Feeling stiff? A little achy in the joints? Your diet can deliver relief from arthritis and even prevent this disease. Nutritionist Bronwen King tells how.
If you suffer from arthritis or know someone who does — it affects 3.85 million of us — you understand how debilitating it can be.
What is arthritis?
There are around 100 forms of arthritis. Each has specific symptoms, but the most common include pain; swelling, redness or warmth in a joint; stiffness or reduced movement in a joint; and even feelings of fatigue or malaise. Here are the three main types:
This is the most common form of the disease. As the result of wear and tear on joints, this disorder is caused by the damage to cartilage, the flexible connective tissue that covers the bones’ ends where they meet to form a joint. Elderly and overweight people are more prone to osteoarthritis, which can also affect joints that endure heavy use, such as hips, knees and thumbs.
A chronic autoimmune condition, its sufferers experience inflammation that causes the tissues in and around affected joints to swell and stiffen, causing pain. Although inflammation is the body’s normal way of healing, rheumatoid inflammation occurs for no apparent reason and recurs constantly. More common in women, this disease can start when we’re anywhere from 20 to 55 years old.
Gout is caused by a build-up of uric acid in the blood. This form of arthritis occurs mainly in the foot, particularly the big toe, where uric acid crystallises in the joints, causing damage and severe pain. Gout affects men more than it does women.
We tend to think of this common condition as a disease of ageing, but arthritis can strike at any time. Fortunately, health experts now recognise that our diet and lifestyle can play a vital role — not only in delaying the onset of this pervasive disease, but also in controlling the degree of discomfort and pain. Here’s everything you need to know.
Enjoy a healthy diet
Eating a balanced diet can help slow arthritis symptoms and even prevent its onset. In fact, making your menu as healthy as possible can alleviate the side effects of even heavy medication. Pile your plates with generous amounts of fruit and vegies plus wholegrain breads and cereals, along with legumes (such as beans, lentils and chickpeas), nuts, seeds, lean meat, fish and low-fat dairy foods.
People with arthritis need to pay particular attention to their intakes of calcium, vitamin D and iron, because insufficient amounts seem to be linked with a more rapid progression of the disease.
Calcium is crucial to our bones. Being deficient in this key mineral ramps up the risk of osteoporosis (especially in postmenopausal women), as does the long-term use of steroids. Happily, you can lower this risk by ensuring that your eating plan includes dairy foods such as milk, cheese and yoghurt. Following a dairy-free diet? You can now find plenty of calcium-enriched soy, rice, nut and oat milks. This bone-building mineral is also present in fish with intact bones, including canned varieties of sardines and salmon.
To absorb and utilise calcium, you need vitamin D. Your body can produce D, but only when you expose your skin to sunlight, so if you cover up in winter (or for religious or cultural reasons), you might not produce enough. You can also find the ‘sunlight vitamin’ in many foods, including oily fish, which is a rich source. A simple blood test can determine your D levels, so see your doctor if you have any niggling concerns.
Iron is central to the prevention of anaemia, a common condition in people with arthritis. Anaemia is a symptom of chronic disease, such as rheumatoid arthritis, and it’s also a possible side effect of non-steroidal anti-inflammatory drugs (NSAIDs), which include ibuprofen and aspirin.
To pump up the iron in your diet, eat red meat, oily fish, eggs, legumes and leafy dark-green vegetables. Adding vitamin C to the mix will boost your body’s iron absorption even further. Try eating more C-rich foods, such as oranges, berries and broccoli. If you still feel tired after doing this and suspect you have low iron levels, talk to your doctor.
A traditional Mediterranean diet can help you achieve all of the above. Studies suggest that this diet is anti-inflammatory, so it can help relieve inflammatory types of arthritis. The Med diet also promotes good health and a healthy weight, both of which benefit people who have other forms of the disease. (See our article Explore the Mediterranean for more.)
Add healthy omega-3 fats to your diet
Both omega-3 and omega-6 fatty acids help control inflammation. Our bodies can’t make either of these essential fats, so we have to source them from our diets. Getting the balance right is also critical to the way they affect us. Having a high intake of omega-6 fats stimulates inflammation, and so does consuming insufficient omega-3 fats, because this results in less anti-inflammatory action.
Most Australians (and other westerners) consume more than enough omega-6 fatty acids from vegetable oils and margarines, but adding enough omega-3s to your diet takes a little more effort. (Top sources include oily fish, linseeds and walnuts.)
To ensure an adequate intake of omega-3s, the National Heart Foundation recommends we eat oily fish, such as tuna, salmon, sardines, herring or mackerel, two to three times a week.
Keep a food diary
Ask anyone with arthritis about what they think aggravates their symptoms, and they’re likely to give you a long list of foods. The usual suspects include red meat, alcohol, citrus fruit, sugar, fats, salt, food and drinks that contain caffeine, and nightshade plants (such as tomatoes and eggplant).
Keeping track of what you eat and the severity of your arthritis will help you make some clear food–symptom connections. Try taking any possible culprits off the menu and watch for signs of improvement. But wait — before you ban anything for good, talk to a health professional, such as an Accredited Practising Dietitian. Eliminating certain foods could seriously compromise your intake of nutrients your body needs.
Lose that excess weight
Shedding kilos appears to ease all forms of arthritis. People with osteoarthritis definitely benefit from lightening the pressure on their joints. For arthritis sufferers, fat is a double whammy, because it also produces pro-inflammatory chemicals. Losing weight reduces this inflammation and hence the symptoms of rheumatoid arthritis and other inflammatory forms of the disease. People with gout can also gain some relief if they drop a few kilos. Carrying less weight lowers their uric-acid levels, alleviating painful symptoms.
Eat to beat gout
You can substantially control gout with the right diet and lifestyle changes. To relieve symptoms, you need to lower the level of uric acid in your blood, which is just what the following strategies do.
Eat fewer purine-rich foods, such as meat, chicken and seafood. (The compound purine is a precursor of uric acid.) Downsize your portions or choose alternative high-protein foods, such as low-fat dairy products, eggs and legumes (beans, chickpeas and lentils)
Drink less alcohol, especially beer
Drink fewer fructose-rich beverages, such as soft drinks, energy drinks and fruit juice
Drink plenty of water
Can supplements soothe the pain?
Many people with arthritis find they can ease their symptoms with the following supplements.
Rheumatoid-arthritis sufferers who have an adequate intake of omega-3 fatty acids may experience less inflammation, stiffness and joint pain. If you’re not a fan of fish, or worried that you’re not getting enough omega-3 fats, try fish-oil supplements. To reduce inflammation, Arthritis Australia suggests you take at least 2.7g (2700mg) of the long-chain omega-3 fatty acids EPA and DHA every day. If you use supplements, make sure you buy a reputable brand and follow the instructions to work out the dose you need.
Green-lipped mussel extract
Another good source of omega-3 fats that shows some promise for the treatment of arthritis. Evidence suggests that people with osteoarthritis can find some relief by taking this mussel extract with paracetamol or certain anti-inflammatory drugs (such as aspirin, ibuprofen or naproxen), but that it’s ineffective at treating rheumatoid arthritis. The best approach? Seek professional medical advice before taking this supplement.
Often combined with chondroitin in joint-support formulas. In theory, taking these supplements should improve joint health because cartilage contains both of these compounds. Even so, results of research into glucosamine and chondroitin’s effectiveness at treating osteoarthritis remain unclear. Although some health experts say they’re little more than placebos, these relatively safe options are virtually free of side effects, so you can give them a try.
According to Arthritis Australia, a daily dose of 1500mg of glucosamine sulphate is enough. If you see no improvement in four to six weeks, there will be little point in continuing with it. The best way to manage your arthritis is to talk to your doctor about alternative strategies.
Did you know? Nearly 20 per cent of Australians have arthritis, and though we have no cure, the strategies on these pages can help.
Try a little patience: What works for one person mightn’t work for another. Finding relief from arthritis is a process of trial and error.