting up every single day, going out for a walk, went out and got a job.

Did not have a job for years before that, was holding- Lacey: Because they're in so much pain.

Kacy Jo: Yes.

And they realized that they were in control, and helping them see that they can be in control is a huge thing for them.

They can control what they're eating and they can control how they feel once they figure that out, and so it was neat to see that not only did we see an improvement in the functionality and decrease in pain, but they now had a job, they now had a full-time job.

And that to their mental health was huge, too.

They were contributing to their family again, you know?

And so that was pretty awesome to see, too.

Lacey: That is a wonderful turnaround.

And again, it's just crazy to think that our food can be harming us so much.

We don't even realize it.

Kacy Jo: I know.

Lacey: What do you think is the biggest culprit that people you've maybe talked with struggle with?

Maybe not just with inflammation, but just to kick.

Is it things with sugar or... Kacy Jo: A lot of times it is sugar.

It's so addicting to us and it's wherever we want it to be.

Everywhere we go, there's sugar in drinks, in foods, pastries and bakeries and all of that.

And not that we never can eat sugar again.

I always tell people that we aren't going to eliminate anything forever, but those are things that we have to have in moderation.

If there's a special occasion, absolutely you can have a cupcake, but just knowing that it's a lifestyle that we're creating and it's not an everyday food.

But sugar is the main one, but processed foods, too.

And processed foods are right at our fingertips, too.

Lacey: So easy.

Kacy Jo: Yeah.

Lacey: So as we're in our last couple of minutes here, if I'm somebody who's heading to the store, do you have any recommendations of where to shop, what to look for to kind of help me on this health journey and inflammation lowered journey?

Kacy Jo: Yeah.

Stay on the outside of the store.

I mean, that's so cliché.

We hear that so often, but it is true because that's where we're going to find all of our fresh produce, our lean meats and less processed packaged foods.

If we think about all the things that are in the aisles, those are all packaged foods.

But if we are going into the aisles, even though there's things that we need that are essential there, too, looking for products that have a green leaf, usually.

That's what's classified as having Stevia in it for a sweetener as opposed to high sugar or the artificial sweeteners.

So that's one thing.

Lacey: So Stevia's a good one?

Kacy Jo: Stevia's a good one.

Yep.

Lacey: Okay.

Kacy Jo: And it usually has a package with a green leaf on it or it's a green package or a brown package.

Lacey: Airs that it's a little more natural.

Kacy Jo: Yes.

Lacey: Hopefully.

Kacy Jo: Yes.

Yep.

Lacey: But always check those labels just to be sure.

Kacy Jo: Yeah.

We don't have to be organic by any means.

That's kind of a fad that went.

I mean, there are certain things that are good organic.

Lacey: There's pros and cons everywhere.

Yep.

Well, Kacy Jo Rogers, thank you so much for coming on our show today.

We sure appreciate it.

Kacy Jo: Thank you for having me.

Thank you.

Lacey: The pleasure is ours.

We hope to see you, our viewers, next time for our next episode of Being Well.

Speaker 3: Carle is redefining healthcare around you, innovating new solutions and offering all levels of care when and where you need it.

Investing in technology and research to optimize health care, Carle, with Health Alliance, is always at the forefront to help you thrive.

Speaker 2: For over 50 years, Horizon Health has been keeping you and your family healthy, and although some things have changed, Horizon Health's commitment to meet the ever-changing needs of our community has remained the same.

Horizon Health, 50 years strong.

Lori: They're the ones who raise the bar, the ones dedicated to providing care in the most demanding of circumstances, the ones that understand the healing benefits of kindness and compassion.

They're the people of Sarah Bush Lincoln, and they set the bar high.

Sarah Bush Lincoln, trusted compassionate care right here, close to home.

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