Arthritis? Try the food fight

Nutrition for Arthritis

According to the 2017 Global Burden of Disease Study⁽¹⁾, 3 in 10 people in the UK suffer some type of muscular skeletal disorder, including osteoarthritis, rheumatoid arthritis, gout, low back pain and neck pain.  Randomised control trial studies relating to diet and supplements are limited but there is some evidence that certain interventions may have positive effects.  

Types of Arthritis.

There are varying types of arthritis, each requiring a differing approach:

1. Inflammatory arthritis includes auto-immune conditions such as rheumatoid arthritis (RA), ankylosing spondylitis, and lupus or Sjogrens syndrome.  Much of the research on inflammatory arthritis focuses on the gut-arthritis connection – yes the gut strikes again.  With RA, there is chronic joint inflammation, severe pain and swelling, joint damage and disability.

• Osteoarthritis and gout are often related to obesity, metabolic syndrome and diet. The inflammation in the body manifests itself in joint pain.  Injury and repetitive stress increases risk as does ageing.  The damage is caused by oxidative stress on the joints.

• Finally there are more rare forms of arthritis often triggered by issues such as Lyme Disease, environmental toxins, viruses, and bacteria.

Supporting arthritis with nutrition and lifestyle

Supporting arthritis is about identifying and supporting the root cause.  This could be through improved gastro-intestinal health, ensuring the right balance of nutrients in diet, weight loss, supporting stress and trauma, dealing with environmental exposure, eg heavy metals, pesticides, moulds, or identifying sources of infection. 

Nutrition and lifestyle wise, there are three steps to approaching arthritis – a therapeutic phase, a food phase, and addressing underlying stress factors.

Therapeutic Phase.  This phase relates to gut issues and amongst others, focuses on exposures that may exacerbate the condition.  For example, it is not uncommon to find that certain foods may aggravate the inflammatory response.  Whilst my approach with clients is generally to widen the diversity of foods, in arthritis (depending upon root cause), there is a case for identifying food-types that are inflammatory in nature. Eliminating these food-types in a systematic way helps to identify what may be aggravating the condition. Common inflammatories are gluten and gliadin (found in wheat and other grains), dairy, nightshades (tomatoes, potatoes, aubergines, peppers) and lectins (found in beans, lentils and grains). Elimination diets are temporary, requiring a strict approach to elimination and managed re-introduction to assist in the identification of potential inflammatory mediators.

Food Phase.  A good dietary strategy focuses on foods rich in antioxidants, are anti-inflammatory and support optimal gut health, since this is frequently where the stress and inflammation begins.  Foods should support the liver in order to reduce build-up of oxidative stress, allowing the liver to function properly.  A sensible weight loss plan is a key step for overweight osteoarthritis sufferers. Nutritional deficiency may need to be addressed.  Below is not a complete list but is a healthy start.

Bone Building Nutrients.  People with RA are at greater risk of osteoporosis due to bone erosion⁽²⁾. 

• Calcium  – yogurt, bones from tinned fish, green veg
• Magnesium – cocoa and pumpkin or chia seeds
• Potassium – fruits and vegetables
• Vitamin C – fruits such as berries and kiwi

Anti Inflammatory Foods (fibre, antioxidants and omega 3)

• Increasing fibre (especially from plants), fermented vegetables and cultured foods is a positive step for good gut function. 
• Foods high in polyphenols and anthocyanins, eg berries, plums, pomegranate, cherries, apples, oats, turmeric, black beans, as well as black and green tea, coffee, red wine, olive oil and dark chocolate are all your friends.   Anthocyanins may help ease the swelling associated with gout ^(3).
• Other antioxidants such as vitamin E, carotenoids and selenium may be supportive and are found in nuts, seeds and brightly coloured (orange) fruits.
• Omega-3 fats found in oily fish may also support a reduction in inflammation and improve joint stiffness⁽⁴⁾. 

For rheumatoid arthritis, a 2020 Systematic Review of Randomised Control Trials⁽⁵⁾ concluded that studies showed ‘moderate strength’ evidence for positive effects from a Mediterranean diet, spices (ginger, cinnamon, turmeric, saffron), antioxidants and probiotics.  Other diets or supplements had either no effect or low to very low strength of evidence.

Supplements

There are supplements and probiotics on the market that may or may not support arthritis conditions.  However many arthritis sufferers already take medications for their conditions and long-term use of arthritis medications may also lead to nutrient deficiencies. Don’t fall for the latest supplement being touted on the internet especially when taking medications.  A qualified professional will always carefully check any interactions with your medications and supplements to ensure there are no contraindications and that you are receiving the best benefit. They will also be alert for nutritional deficiency, which can be confirmed with testing.

If you would like to try a free 7 day arthritis support meal plan and more detail on nutrients, you can find one on my website.

References

1. Findings from the Global Burden of Disease Study 2017. (2018). www.healthdata.org
2. Nelson, J., Sjöblom, H., Gjertsson, I., Ulven, S. M., Lindqvist, H. M., & Bärebring, L. (2020). Do Interventions with Diet or Dietary Supplements Reduce the Disease Activity Score in Rheumatoid Arthritis? A Systematic Review of Randomized Controlled Trials. Nutrients, 12(10), 1–23. https://doi.org/10.3390/NU12102991
3. Norling, L. V., & Perretti, M. (2013). The role of omega-3 derived resolvins in arthritis. Current Opinion in Pharmacology, 13(3), 476–481. https://doi.org/10.1016/J.COPH.2013.02.003
4. Schett, G., & Gravallese, E. (2012). Bone erosion in rheumatoid arthritis: mechanisms, diagnosis and treatment. Nature Reviews Rheumatology 2012 8:11, 8(11), 656–664. https://doi.org/10.1038/nrrheum.2012.153
5. Zhang, G., Chen, S., Zhou, W., Meng, J., Deng, K., Zhou, H., Hu, N., & Suo, Y. (2019). Anthocyanin composition of fruit extracts from Lycium ruthenicum and their protective effect for gouty arthritis. Industrial Crops and Products, 129, 414–423. https://doi.org/10.1016/J.INDCROP.2018.12.026

By: Karen Geary