Hi, my name is Carolyn Berry and I'm a registered dietitian here in Vancouver BC. I am passionate about being a dietitian because I feel there is so much information going around about nutrition. There's lots of myths and I really like to debunk those myths. I think that's really important.
I do work in a hospital. I work in a private clinic and I also have my own private practice called Berry Nourished. My website is berrynourish.com. I feature lots of different recipes on my website, so really easy to make, simple ingredients. I'm also very active. I run marathons and I like to help people basically learn how to eat and be fit at the same time. When it comes to eating organic foods we really need to weigh out the costs versus the health benefit of the organic food.
We do know that organic foods have a lower amount of pesticides than non organic foods. However, they are quite expensive. A rule that I like to go by is the dirty dozen versus the clean 15. That's something that you can look up to see the entire list but just to give you an example, the dirty dozen would include apples, nectarines, grapes, spinach. Those are things if you are going to buy organic, I would spend your money on the more pesticide dirty dozen. The clean 15 would include things like onions, cabbage, cantaloupe. If you think about cantaloupe, it has a really thick skin so you're not eating the skin, right, so that's a bit of a cleaner fruit in terms of pesticides.
Inflammation is at the root of a lot of illnesses and there's things that we can do in our diets to help. One of the things would be increasing Omega 3 fats. Omega 3 fats are found in cold water fatty fish, so examples would be salmon, trout, herring, mackerel, sardines. Plant sources of Omega 3 would be ground flax seeds, chia seeds, walnuts, canola oil. We really want to increase our intake of these Omega 3 fats. They are anti-inflammatory. On the other hand, we have Omega 6 fats and Omega 6 fats are found in a lot of those really light tasting oils that are used in a lot of processed foods. For example, sunflower oil, safflower oil, soy bean oil. Companies are using those oils because they're cheap to produce. They're putting them in cookies, crackers, baked goods. A lot of those processed foods that we're eating so as a result, in our North American diets, we get a lot of Omega 6 fats. We actually want to be achieving a ratio of Omega 6 to Omega 3 of 4 to 1. 4 Omega 6 to one Omega 3. Unfortunately in North America our ratio is more like 15 to 1 so we have a lot of Omega 6 in our diets. We want to work on cutting down the Omega 6 and replacing those with more Omega 3 fats.
As someone who's complete 4 marathons I do think that eating an anti-inflammatory diet is really really important, because we put so much strain on our joints and anti-inflammatory foods can really help with that. One of the things would be eating lots of fruits and veggies. I know that this is something that we're always preaching about but it's so so important. Fruits and vegetables have a high amount of antioxidants which can help combat inflammation. Another big one would be minimizing those refined carbohydrates, so the white pastas, the white rice. We want to try and switch those to the whole grain version. Whole wheat pasta, whole grain rice, quinoa, etc.
Another big one would be saturated fats and trans fats. Saturated fats and trans fats start the promotion of the inflammatory process in the body. It's okay to have some saturated fats but we want to do is try and eat more of the healthy unsaturated fats. When it comes to choosing meats, minimize your red meat intake a little bit. Choose more poultry, skinless poultry, fish, high in Omega 3s. Those are better choices. Also the pulses, so the dried beans, peas and lentils. Choose more of those vegetarian proteins as well, incorporate that into your diet. Another big one is stay away from those sugar sweetened beverages. It's okay to have them once in a while but they spike your blood sugars and that causes inflammation. Bottom line, try and eat fresh foods and minimize any processed foods, always go for the fresh whole food.
When it comes to supplementation, as a dietitian, I'm all about foods before supplements. That being said, there are some nutrients that we don't always get enough of in our diets. One big one would be vitamin D. We do get vitamin D from the sun. We also get it from milk products, from fish, from eggs, but we tend to not get quite as much as we need. Vitamin D is anti-inflammatory. I recommend taking an additional supplement. That would be about a 1,000 IU per day. Then Omega 3s would be another supplement that you might want to consider taking. If you're not getting those 2 servings of fatty fish a week, so your salmon, your trout, your sardines, if you're not getting 2 servings a week, I would suggest an additional Omega 3 supplement, about 500 mg of Omega 3 per day.
The passion that I have for sports medicine has been there for a long time. As a young child, grade one, I had polio and I went through extensive rehabilitation. Then just as I was getting over that into junior high school, I got hit by a car and had a fractured dislocation of an ankle and I was in a cast for 32 weeks and went through a lot of rehabilitation. My friends were athletes. My friends were successful. I equated being an athlete and being successful as one and I was neither, so that I had a passion to get better, to thank the people that helped me and to be able to get into a running program, getting into a cycling program, a program that would allow me to catch up to my friends and get better than them.
My big passion was to make a major games which most people would laugh about. The question is in terms of the work with sports medicine and how much work does an athlete require. Sports medicine is now been recognized as a true specialty in sports medicine that's just been ... They've gone through a whole process. They've just now started to announce the ones in Canada that have now got this specialty and I was very, very lucky to get one of the early ones a month ago. What sports medicine is it's basically taking that science of human movement that you understand from kinesiology and then applying that to a diseased state. That diseased state may be arthritis, it may be an ankle sprain. It may be a spinal cord injury.
We need to be able to diagnose that. Most important, we have to know what we're dealing with, to diagnose it and utilize the most up to date, current, and we want to be up to date and current, that's why we do research, to be up to date and current and to give that athlete, young or old. It's got nothing to do with age, and it's got nothing to do with ability. Young or old to get them the best chance to recover and get back to doing the activity that they want to do. When you run 62 marathons, you get injured. Yes, you do. Particularly you have to look at somebody as old as myself. I mean I co-founded the Vancouver Marathon and started the first running club in Canada.
It was only 6 of us and we put on the first Vancouver Marathon and there was 32 of us, but all those 32 were hard core runners. Nowadays we have many, many more, obviously tens of hundreds more but are they any better than the group that I first started with? No, but the important thing is for the people that are now, they now are doing it much safer. They don't go through the same number of injuries that we went through because it was trial and error. We didn't know what a stress fracture. As soon as we know that somebody's got pain in their foot or pain in their hip and it hurts to hop on, you got a stress fracture until proven otherwise. Because if you continue to push, let's say you've got groin pain and you're continuing to push in your marathon training and it hurts to hop but the next day you get out and do it again.
That hip can break right through. You can lose the blood supply to it. You could end up having to have an artificial hip at the age of 20 which you would rather not have since the artificial hips only last 15 to 20 years. Prevention is everything that we're trying to do now is by looking at the strength, looking at flexibility and balance because all of those factors are so critical, particularly as you start to fatigue in whatever sport you're doing. We want to be able to prevent those injuries because some of those injuries can be very significant. Inflammation early on is important because it attracts the white cells which help the healing process. The problem becomes when you continue to aggravate it. You get more and more inflammation.
Now it's not just localized attracting these white cells to come and heal that small muscle injury, but it becomes a massive inflammation which can create ... People can get autoimmune conditions where you can get inflammation in other joints not related at all to the calf strain that you had. It prevents at a certain level the actual healing process to occur. You need some inflammation to attract cells, but then the cells have to be able to do their job, turn on the fibroblast, lay down the type one collagen and heal that tear. If it's all inflammatory cells, that's where the process stops and the healing stops. There are certain conditions. Tennis players get chronic tennis elbow because ll that inflammation there, it stimulates the laying down of what's called type 3 collagen.
It's weak, it's haphazard. It continues to re-tear. If you get rid of the inflammation, you stimulate that fibroblast to lay down type one collagen. You get strong collagen. It heals and we follow you up one, two, three years that 80 or 90% of those people are healed. We wanted to see whether we could enhance athletes, not aerobic capacity, could you run faster, run further but could we enhance your anaerobic power. These are power sports, so we selected 10 football players. Then we put them on 3 weeks of either the supplement or SierraSil. Then they were off 3 weeks to clear it out and then they got the opposite. We wanted to see because when you do an anaerobic work, you create anaerobic products which impair your performance.
Lactic acid, people would understand. What the actual mechanism of action of of SierraSil is, is it clears and removes information. It removes the lactic acid and then allows you to train that much harder. We train these athletes. These are top, top athletes. We wanted to see if sure could we do it with individuals that were neophytes but we wanted to take top athletes. We wanted to train them incredibly hard and to create one of the most painful exercise test called the Wingate test and to really stress them and could we improve their anaerobic power. Yes, we could. We improve their power 3% and people say, "Well 3%. That's not very much." Well, you take a look at our power sport, let's say it's a cyclist. In that sprint 3%, 3 seconds.
You look at Dawn is our coach for our national kayak and canoe team. He coaches world champion and he's got all these athletes. Boy, if they could get 3% on him, that would be a huge, huge difference.
My career has been most at UBC. I've trained at UBC in medicine and internal medicine, rheumatology, and then I became faculty whereupon I became head of rheumatology at UBC and also St. Paul's and VGH. My career is mainly seeing patients, but also teaching and doing research at the Arthritis Research Canada, which is our largest freestanding arthritis center in Canada.
We have an aging population, and that impacts one type of arthritis. The most common type is osteoarthritis, which gets worse as we get older, and it affects many of us. The other types, however, like lupus and rheumatoid don't change with age and actually affect younger people, so younger women and men. With one type of arthritis, osteoarthritis, it is going to be a tsunami with the aging population. If we want to keep active and mobile into our 80's and 90's and even 100's, then there need to be some changes in our lifestyle.
Sometimes, when a patient sees me for arthritis, they will preface it by saying they aren't really keen on taking a medication. After assessing them, I may say, "You know, your type of arthritis is best managed by lifestyle measures," and then I go through the exercise and the weight loss and the lifestyle changes they need to make, and, at the end, some of them will say, "Isn't there just a pill I can take?" While that's an amusing anecdote, it does hold true for a number of patients that I see. Lifestyle measures are particularly difficult to change.
With regards to weight, a 10-pound weight loss for overweight people can translate into a 25% reduction in the need for a total knee replacement. That's huge both for the patient, but also for our system. If we could reduce the number of knee replacements, we can save a lot of money.
Sometimes, we talk about a cure for arthritis, but I think the important thing is there are many types of arthritis, some in fact we can cure. One of the common types of arthritis in men is gout, which is totally preventable now, so there's one down.
If we look at rheumatoid arthritis, we have amazing new treatments over the past 15 years that basically can put it into remission and using old treatments early can actually put it into remission, older, less expensive treatments, so not two down yet, but getting there. If we look at osteoarthritis, however, we are not that close to preventing it yet.
Osteoarthritis is the most common type of arthritis that we often get. Many of us will get it, and it happens more as we get older. Younger people get it if they've had a traumatic injury to a knee, for example, or a back. However, one of the big factors for osteoarthritis is obesity and muscle deconditioning.
In treating osteoarthritis, we don't have a pill that's going to slow it down. The pain medications for osteoarthritis leave a lot to be desired. The best way to manage it is by lifestyle measures. This is particularly hard, but, on the plus side, these lifestyles measures of exercise, achieving appropriate weight, help other conditions as well like diabetes, cardiovascular risks, cancer even. I think that, in the hopes of improving their joint symptoms through lifestyle measure, we are going to achieve a lot of other benefits.
Other tips in preventing joint diseases, I think one of the biggest factors in rheumatoid arthritis, which, remember, these are all different types of arthritis, but rheumatoid arthritis, if you can quit smoking, it reduces the risk of even developing rheumatoid arthritis significantly.
Here's another one for rheumatoid arthritis that most people don't know about, but gingivitis or inflammation of the gums is associated with more with the onset and severity of rheumatoid arthritis. Flossing your teeth and having good dental care, also, smoking makes gingivitis worse, too, but good dental care reduces the risk of rheumatoid arthritis.
Going to gout, which is another type of arthritis, completely separate from these other two I've mentioned, high fructose corn syrup makes it worse or increases gout, so sugary sodas and even fruit juices with high ... supplemented with high fructose corn syrup are not good for gout. Preventing gout is, again, no fast foods, reducing sugary drinks. Cherries, for example, are good for gout, so these little tips as you said that can help different types of arthritis.
In the Arthritis Research Canada, we have a number of outstanding research projects looking at ways for people to cope better with their arthritis, reduce symptoms and even prevent arthritis, also looking at ways of getting the inflammation out. We call that knowledge transfer, because there's lots of great research, but how do we get that knowledge to people? If people are interested, they can go to the website, www.arthritisresearch.ca and look for information or ways to help.
One other tip I forgot to mention was a BC government website called HealthLink BC. Now, if people are interested in looking at lifestyle measures, up on the left, there's weight loss, diet and exercise, and there's ... They have them for different age groups and different conditions, so I urge people to go there. It's free. It's our provincial program, and it's very useful.