Can food act as medicine?
Wednesday, May 15, 2019
Q: Can you address whether curcumin is effective in relief for inflammation? I have joint pain and interested in finding relief from exercise soreness. I am looking for something other than NSAIDS? AG, Greenville
A: Thanks for your question. You certainly aren’t alone, many people are looking for effective alternatives to taking nonsteroidal anti-inflammatory drugs or NSAIDs to treat their inflammation, mild-to-moderate pain, and fever. Some don’t like the side effects which can include indigestion and other gut complaints, headaches, dizziness and drowsiness. Others have a medical condition that their doctor has warned them not to take either high doses or take them for a long time.
We often say that food can be your medicine, so it’s natural to see if food or dietary supplements can help. As you might expect there is no simple answer to your question. Western medicine studies of the use of curcumin have mixed results. The Rhizome or the horizontal stem of the turmeric plant has been used as a spice as well as in traditional medicine for a variety of disease in the middle East and Asia. I think of it, too, as a natural food coloring -- yellow. If you have eaten curry, you had at least a little bit of curcumin in it.
The good news is that in clinical studies there have been no serious safety concerns from using the spice or the dietary supplements containing curcumin. Once you have checked with your doctor or registered dietitian to make sure there are no interactions with your medicines, you can feel pretty good about experimenting to see if you find a benefit.
There could be a concern for individuals who are taking blood thinners, blood pressure and diabetes medicines. If you are prone to having calcium oxalate kidney stones, they be aware that curcumin has oxalate in it. If you are interested in using the spice, be aware that the available products often have a fair number of insect parts in them. They aren’t harmful, just undesirable or as the kids would say -- nasty.
If you are generally healthy and not taking medicines, consuming 8-12 grams per day of curcumin appears to be well tolerated. The side effects participants in studies experienced include headache, nausea, diarrhea and yellow stools.
Part of the reason for mixed results is that curcumin typically has had low bioavailability so it’s not easy to tell how much is absorbed in the body. That limits the practicality of using it for relief of inflammation.
I couldn’t find a study that showed curcumin from food or from dietary supplements superior to NSAIDs. Although the fact sheet found at the National Institutes of Health Center for Complementary and Integrative Health states that preliminary studies found that curcumin might help control knee pain from osteoarthritis just as well as ibuprofen (https://nccih.nih.gov/health/turmeric/ataglance.htm).
The health benefits from using curcumin in food are likely to be modest because Americans don’t eat it daily and not in large enough amounts. In recent years there has been some improvement of the bioavailability through the development of new analogs. If you want to try this approach, buy a product that has a black pepper extract with the ingredient piperine.
The studies in cell culture and animals show lots of other potential benefits from consuming turmeric and curcumin including anticancer action, alleviation of gastrointestinal tract disorders as well as the hyperglycemia and other consequences of diabetes, protection against cardiac injury, lessening the development and progression of Alzheimer disease, alleviation of arthritic disease, and some other conditions that aggravate humans like skin problems and fatigue.
To date, the human studies have been small in number, size and most without placebo control. The amounts of curcumin in the studies vary a great deal. If you want to see if it works for relieving your muscle soreness the human studies that show some success have participants taking it 4-7 days before intensive exercise or 4-7 days after intensive exercise and then feeling benefit a few days later. I didn’t find a study that followed people who regularly exercise and routinely take curcumin. Follow the dosage on the product you choose.
In most studies, the participants took it at breakfast and dinner. The same is true for the studies that showed benefit for joint pain. The study dosages varied from 1,000 mg to 1,500 mg per day with reports of reduced pain after 6-8 weeks. This is well below the amount I mentioned above as tolerable. The cost would be about $1 per day for the supplement. There might be about 1,000 milligrams of the active ingredient in ¼ teaspoon of turmeric.
The bottom line is that the available evidence isn’t strong enough yet for you to expect your health care provider to suggest curcumin over a NSAID for effectiveness for inflammation or slowing the progression of Alzheimer’s. I recently mentioned the Harvard anti-inflammatory diet pyramid. Following an anti-inflammatory diet might work better than supplements. See the Healthy Plate by Harvard experts at https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate.
Professor emeritus Kathy Kolasa, a registered dietitian nutritionist and Ph.D., is an affiliate professor in the Brody School of Medicine at ECU. Contact her at firstname.lastname@example.org.