The diet that kills pain
About the author: Dr Joseph Mercola
Diseases, Fatigue, Food allergies, Headaches,Inflammatory, Pain
If you suffer from arthritis, migraine or fibromyalgia,noted American
doctor Joseph Mercola has discovered why a fat-burning diet can
end pain—and much more.
Whether you're ill or well, you already know how frustrating it is, and how
much confusion you face, trying to sort through all the conflicting nutritional
advice about how to eat healthily. The fact is, there's little scientific evidence
to support any single eating plan that will work for all sufferers with their
myriad conditions.
much confusion you face, trying to sort through all the conflicting nutritional
advice about how to eat healthily. The fact is, there's little scientific evidence
to support any single eating plan that will work for all sufferers with their
myriad conditions.
If you're in pain—whether from migraines, arthritis, or even puzzling illnesses like fibromyalgia and
chronic fatigue—a high-fat diet will go a long way towards dramatically reducing your symptoms
and improving your quality of life. It does this by improving the body's ability to produce energy by
improving the functioning of mitochondria.
chronic fatigue—a high-fat diet will go a long way towards dramatically reducing your symptoms
and improving your quality of life. It does this by improving the body's ability to produce energy by
improving the functioning of mitochondria.
Mitochondria are tiny organelles
(think of them as micro-organs) contained
within nearly all your cells.
One of their many critical roles is to produce
energy by combining nutrients from the
sugars and fats you eat with oxygen from the
air you breathe.
(think of them as micro-organs) contained
within nearly all your cells.
One of their many critical roles is to produce
energy by combining nutrients from the
sugars and fats you eat with oxygen from the
air you breathe.
Researchers estimate that mitochondria account for 10 per cent of your body weight, with
approximately 10 million billion of them within the cells of an average adult. If that number is
hard to comprehend, consider that more than 1 billion mitochondria would fit on the head of a pin.
The more metabolically active cells are—such as those found in the heart, brain, liver, kidneys and
muscles—the more mitochondria they have.
muscles—the more mitochondria they have.
Mitochondria continuously generate energy molecules called 'adenosine triphosphate' (ATP); in fact,
they produce about 110 lbs of ATP every day.
they produce about 110 lbs of ATP every day.
Optimal mitochondrial function is key to a well-functioning metabolism.
Repairing mitochondrial dysfunction offers one of the simplest and most promising new strategies
for improving your health and helping to prevent diseases like cancer from developing in the first
place, or repairing problems involving pain.
Repairing mitochondrial dysfunction offers one of the simplest and most promising new strategies
for improving your health and helping to prevent diseases like cancer from developing in the first
place, or repairing problems involving pain.
The role of free radicals
ATP, the body's 'currency of energy', drives essentially every biological process in the body
—from the function of your brain to the beating of your heart.
—from the function of your brain to the beating of your heart.
Your mitochondria host a complex series of chemical reactions use electrons liberated from the
food you eat, and protons contained within the cycle, to produce energy and keep the process rolling.
At the end of the chain, electrons react with oxygen to form water.
food you eat, and protons contained within the cycle, to produce energy and keep the process rolling.
At the end of the chain, electrons react with oxygen to form water.
A percentage of electrons will leak and form what is called 'reactive oxygen species' (ROS).
These are molecules that contain oxygen, and their atoms have gained one or more unpaired electrons,
making them very unstable. These highly reactive atoms form potentially destructive free radicals.
These are molecules that contain oxygen, and their atoms have gained one or more unpaired electrons,
making them very unstable. These highly reactive atoms form potentially destructive free radicals.
But it's not ROS in general that are harmful; it's ROS in excess that are damaging to your health.
For this, you can use what I call 'mitochondrial metabolism therapy' (MMT) to optimize the generation
and reduction of ROS in your cells. Think of it as the 'Goldilocks phenomenon': not too much and not
too little, but just the right amounts of ROS. So rather than suppressing excess free radicals with
antioxidants, the ideal solution is to produce fewer of them in the first place.
For this, you can use what I call 'mitochondrial metabolism therapy' (MMT) to optimize the generation
and reduction of ROS in your cells. Think of it as the 'Goldilocks phenomenon': not too much and not
too little, but just the right amounts of ROS. So rather than suppressing excess free radicals with
antioxidants, the ideal solution is to produce fewer of them in the first place.
When you eat a diet high in quality fats and low in net carbs (total carbs minus fibre) and adequate in
protein, it optimizes the capacity of your mitochondria to generate a fuel known as 'ketones' that, in
conjunction with low blood glucose levels, produces far fewer ROS and secondary free radicals than
when you primarily eat carbohydrates. And this can have a major impact on lowering the inflammation
that's causing your pain.
protein, it optimizes the capacity of your mitochondria to generate a fuel known as 'ketones' that, in
conjunction with low blood glucose levels, produces far fewer ROS and secondary free radicals than
when you primarily eat carbohydrates. And this can have a major impact on lowering the inflammation
that's causing your pain.
Migraines
Despite their prevalence, migraines are still one of the most poorly understood medical disorders
out there. The symptoms are commonly confused with stroke, as sufferers can temporarily lose
their vision and experience unusual nerve sensations.
out there. The symptoms are commonly confused with stroke, as sufferers can temporarily lose
their vision and experience unusual nerve sensations.
Diet does appear to also play a role in migraines: searching the medical literature in PubMed.gov using
the search terms 'migraine' and 'food allergies' will net you at least 160 different studies.
One randomized, double-blind, crossover study published in 2010 found that a six-week-long diet that
excluded known food allergens produced a statistically significant reduction in the number of migraine
attacks and number of headache days.1
the search terms 'migraine' and 'food allergies' will net you at least 160 different studies.
One randomized, double-blind, crossover study published in 2010 found that a six-week-long diet that
excluded known food allergens produced a statistically significant reduction in the number of migraine
attacks and number of headache days.1
More recent research has noted an association between highfat, low-carb diets and dramatic
reductions in migraine attacks.
reductions in migraine attacks.
In one 2015 study, 45 women who experienced regular migraines were given to a ketogenic diet for one
month, then switched to a standard calorie-restricted diet for another five months.
The control group in the study ate the standard calorie-restricted diet for the entire six months.
month, then switched to a standard calorie-restricted diet for another five months.
The control group in the study ate the standard calorie-restricted diet for the entire six months.
The women eating the high-fat, low-carb ketogenic diet experienced a significant reduction in the number
of attacks, number of days with a headache and medicine use during the first month (whereas the
standard low-calorie dieters didn't). But once they switched to the standard low-calorie diet, their symptoms
worsened—although they were still improved compared to how they'd been before. T
he group that didn't start with the ketogenic diet did see a reduction in the number of days with a
headache, but not until month three, and they did not see a reduction in attack frequency until month six.2
of attacks, number of days with a headache and medicine use during the first month (whereas the
standard low-calorie dieters didn't). But once they switched to the standard low-calorie diet, their symptoms
worsened—although they were still improved compared to how they'd been before. T
he group that didn't start with the ketogenic diet did see a reduction in the number of days with a
headache, but not until month three, and they did not see a reduction in attack frequency until month six.2
A fascinating 2013 Italian study reported on a case where 47-year-old twin sisters adopted a low-carb,
high-fat weight-loss diet. After three days on the diet, their frequent migraines also
"unexpectedly vanished". The sisters ate a ketogenic diet for four weeks and then transitioned to a
low-calorie, non-ketogenic diet for two months before starting the ketogenic diet cycle again.
high-fat weight-loss diet. After three days on the diet, their frequent migraines also
"unexpectedly vanished". The sisters ate a ketogenic diet for four weeks and then transitioned to a
low-calorie, non-ketogenic diet for two months before starting the ketogenic diet cycle again.
Before starting the diet, the sisters suffered from five to seven migraine attacks a month.
They experienced no headaches while on the high-fat four-week cycle, while their migraines did recur
during the two-month non-ketogenic intervals, although with reduced frequency, duration and intensity.
They experienced no headaches while on the high-fat four-week cycle, while their migraines did recur
during the two-month non-ketogenic intervals, although with reduced frequency, duration and intensity.
The researchers theorized that the diet reduced inflammation and oxidative stress in the patients' neurons
and enhanced mitochondrial genetics that, in turn, resulted in a dramatic reduction of migraine attacks.3
and enhanced mitochondrial genetics that, in turn, resulted in a dramatic reduction of migraine attacks.3
Arthritis
Plenty of research shows that improving your omega-6 to omega-3 ratio—an integral part of MMT—
has exciting potential to prevent and treat arthritis. According to a 2011 animal study (which of course,
may not apply to humans), a diet enriched with omega-3 fats reduced the majority of disease indicators
in guinea pigs with osteoarthritis, including both cartilage and subchondral bone changes.
The lead researcher noted that there was strong evidence that omega-3 fats may help to prevent the
disease, and also slow its progression in those already diagnosed.4
has exciting potential to prevent and treat arthritis. According to a 2011 animal study (which of course,
may not apply to humans), a diet enriched with omega-3 fats reduced the majority of disease indicators
in guinea pigs with osteoarthritis, including both cartilage and subchondral bone changes.
The lead researcher noted that there was strong evidence that omega-3 fats may help to prevent the
disease, and also slow its progression in those already diagnosed.4
In addition, a 2013 study showed that omega-6 fatty acids, when injected into cartilage cells, provoked
an inflammatory response where monounsaturated and saturated fats appeared to inhibit cartilage
destruction.5
an inflammatory response where monounsaturated and saturated fats appeared to inhibit cartilage
destruction.5
A high-fat ketogenic diet has been shown to reduce pain and inflammation in animal studies.6
This means that adopting a healthy high-fat diet (which includes eating more omega-3s and fewer
omega-6s) is a viable and very promising avenue to pursue in the relief of the pain and disability that
can be brought on by osteoarthritis.
This means that adopting a healthy high-fat diet (which includes eating more omega-3s and fewer
omega-6s) is a viable and very promising avenue to pursue in the relief of the pain and disability that
can be brought on by osteoarthritis.
Fibromyalgia
Science is also beginning to recognize a link between oxidative stress and mitochondrial dysfunction
and health issues such as chronic fatigue and fibromyalgia—two conditions that a high-fat diet takes
full aim at by bringing the body back into balance.
and health issues such as chronic fatigue and fibromyalgia—two conditions that a high-fat diet takes
full aim at by bringing the body back into balance.
Although few studies have looked specifically at the effect of a high-fat diet on these conditions and
chronic pain, one promising study was published in the December 2013 issue of the Journal of
Musculoskeletal Pain. The diet in this case was expressly non-ketogenic (it wasn't designed to promote
the production of ketones through either a high-fat content or regular fasting), but it was low-carb.
The 33 middle-aged women who followed the diet reported increased energy, less pain and improved
symptom scores on the Fibromyalgia Impact Questionnaire.7
chronic pain, one promising study was published in the December 2013 issue of the Journal of
Musculoskeletal Pain. The diet in this case was expressly non-ketogenic (it wasn't designed to promote
the production of ketones through either a high-fat content or regular fasting), but it was low-carb.
The 33 middle-aged women who followed the diet reported increased energy, less pain and improved
symptom scores on the Fibromyalgia Impact Questionnaire.7
There is also some evidence that people with fibromyalgia experience fewer symptoms if they eliminate
one or more of the foods that frequently trigger food allergies or sensitivities.
The most common offenders are corn, wheat, soy, dairy, citrus and sugar, with the top three being
pasteurized milk, soy and gluten (from wheat and similar grains). In one study of 17 fibromyalgia
patients, nearly half experienced a "significant reduction in pain" after eliminating corn, wheat, dairy,
citrus and sugar.8
one or more of the foods that frequently trigger food allergies or sensitivities.
The most common offenders are corn, wheat, soy, dairy, citrus and sugar, with the top three being
pasteurized milk, soy and gluten (from wheat and similar grains). In one study of 17 fibromyalgia
patients, nearly half experienced a "significant reduction in pain" after eliminating corn, wheat, dairy,
citrus and sugar.8
Why the diet works
Carbs are a far dirtier fuel than fats. When you adopt a high-fat, low-carb diet and make the switch to
burning fat and ketones for fuel instead of glucose, your mitochondrial exposure to oxidative damage
drops by as much as 30-40 per cent compared with when your primary source of fuel is sugar, as is
typical in American and British diets today.
burning fat and ketones for fuel instead of glucose, your mitochondrial exposure to oxidative damage
drops by as much as 30-40 per cent compared with when your primary source of fuel is sugar, as is
typical in American and British diets today.
This means that when you have made the transition to burning fat for fuel, your mitochondrial DNA,
cell membranes and protein will remain stronger, healthier and more resilient.
cell membranes and protein will remain stronger, healthier and more resilient.
For your body to regain its ability to burn ketones as its primary fuel, you must focus on increasing your
intake of healthy fats, while decreasing your consumption of carbs to keep your blood glucose levels low.
This is what MMT was designed to do.
intake of healthy fats, while decreasing your consumption of carbs to keep your blood glucose levels low.
This is what MMT was designed to do.
Limiting net carbs is a crucial part of MMT not just because glucose is a 'dirty' fuel that produces an
excess of ROS, but also because excessive net carbohydrate consumption suppresses fat-burning.
Notice that I say 'net' carbs: that's total carbs minus fibre. This means MMT is not a low-total-carb diet:
fibre is an important carb that's actually converted into beneficial short-chain fats in your intestines.
In other words, this is a low-net-carb diet.
excess of ROS, but also because excessive net carbohydrate consumption suppresses fat-burning.
Notice that I say 'net' carbs: that's total carbs minus fibre. This means MMT is not a low-total-carb diet:
fibre is an important carb that's actually converted into beneficial short-chain fats in your intestines.
In other words, this is a low-net-carb diet.
The only catch is that, when you replace carbs with fat, you must do it with care.
The fats you choose must be high quality and, ideally, organic. But more importantly, they should not be
industrially processed omega-6 vegetable oils.
The fats you choose must be high quality and, ideally, organic. But more importantly, they should not be
industrially processed omega-6 vegetable oils.
If you look at the nutrition facts label on any processed food package, it will list total carbs.
But you need to also look at the fibre content and subtract that from the total carbs.
This is important to understand as, otherwise, you may end up feeling that your choices are too limited
to stick to your MMT food plan.
But you need to also look at the fibre content and subtract that from the total carbs.
This is important to understand as, otherwise, you may end up feeling that your choices are too limited
to stick to your MMT food plan.
On MMT, you'll replace those non-fibre carb calories (from foods like sweets, sugary beverages, breads,
pasta, crackers, chips and fries) with organic vegetables and healthy fats.
This will transition your body to primarily burning fats for fuel, while radically reducing your risk for
most chronic diseases.
pasta, crackers, chips and fries) with organic vegetables and healthy fats.
This will transition your body to primarily burning fats for fuel, while radically reducing your risk for
most chronic diseases.
In general, the high volume of vegetables, together with the nuts and seeds you eat while following
MMT (which are listed below), will provide you with more daily fibre than the average American typically eats.
MMT (which are listed below), will provide you with more daily fibre than the average American typically eats.
Diamonds and rust
Free radicals react with other molecules in what are known as 'oxidation reactions' to neutralize their
unstable electrical charge. Oxidation is essentially 'biological rusting'. It creates a snowball effect
—as molecules steal electrons from one another, each one becomes a new free radical, leaving
behind a trail of biological carnage.
unstable electrical charge. Oxidation is essentially 'biological rusting'. It creates a snowball effect
—as molecules steal electrons from one another, each one becomes a new free radical, leaving
behind a trail of biological carnage.
This rapidly expanding horde of free radicals collects within the cell, and degrades cell and
mitochondrial membranes in a process known as 'lipid peroxidation'. When this happens, the
membranes become brittle and leaky, causing them to disintegrate.
mitochondrial membranes in a process known as 'lipid peroxidation'. When this happens, the
membranes become brittle and leaky, causing them to disintegrate.
Free radicals also damage your DNA by disrupting its replication, interfering with its maintenance
activities and altering its structure. Recent research estimates that your DNA suffers a free-radical
attack somewhere between 10,000 and 100,000 times a day, or nearly one assault every second.
activities and altering its structure. Recent research estimates that your DNA suffers a free-radical
attack somewhere between 10,000 and 100,000 times a day, or nearly one assault every second.
Beyond Atkins and Paleo
Many other popular diets, like the Atkins and the Paleo, are similar in some aspects to mitochondrial
metabolism therapy (MMT)—yet there are many key differences:
metabolism therapy (MMT)—yet there are many key differences:
• Too much protein. The Paleo diet calls for some 38 per cent protein and 39 per cent fat.
A high-protein diet stimulates the production of a hormone called 'insulin-like growth factor
1' (IGF-1). Like insulin, IGF-1 is a powerful stimulus of ageing.
A high-protein diet stimulates the production of a hormone called 'insulin-like growth factor
1' (IGF-1). Like insulin, IGF-1 is a powerful stimulus of ageing.
Limiting protein also limits the production of mTOR (mammalian target of rapamycin), which suppresses
cellular and mitochondrial repair and regeneration (see box, page 33). Protein levels closer to 10 per cent
during nutritional ketosis is far more optimal.
cellular and mitochondrial repair and regeneration (see box, page 33). Protein levels closer to 10 per cent
during nutritional ketosis is far more optimal.
• Not enough caution regarding seafood. The Paleo diet includes lots of fish and other seafood, and the
omega-3 oil found in fish is clearly one of the most important and essential nutrients for health.
omega-3 oil found in fish is clearly one of the most important and essential nutrients for health.
But as a result of industrial pollutants, including mercury, polychlorinated biphenyls (PCBs) and dioxin,
it's difficult to find seafood that is toxin-free. (Page 35 lists the safest fish to consume regularly.)
it's difficult to find seafood that is toxin-free. (Page 35 lists the safest fish to consume regularly.)
• Still too many starches and sugars (net carbs). Even though sweet potatoes and fruit—two popular
foods on the Paleo plan—are whole foods, they still raise glucose and trigger an insulin reaction,
especially when you're seeking to make the transition from burning sugar to burning fat.
foods on the Paleo plan—are whole foods, they still raise glucose and trigger an insulin reaction,
especially when you're seeking to make the transition from burning sugar to burning fat.
But once you're able to burn fat rather than carbs as your primary fuel, this will no longer be an issue
and you can slowly reintroduce these back into your diet.
and you can slowly reintroduce these back into your diet.
Why burn ketones?
Shifting to a fat-burning diet has been shown to spur mitochondrial biogenesis—at least in animal studies.
1 Mitochondria then have more energy to focus on processes involved in creating more—
and healthier—mitochondria. In a sense, your mitochondria become supercharged.
1 Mitochondria then have more energy to focus on processes involved in creating more—
and healthier—mitochondria. In a sense, your mitochondria become supercharged.
Ketones are water-soluble energy molecules made by mitochondria in your liver from dietary or stored
fats, and are used as an alternative fuel to glucose. (Nutritional ketosis is completely different from
diabetic ketoacidosis, a life-threatening complication of uncontrolled diabetes.)
fats, and are used as an alternative fuel to glucose. (Nutritional ketosis is completely different from
diabetic ketoacidosis, a life-threatening complication of uncontrolled diabetes.)
In addition to allowing us to survive periods of food scarcity, burning ketones means:
• far fewer ROS are produced than when you burn glucose
• you reduce the amount of sugar available to cancer cells and the load of ROS your cells are exposed
to, making it less likely that cancer will develop in the first place
to, making it less likely that cancer will develop in the first place
• a variety of signalling functions happen that can ultimately affect gene expression1
• you reduce inflammation by decreasing, or downregulating, proinflammatory cytokines while increasing,
or upregulating, anti-inflammatory cytokines2
or upregulating, anti-inflammatory cytokines2
• there's a powerful protein-sparing effect, allowing you to consume lower quantities of protein while
retaining or even building muscle mass;3 this also inhibits mTOR, an important metabolic pathway
that's often overactive in disease states, including cancer, whereas its reduced activity is associated with
an improved health span and longevity4
retaining or even building muscle mass;3 this also inhibits mTOR, an important metabolic pathway
that's often overactive in disease states, including cancer, whereas its reduced activity is associated with
an improved health span and longevity4
• you enjoy protective benefits for brain cells exposed to hydrogen peroxide—a common compound
found in the brains of people with dementia and Alzheimer's disease5
found in the brains of people with dementia and Alzheimer's disease5
• you upregulate (increase) mitochondrial biogenesis in your brain6—so boosting its capacity to make
more energy by increasing the number of mitochondria.
more energy by increasing the number of mitochondria.
MMT-friendly vegetables
Asparagus Cucumber
Avocado Kale
Broccoli Mushroom
Brussels sprouts Salad greens
Cabbage Sautéed greens
Cauliflower Spinach
Celery Zucchini
(courgette)
After you are fat-adapted, you can add back limited amounts of these foods:
Eggplant Pepper
Garlic Rutabaga
Onion Tomato
Parsnip Winter squash
(very limited amounts)
MMT-friendly fruits
Berries (a small handful in lieu of a serving of vegetables)
Grapefruit (a few sections, again instead of a serving of vegetables)
MMT-friendly fats
Eliminate all industrially processed fats—including vegetable oils like canola, peanut, cottonseed, corn and soy—as well as all trans fats, such as those found in commercial salad dressings, peanut butter, most mayonnaises and anything processed or packaged. If you see 'hydrogenated fat' listed in the ingredients, that food contains trans fats even if they're at a quantity below what must be reported on the label.
Here are the sources of fat that burn clean and help heal your mitochondria:
Organic, grass-fed butter and ghee
Coconut milk
Chicken fat
Duck fat
Coconut oil
MCT (medium-chain triglyceride) oil
Avocado oil
Extra virgin olive oil
Protein
Keep your protein intake in any given meal to 12 -15 g for women and 15 -20 g for men (assuming three meals per day). However, if you are immune-compromised or recovering from surgery or illness, or have greater physical-activity demands, you will need about 25 per cent more.
Avoid any low-fat dairy products or 'lean' meats. Instead, aim to make the majority of your sources of protein high-fat options—chicken thighs with the skin on rather than skinless chicken breast, for example. For meat, opt for pasture-raised animals (ideally grass-fed) with no added hormones or antibiotics.
Nuts and seeds are excellent sources of protein, with an average of 4-8 g per ¼ cup (2 oz), while most vegetables contain 1-2 g of protein per ounce. With a target of 45-55 g/day of protein, plant sources alone can easily meet your protein needs.
Meats
Beef
Lamb
Pork
Poultry
Wild game meats
Eggs
Organ meats
Safer seafood
As levels of pollutants in our waters (including mercury) have increased, be very choosy about which types of seafood you decide to eat. Among the least-contaminated fish and the highest in healthy omega-3 oils are Alaskan and sockeye salmon. Neither is allowed to be farmed and they are therefore always wild-caught.
Here are the seafoods with the least amounts of mercury.
Anchovy Pollock
Clam Salmon (canned)
Crab (domestic) Salmon (wild)
Flounder Sardine
Haddock Scallop
Hake Shrimp
Herring Sole (Pacific)
Mackerel Squid
Mullet Trout
Oyster (freshwater)
Whitefish
Plaice Whiting
Nuts and seeds
Almonds (in very limited amounts, as they are high in protein)
Black cumin seeds
Black sesame seeds
Brazil nuts
Raw cacao powder, nibs, butter
Chia seeds
Flaxseeds
Macadamia nuts
Pecans
Psyllium seed husks
Pumpkin seeds
Sunflower seeds
High-fat dairy (okay in moderation)
Butter (12 g of fat per Tbsp; minimal protein)
Ghee (13 g of fat per Tbsp; no protein)
Heavy whipping cream (5-6 g of fat per Tbsp; minimal protein)
Cream cheese (4-5 g of fat per Tbsp; some protein)
Sour cream (2-3 g of fat per Tbsp; some protein)
Parmesan cheese (1.4 g of fat per Tbsp; high protein; use all cheeses mainly as condiments)
Cheddar cheese (9 g of fat per Tbsp; high protein)
Brie cheese (8 g of fat per oz; high protein)
Excerpted from Fat for Fuel by Dr Joseph Mercola , £20 (Hay House UK, 2017
https://www.wddty.com/magazine/2017/may/the-diet-that-kills-pain.html
https://www.wddty.com/magazine/2017/may/the-diet-that-kills-pain.html
References
Why burn ketones?
References
| |
1
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Ann Neurol, 2006; 60: 223-35
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2
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Phinney SD, Volek JS. The Art and Science of Low Carbohydrate Living. Miami, FL: Beyond Obesity LLC, 2011
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3
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http://articles.mercola.com/sites/articles/archive/2016/01/31/high-fat-low-carb-diet-benefits.aspx
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4
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Diabetes Res Clin Pract, 2014; 106: 173-81
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5
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J Neurochem, 2012; 121: 28-35
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6
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Moore J, Westman EC. Keto Clarity (audiobook). Las Vegas, NV: Victory Belt Publishing, 2014
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Main article
References
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1
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Cephalalgia, 2010; 30: 829-37
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2
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Eur J Neurol, 2015; 22: 170-7
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3
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Funct Neurol, 2013; 28: 305-8
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4
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Osteoarthritis Cartilage, 2011; 19: 1150-7
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5
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Cartilage, 2013; 4: 321-8
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6
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PLoS One, 2009; 4: e8349; J Child Neurol, 2013; 28: 993-1001
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7
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J Musculoskelet Pain, 2013; 21: 365-70
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8
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Presented at the Annual Meeting of the American College of Nutrition in Orlando, Florida, 3-7 October 2001
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