How Can Nutrition Help My Physical Therapy? Chatting with Nutritionist Christina Ellenberg.

December 30, 2020

Many physical therapy clients ask their PT about certain diet types or nutritional supplements. Although physical therapists receive some background education about nutrition during their course of study, it is outside of our scope of practice to recommend specific dietary changes or meal plans. As a profession we do strive to be aware of different types of diets, as well as the molecular biology of how food breaks down in our body, which affects our ability to perform physical activity. We are also aware of how nutrition can affect tissue healing which is why we address the topic as an overview for our clients to understand its importance in their recovery. 

Below I interview Christina Ellenberg, a Registered Dietitian Nutritionist (RDN) and Strength and Conditioning Specialist (CSCS) who practices in metro Atlanta. As owner of Dietitian Dish, she helps individuals with many different conditions, especially chronic disease management, including hypertension, diabetes, heart disease, digestive health/irritable bowel syndrome, GERD, weight management loss/gain, sports specific nutrition plans, wellness plans, meal planning, healthy recipes, grocery store tours, and food allergies/intolerances.

KS: What foods do you recommend to reduce systemic inflammation, especially for those patients with arthritis?

CE: Unfortunately there isn’t a “diet cure” for arthritis, but there are foods shown to reduce inflammation in the body. Fatty fish such as salmon and tuna, olive oil, and walnuts are all packed with omega 3 fatty acids which have been shown to reduce chronic inflammation. Cherries, pomegranates, and berries are full of quercetin which is an antioxidant with anti-inflammatory effects which might help reduce inflammation. Foods from the allium family such as garlic, onions, and leeks contain a compound diallyl disulfide which has pharmacological qualities including antioxidant and anti-inflammatory. And of course, turmeric. Turmeric contains a compound called curcumin, and studies have shown curcumin to be beneficial in fighting inflammation in participants with arthritis. These are just a few common foods that have anti-inflammatory properties.

KS: Give us your top three pieces of nutritional advice that you recommend.

CE:

1. Hydrate!
I can’t emphasize this one enough. Drinking enough water each day is crucial. Staying hydrated helps regulate body temperature, keeps joints lubricated, prevents infections, delivers nutrients to cells, and keeps organs functioning properly. Being well-hydrated also improves sleep quality, cognition, mood, and can even assist in reducing inflammation!

2. Eat Vegetables and Fruit!
Everyone knows to eat veggies and fruits, but in practice we just don’t eat them as often as we should. Fruits and vegetables are packed with essential vitamins, minerals, fiber, and disease-fighting phytochemicals. There is so much more to this, but the bottom line is that increasing your vegetable and fruit intake directly correlates to reducing your risk of chronic diseases such as heart disease, hypertension, diabetes, cancer and more.

3. Balance!
Diet culture and quick fixes have taken over. But here’s the problem: 95% of diets fail. Our society has overcomplicated nutrition. I don’t recommend following any diet that cuts out an entire food group or has major restrictions. With my clients, I want them to learn a healthy balance with sustainable results, get rid of the all-or-nothing mindset, and actually enjoy food again! Everybody’s body is different –– therefore, there isn’t one blanket diet to fit everybody’s needs. Nutrition is individualized and specific to you. Before you start another diet, ask yourself: Is this something I can do forever.

KS: Who is a candidate for nutritional consulting? 

CE: Any person looking to change their diet, or improve their overall health and well-being, through nutrition. The majority of my clients include those seeking to lose or gain weight; post-menopausal women; athletes; and those diagnosed with IBS/gut issues, diabetes, and high blood pressure and cholesterol. In addition, I work with many people who struggle with emotional eating and wish to heal their relationship with food.

KS: As a strong immune system has become more important than ever at this time, are there certain foods that can boost our immunity?

CE: Yes! Fun fact: about 70% of our immune system is located in our gut. The gut microbiota has profound effects on both the innate and adaptive immune system. There are emerging studies on supporting gut health, and incorporating prebiotic and probiotic foods into your diet. Prebiotic foods set the environment to promote healthy gut bacteria. Some prebiotic foods are onions, leeks, bananas, asparagus, garlic, and oatmeal. Probiotics feed your gut bacteria which occur naturally in yogurt, kimchi, sauerkraut, pickles, tempeh and kefir. Talk to an RD before starting a probiotic supplement. Other vitamins to improve immunity include foods rich in Vitamins, A, C, D and Zinc. It’s important to obtain these nutrients from food over supplements!

Here are a few tidbits on how each nutrient helps your immune system:

- Vitamin A helps regulate the immune system by protecting against infections and can be found in sweet potatoes, carrots, broccoli, spinach and eggs.

- Vitamin C supports the formation of antibodies and can be found in citrus fruits, strawberries, tomato juice, and green and red peppers.

- Vitamin D deficiency is associated with increased risk of infections and can be found in fortified foods, fatty fish, cheese, egg yolks and mushrooms. Here’s the best part: our main source of vitamin D is sunlight exposure. Enjoying the great outdoors is good for you!

- Zinc helps the immune system work properly by balancing the immune response and can be found in lean meats, poultry, seafood, milk, beans, nuts, seeds and whole grains.

KS: What do you generally recommend as the ideal fuel before and after physical therapy or performance training sessions?

I want you to think of food as fuel for your body. Fuel=energy. Before a workout or session, aim to combine a healthy carbohydrate with some protein for optimum fuel. 

Some examples of pre-workout snacks include:

- Banana and nut butter

- Greek yogurt and berries

- A handful of nuts and fruit, like peaches

If you use the same concept (food=fuel) then after working your body out, you will want to replenish the fuel used. Post-workout nutrition aids in muscle building and recovery. It’s key to focus on a balance of complex carbs and protein here as well. Examples include avocado toast, cottage cheese + fruit + nuts, hard-boiled eggs + fruit such as oranges.

KS: One of your recent blog posts was about intuitive eating, which to me sounds very ‘mindful.’ Could you tell us what you mean by intuitive eating?

CE: My key takeaway about intuitive eating is to ditch the ‘diet mentality.’ Intuitive eating is about listening to what your body wants to eat, rather than making choices based on a set of strict guidelines or rules somebody else set for you. Intuitive eating helps you reestablish a healthy relationship with food. Food is one of the joys of life — so let’s enjoy it!

Interested in meeting with Christina for a nutritional consult? Check out her website at DietitianDish.com or reach her at Christina@DietitianDish.com.

Disclaimer:  The views expressed in this article are based on the opinion of the author, unless otherwise noted, and should not be taken as personal medical advice. The information provided is intended to help readers make their own informed health and wellness decisions.

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Dr. Krystal Fannin

Physical Therapist
Krystal Fannin is a Doctor of Physical Therapy (DPT) specializing in pelvic health, chronic pain, and orthopedic conditions related to the spine and pelvis. She works at Activcore in Atlanta, Georgia, located just 2 miles from Emory University.
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