Afiya Spine & Pain Institute
Holistic Pain Management & Nutrition | A Conversation with Zoha Matin and Dr. Pirani
Join Dr. Pirani from Afiya Spine and Pain Institute and nutrition expert Zoha Matin as they discuss the importance of holistic care in managing chronic pain. Discover how nutrition, movement, and lifestyle play vital roles in improving patient outcomes, especially for those dealing with conditions like osteoarthritis and neuropathic pain. Learn about anti-inflammatory diets, supplements, and how small changes can lead to long-term health benefits.
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happy Friday happy Friday it's been a busy week I'm with Zoho matin one of my good friends who I met a couple years ago two friends you're a a very esteemed and knowledgeable nutritionist and we were talking about our passion for holistic care and as you know my background is in chronic pain uh my true love is chronic pain um we're sitting in AIA Spine and Pain Institute which is kind of like the twinkle in my eye and we've really seen our our our Clinic grow over the last year and a half in downtown Toronto and um you know really there's more to to what we do we do you know medication management um we run pain classes here that has you know psychotherapists physiotherapists we focus on Movement we also do very very Advanced interventions and a large component of holistic care and getting our patients back to doing what they really love is uh nut nutrition aspect and I'm no by any means I'm not a nutrition expert so my patients ask me sometimes you know what should I eat what should I what should I not eat and I I say you know to be honest I'm not really sure I mean I do have a a general general knowledge and I say you know um how like they ask me what kind of diets they should be um consuming and things like that so I'm glad you've decided to come down to see me uh here and spend some time with us at AIA and discuss some of these things um we have a lot of patience PTI s with inflammatory conditions like osteoarthritis rheumatoid arthritis um patients with other autoimmune diseases and and inflammatory conditions such as ulcer of colitis that have a pain condition compon pain component part to their condition um and so these patients suffer with chronic pain um we also have you know one of my clinical interests is neuropathic pain and nerves um as you know are are very responsive to good supplements and um and the correct food so a little bit about you and maybe I hope I don't miss anything but you um are very passionate about nutrition you have a BSE from the University of Toronto uh an MSE from Mill University in Montreal uh you practice out of the GTA and have your own private practice um but you also have kind of a global voice and that goes all the way all the way to Pakistan where your family's from and I believe you grew up there for a period of your life um and you're really passionate about getting people not only with nutrition but moving and weight loss and making good lifestyle choices so I was hoping if you could help uh link that in with what kind of I'm doing uh and tell me about um a little bit more about yourself thanks so much for that intro uh yes I'm very passionate about healthy living and I think it's holistic so not just nutrition but movement Stress Management uh sleep all those important things and um at AIA you cater to individuals who have issues with pain right and while the first line of intervention is usually medication or other therapies uh nutrition also has a big role to play and many people aren't aware of that so I'm glad that we're talking about that today to spread that awareness right yeah so the first question I get asked is like what's the best diet and like I really know that I know that you have quite um a large Private Practice here in the GTA and I you know with anything in healthare every patient is an individual and you have to have individual treatment plans for every patient right so what's your kind of approach uh in your own private practice so a client will reach out to me potential patient and they will say I'm suffering with XYZ condition it can be hormone issues weight loss uh high cholesterol certain things that I can help them with if they're a good fit and then I will onboard them I'll do an initial assessment where I ask a lot of detailed questions about their medical history what their current diet is if they're on any medication their age ha height weight everything um to kind of then guide them accordingly and give them a personalized plan on what they should be eating um what kind of exercise they should be doing I kind of guide them in those ways and I'll make sometimes a customized meal plan for them so there's something like more structured for them to follow um and then based on the individual client we have numerous follow-ups to just make sure that they're on track to hold them accountable and to help guide them through that Journey because I feel like uh changing habits and eating Styles can take some time like if one is to just give like one plan to somebody and say okay here go follow it it's pretty hard to completely completely change one's diet in that kind of way one's behaviors Essen one's behaviors yeah eating behaviors um even the skills required to cook right meal prepping cooking all that stuff requires a little bit of support and so my programs I help give that support to my clients so that I'm with them through that Journey for 3 to six months so do you do group- based or do you do individual um um mostly individual yeah okay um and is it do you find yourself in a kind of a coaching role as well as like as an expert role do you find that you know what are your kind of coaching techniques to get people moving in the right direction yeah so I did a certification in NLP which is neural linguistic programming uh which helps me to to help guide my clients as well through their own self-sabotage like a lot of the times we know what the healthy thing is to do but we kind of sabotage ourselves where I not exercising or not eating the right thing so helping clients come out of their own way in that way um I really enjoy Health coaching so with the nutrition background and even a background in um Fitness I help my clients kind of guide them but also overcome those psychological barriers to changing their lifestyle habits so I really enjoy being a coach in that way I read a lot of books on on changing habits um and all the I guess psychology and brain science associated with changing habits there's so much out there one really amazing book is actually Atomic habits have you read it I have not I always keep telling myself I'm going to read a book I have a vacation coming up soon so maybe I'll uh if you have a copy of that you can lend it to me yeah it's a great book anyone looking to change their habits and kind of want you know some good literature to read or an audio book do check out that book and so you know I am very uh passionate about getting my patients moving giving them the quality of life back because you know not very many people are aware but one in five patients have chronic pain and I'm sure in your individual circles family friends Etc if you were to scan and actually ask some of your friends uh and family Etc if any of them were suffering with chronic pain many of them you know 20% do and that's statistics in Canada and so a lot of chronic pain you know once pain becomes goes from kind of an acute to a Subacute to a chronic phase you know patients Lifestyles motivations they all change they start developing anxiety depression some of them become start catastrophizing they get fear of movement their diets changed because sometimes they feel like food is the only thing that makes them happy and things they can do they unfortunately suffer relationship uh uh uh changes and uh difficulty for them uh when their own personal relationships they also uh sometimes get job losses and you know despite everything that we do here at AIA is to try to get them their quality of life back so that they can do the things they love and nutrition is a large holistic part of it so I touched a little bit about you know we can talk all day about the different types of diets the first question I have for you is you know question patients ask me and I've been to a number of pain conferences where diet is you know um has been brought up by certain experts what's the best diet like even for myself Mediterranean diet you hear vegan diet you hear vegetarian diet you hear a meat diet right so I know this is a big topic but how do what are you kind of the pros and cons and I know every patient's individual and you probably give individual tailored advice which is great but if you could touch on that I think that would really help some of our patients and the people who hopefully W watch this video sure uh so according to the research for inflammatory conditions or autoimmune conditions related to pain an anti-inflammatory diet is by far the best um and an example of an anti-inflammatory diet is the Mediterranean style diet it's not a fixed diet plan but it's more like a generalized guideline around how to eat and it it includes a lot of plant-based Foods um whole nutrient-dense foods that are high in fiber um so for example legumes are really encouraged in this diet so uh chickpeas beans and lentils are really good and also high in fiber lots of fresh fruits and vegetables and generally fresh fruits um foods and staying away from processed foods that have a lot of chemicals that comprises the Mediterranean diet there's a there's a few other things what about olive oil everyone thinks a mediter is olive oil right yeah healthy fats are a big part of that Mediterranean diet and anti-inflammatory diet so healthy oils are um extra virgin olive oil avocados fatty fish like salmon mackerel and S chia seeds flax seeds and walnuts these are the best uh healthy fats that you can have in your diet because they're high in Omega 6 fatty acids which is a powerful nutrient especially for pain management so definitely include those Foods in your diet um and so this anti-inflammatory diet overall is superior to even a vegan diet or a vegetarian diet though vegan and vegetar are also good and they also include plant-based foods but including a little bit of um you know dairy or a little bit of seafood in the form of Omega-3s for example can also have some benefits um one can also choose to follow vegetarian diet for whatever reason to manage their pain that's completely fine but I would recommend that one carefully plans their diet maybe with a dietitian on their side to make sure that they're not going to suffer from any nutrient deficiencies that might exacerbate their pain so you have to be a little bit careful with the vegan and vegetarian diet in that way um so again research shows anti anti-inflammatory is the best um and what does that mean what is anti-inflammatory basically foods that have a lot of antioxidants are considered anti-inflammatory foods so let's say the top few foods that I would recommend in this kind of diet would be um fruits and vegetables especially berries are really good for antioxidants so strawberries blueberries um blackberries those the berry family and grapes and cherries they're especially good for pain management they reduce inflammation in the body uh in terms of vegetables dark green leafy vegetables have are the best so there those include uh spinach kale and swiss Swiss chard um and then your cruciferous vegetables family so that's broccoli cauliflower cabbage and Brussels sprouts those contain a compound called s sulforaphane and that has actually been shown in studies to help with pain relief so those would be the fruits and vegetables that are especially good in this type of anti-inflammatory diet um along with this whole grains are really good as well so kind of avoiding those refined carbohydrates like white bread white flour white rice and just sugary foods which are refined carbohydrates and sugars those actually cause a bit more inflammation in the body instead going towards whole grains like oats barley quinoa um brown rice those can be way more beneficial again because they contain fiber now I've talked about fiber a few times like legumes whole grains your fruits and vegetables nuts and seeds are high in fiber and why that's important it's because the more fiber you have in your diet it helps improve your gut health and again your gut health is directly linked to your inflammatory response which all ties into pain yeah then that's those are great that's you know well above what I know and I am motivated now to even eat healthier what's the consensus on and I've actually had patients ask me this and there's a lot of information there's a lot of fat diets we have access to YouTube and all the social media what's your consensus on a high fat diet and a high meat diet um would you recommend that to any of your clients is there any situations where you know it's better than you know the Mediterranean diet which we've discussed at length um which I I believe and you know I've seen some of the studies and some of the experts in pain at some of the conferences that been to have discussed this Mediterranean diet in the past and they've really kind of hammered home the importance of it and decreasing inflammation in your body and gut health Etc so what's your kind of consensus on that topic so I think that the high fat diet can go against recommendations especially for chronic pain relief the reason I say that is because a high-fat diet may include a lot of saturated fat which is something that people with chronic pain should avoid or limit as much as they can and so certain foods that are high and saturated fat that should be limited um one of them is beef so it's not that you can never have it but kind of try to limit it to maybe once a week once in two weeks to have a serving of beef because it does contain more saturated fat levels um and it depends on the cut of beef too so if you're having like a fatty steak or some ribs that can be higher in saturated fat versus a more lean cut of beef um so and then generally other foods that have have High saturated fat include um high fat dairy products like butter and cream so ice cream croissant like stuff you find in the bakery cookies muffins those kind of things can also behind that saturated fat intake I feel like when people are in that state of chronic pain they are pushed to do whatever they can and in those moments having this knowledge to know these are the foods that may not be the best for me let me try to limit these but there's all the variety of really healthy foods that you can eat of course all of these foods can also be made in a healthier way like a healthy recipe right like a healthy muffin recipe or healthy cookie recipe made with oats or made with certain healthier ingredients that's still you know that way you don't feel like you're completely deprived of all your favorite foods but at the same time you're not causing more pain yeah of course it's great and so as I told you I have a a really strong interest in neuropathic pain and a lot of my patients here I get you know surgeons and other Physicians sending me um neuropathic pain P that which is pain coming from nerves what what's the best diet and what are foods that I think neuropathic pain patients um should avoid H so again high sugar foods cause more inflammation so avoiding like lot of high sugary foods like desserts Candy Pops sweetened drinks cocktails made with a lot of sugar um these kinds of foods can aggravate more inflammation um avoiding alcohol is a good idea idea limiting it doesn't have to be zero but limiting alcohol consumption um losing weight can help so having a healthy BMI if you're carrying any excess weight that can uh trigger more inflammation especially viseral fat so when someone is overweight they carry a lot of visceral fat especially around their organs that is actually metabolically active fat that releases inflammatory substances into the body which cause more inflammation and inflammation can lead to pain right right so um when it comes to neuropathic pain especially uh certain things that can help are your B vitamins B vitamins are found in your whole grains and your fruits and vegetabl is what a lot of patients ask me about like the B vitamins and then um there's also like iron and folate and things like that that you can optimize so vitamin B complex can be a good supplement to take in that case because especially vitamins B1 b6 and b12 are related to uh nerves right so they enhance your nerve function so taking those can help with that kind of pain another supplement is ala Alpha Li lipoic acid um and then another specific kind of supplement is capsacin have you heard of that one yeah so capsacin is actually a really it's actually part of the neuropathic pain guidelines and unfortunately we don't have you know in neuropathic pain it has to be in kind of high concentration so essentially it's like chili pepper right um and so there's defin good quality evidence for caps it's just access to getting it for some of our patients is a bit challenging but you know some of our you know nerve pain can be really really affect your quality of life keeps you up at night so I find patients are willing to try mostly everything and actually we have a pain pharmacist here who works in our clinic and part of our actually pharmacological management is supplements and you know we've gone through some of the evidence and I'm glad I'm talking with you about this because it further enforces my knowledge so that I can you know um share this with some of my patients and some of our patients can watch this video and they can get further reinforced that these are part of an important healthy diet so what I normally tell them is I say you know this is part of your lifestyle like you're coming here a few times a year to get your pain uh pain procedures your exercise or you're losing weight but adding supplements are part of you know you have coffee in the morning have it with your coffee in the morning um so making that really those lifestyle changes and making it part of their life is really really important so um yeah so I'm a very very big believer in supplements um for our patients with anti with uh anti with inflammatory conditions as well as neuropathic conditions and just generalized pain conditions because you know healthy body healthy mind Etc we always talk about that right so yeah I'd like to add to that by just saying that you know the foundation for just a healthy Whole Foods diet has to be strong and then we add supplementation on top as just that a plus you know so it has to be grounded in a good healthy diet to start and then the supplements really do help to enhance that care so one of the questions I want to ask you is you brought up all these wonderful Foods these delicious foods sometimes getting access to these foods can be difficult for some of our patients for different social economic statuses and you know some patients their behavior for example um is used to having a high fatty diet so what are kind of your like coaching strategies to get people to start eating these kind of foods um you know obviously things are gradual in most patients um what's your motivation maybe I'll be more motivated to eat healthier too after today I think um if if it's a complete overhaul of diet where one is starting off from a place of eating out all the time like all their meals are fast food and they're not cooking at home and they don't have that kind of knowledge then completely switching their diet 180 to a super health healthy diet may be a little bit overwhelming and unachievable so in those cases you try to make small changes at a time just trying to include maybe a few fruits and vegetables in their diet to to start um maybe moving along to teach a few cooking skills or easy things that can be prepped or even educating them on healthier options that they can buy outside you know so I think the more um education and like step-by-step approach you can take to gradually bring in those changes makes it more likely to so that they can make those long-term changes when it does feel overwhelming and I think working with like a professional or coach can help if it does feel really overwhelming which it can so you've given you know all our viewers you've given me a lot of information I'm really grateful for all your knowledge so how can our patients see you and I would love for you to be integrated into our pain glasses just meet some of our patients in group in some of our group classes to convey this knowledge oh I'd love to um well you can find me on Instagram at zo. the. nutritionist my website is www. zoth nutritionist. comom um and if you need to email me it's Z the nutritionist gmail.com aming touch as we said our goodbyes one of the audience members in the clinic today asked me a really really good question so I had to run back here while I still had you to ask it to so you know people have different Financial situations you know you you talked about some really really really really um excellent food groups but sometimes access to these food groups are can be challenging there's financial implications all these healthy foods seem a little bit expensive to patients so how do you coach someone who has um certain Financial constraints to eat a little bit healthy um what's your approach here because you know we want to make sure that healthy food is accessible to everyone essentially right yeah I'd say um unfortunately it is the case that many Healthy Foods Fresh Foods are more expensive than canned foods or fast foods but if you think of it as an investment into your long-term Health you can create more of a budget around that to make sure that you can still you know make space for these Foods um generally there there are so many good recipes that you can look up online when you write budget friend new recipes that you can batch cook that you can use um less expensive foods like legumes in to get your protein intake um there are many resources online if you just look up budget friendly foods that will give you good recipes which will still be within your budget and you can still eat healthy there's all all kinds of ways and all kinds of tips um around those so do you have any kind of like your top three food hacks for finding finding cheaper food for patients do you know um any um uh grocery stores that you would recommend I guess like obviously like looking at flyers and things like that this this even if I eats because they're on sale and they're healthy food she you know wants them in in the home sometimes canned foods can be a little bit more inexpensive so using canned legumes or canned vegetables can be an option and they last longer to their shelf stable using frozen vegetables or fruits can be an option surprisingly people think they aren't as healthy but they are just as healthy as fresh so those can be more economical and they can stay longer in the fridge without going bad and again like you mentioned the Flyers and the uh coupons and the sales look out for those and make sure that um you're trying those out so yeah patients have to be really motivated I think meeting someone like you would really motivated them because I think I'm motivated much more motivated to eat healthy now too so um I appreciate that and uh thanks again for your time thank you
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