While there is no miracle food cure for arthritis, there are a number of diet strategies that may improve symptoms.
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The link between diet and arthritis has long been a source of overblown claims, confusion and controversy, often creating false hope and frustration for patients. As researchers gain more knowledge, backed by evidence from controlled trials, they are beginning to zero in on which foods might help or harm. What they do know is that there is no miracle food cure for arthritis, rather a number of diet strategies that can improve symptoms for many patients.
There are up to 100 different types of arthritis; two of the most commonly seen are osteoarthritis (OA), a disease affecting an estimated 17 million Americans, and rheumatoid arthritis (RA), occurring in about two percent of the population.
Osteoarthritis is sometimes called a “wear and tear” disease and is associated with aging. Seen most often in hip and knee joints, it occurs when the cartilage in joints breaks down.
Rheumatoid arthritis tends to develop between ages 30 and 50 and is seen more often in women. RA tends to affect multiple joints which become inflamed and cause pain, deformity and stiffness.
Numerous articles have been published regarding either positive or negative effects of various foods on RA. A recently published study conducted by researchers at Umea University in Sweden showed the benefits of a Mediterranean diet for patients with active RA. Although small, the study was carefully designed and tracked 51 patients over three months. Half of the subjects (25) followed the Mediterranean diet while the other half (26) followed a regular Western diet.
The Mediterranean diet (based on the dietary habits of the residents of the island of Crete) emphasized fruits, vegetables, cereals and legumes with plenty of fish and little meat. Fats came mainly from olive oil, and the subjects drank moderate amounts of wine. The diet of the control group was higher in fats from meat and dairy products.
After three months the Mediterranean diet group had less pain, inflammation and disease activity and fewer affected joints than the control group. Researchers concluded that the Mediterranean diet provided moderate relief to patients with mild to moderate active arthritis.
The benefits of the Mediterranean diet are consistent with a number of other diet studies that show the benefits of omega-3 fatty acids found in fish and olive oil and of fruits and vegetables, which are high in antioxidants.
Benefits of Fish and Olive Oil
Both fish and olive oil are rich in omega-3 fatty acids. Scientists know that fatty acids are precursors of prostaglandins some of which suppress inflammation while others make it worse.
Omega-3s suppress inflammation. In fact, fish oils have two of the most effective types of omega-3 when it comes to suppressing inflammation, DHA (decosahexaenoic acid) and EPA (eicosapentaenoic acid). The best sources of DHA and EPA are cold water fish such as salmon, mackerel, sardines, cod and halibut.
Omega-3s are also found in flaxseed oil, pecans, walnuts, green leafy vegetables and tofu. The plant-based omega-3s tend to have a less powerful effect than those from fish.
A diet high in fruits, vegetables, cereals, legumes, fish and olive oil provided moderate relief for RA patients.
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Most of the omega-6 fatty acids belong to the group that promotes inflammation. They include corn, sunflower, safflower and cottonseed oils–all commonly consumed in the American diet. Although you may not be aware you’re using these omega-6 oils, they’re abundant in the food supply in margarines and spreads, prepackaged convenience foods, cereals and baked goods.
Some scientists believe that our excessive consumption of omega-6 fatty acids may contribute to the development of arthritis as well as heart disease and other ills. Americans today consume 10 times more omega-6s than omega-3s. Although some omega-6s in the diet are okay, researchers at Tufts University believe the ratio should be closer to one to one. Historically, humans have consumed roughly equal amounts of omega-3s and omega-6s.
Vitamin C has been associated with a reduced risk of both osteoarthritis and rheumatoid arthritis.
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The Mediterranean diet in the Swedish study was also high in fruits and vegetables, good sources of antioxidants. There are a number of diet studies that show the benefits of high levels of vitamin C, beta-carotene and also of vitamin D in preventing arthritis.
A Finnish study that followed more than 1400 people for 20 years found that those with relatively low levels of beta-carotene (found in yellow, orange and leafy, dark green vegetables) were eight times more likely to develop RA than those with diets rich in beta-carotene.
High levels of vitamin C were associated with a lower risk of developing osteoarthritis, according to data from the Framingham Osteoarthritis Study. People who took in at least 152 milligrams of vitamin C per day (more than double the recommended amount) were only half as likely to develop osteoarthritis over the next two decades as those consuming smaller amounts.
What about the many foods commonly said to exacerbate arthritis symptoms?
Many diet studies of arthritis begin with a fasting phase. Most patients show an improvement in symptoms during this phase but tend to relapse as food is reintroduced. Foods often cited for causing inflammatory responses include pork, beef, dairy products, citrus fruits, wheat, rye, tomatoes (and other vegetables from the nightshade family including potatoes, peppers and eggplant), eggs, coffee, peanuts and alcohol.
Only a small percentage of patients with arthritis have a true food allergy and physicians warn about excluding entire food groups unless you know you have a definite food allergy. To determine if a specific food affects your arthritis symptoms eliminate a number of suspect foods for a least a month and then gradually reintroduce them one by one. Keep a food diary, tracking foods and symptoms so you can tell which ones, if any, help or hurt.
There is no cure for arthritis, but there are a number of things those with arthritis can do to manage and relieve the pain and inflammation they feel. Making sound diet choices has been shown to lower the risk of developing arthritis in the first place, and for those with established disease it may help control symptoms.
REFERENCES:
“Arthritis Diet Remedies: Fact or Folklore?” PDR Family Guide to Nutrition and Health, Annual 2001.
“Beating Arthritis with the Right Food Choices: Eating Right May Even Help You Avoid the Disease,” Tufts University Diet and Nutrition Letter, May 2002.
J. Kjeldsen-Kragh, “Mediterranean Diet Intervention in Rheumatoid Arthritis,” Annals of the Rheumatic Diseases, March 2003.
Evangeline Mantxioris et al, “Biochemical Effects of a Diet Containing Foods Enriched with n-3 Fatty Acids,” American Journal of Clinical Nutrition, July 2000.
“Olive Oil May Help Protect Against Rheumatoid Arthritis,” Tufts University Health and Nutrition Letter, February 2000.
“Pro and Con: Does Diet Influence Arthritis Pain?” Family Practice News, January 1, 2003.
Alan M. Rees, “The New Arthritis Relief Diet,” The Consumer Health Information Source Book, 6th ed., 2000.
Karen Rubin, “A $1 Billion Business: Arthritis and Diet,” Food Service Director, May 15, 2003.
L. Skoldstam et al, “An Experimental Study of a Mediterranean Diet Intervention for Patients with Rheumatoid Arthritis,” Annals of the Rheumatic Diseases, March 2003.
S. Kirk Walsh, “Freedom of Movement,” Vegetarian Times, November 2000.
