Arthritis – what should you do?
Arthritis is a problem for 2.5 million Australians. A couple of people have asked me about it, so I'm discussing it - on the proviso that this is general advice and anything specific should be discussed with your doctor.
Arthritis involves inflammation and thickening in the joints. The most common type is osteoarthritis, and it affects various joints, most commonly those in the knees, hips, ankles, wrists, fingers and toes. Osteoarthritis gets worse with age and the fact that we're living longer is a major reason why it's more common. Even more relevant, however, is the great increase in overweight and obesity. The more weight the knees and ankles must bear, the greater the strain on them, and the higher the risk of osteoarthritis.
Rheumatoid arthritis is much less common, but is a serious inflammatory disease in which the body's immune system malfunctions and starts to attack the joints. It is not related to excess body weight, and the joint changes and pain are accompanied by weight loss and fever. Rheumatoid arthritis sometimes goes into remission. No one really knows why this occurs.
Gout is also a form of arthritis in which crystals of uric acid accumulate in joints. It usually affects the big toe, but can occur in the knees, wrists, thumbs or ankles. Contrary to popular belief, you don't get gout by drinking port and eating steak, although rich food or alcohol can trigger an attack. The reason for this is that when the body is trying to excrete alcohol or cope with lots of fat, it doesn't handle uric acid well.
The fact that some types of arthritis tend to come and go for no apparent reason has led to many unproven causes and remedies. If you eat (or don't eat) some food when arthritis goes into spontaneous remission, it's tempting to think that food is a cure (or cause). Studies comparing reactions to particular foods in large numbers of people do not support the popular idea that certain foods cause or cure arthritis. However, some people can have adverse reactions to certain foods.
What can you do?
The most important way to prevent and treat osteoarthritis or gout is to keep your weight normal. Excess weight puts extra stress on joints. If you are overweight, try to lose weight, but do it slowly, especially if you have gout. Sudden weight loss can trigger an attack of gout. Do as much exercise as your arthritis allows. For some people, the most suitable forms of exercise may be in water or on a bike.
The best way to lose weight is to adopt a sensible eating pattern, low in saturated fat, added sugars and alcohol. In practice, eating three healthy meals and avoiding snacks between meals (apart from a piece of fruit) makes good sense.
For those with rheumatoid arthritis, there is good evidence that omega 3 fatty acids from fish oil capsules or fish can help reduce some of the inflammation. There is currently little evidence that omega 3s help with osteoarthritis, but since these fats offer value for almost everyone, it can't hurt to consume them. Two fish meals a week is recommended. Sadly, world fish stocks can't support that for everyone, but there are some sustainable fish for Australians. Canned fish is a good source of omega 3s.
If you can't eat fish, try fish oil capsules. Meat from grass-fed animals also contains some omega 3 fats. Grain-fed beef has virtually none.
Linseeds (also called flaxseeds) provide some omega 3 fats - although they are different from those in animal products. Eat the linseeds rather than using the oil, because the oil goes rancid almost as soon as it's extracted from the seeds, and rancid oils do more harm than good.
Including lots of fresh fruit and vegetables is potentially valuable for arthritis.
Many people ask whether a vegetarian diet would help. Researchers in Finland have shown that a vegan diet (no animal foods) may be useful, but it's possible that the benefits were due to a high intake of berries, fruits, vegetables and nuts. One Greek study reported that vegetables cooked with olive oil gave some protection against rheumatoid arthritis. Whether the olive oil had any specific benefit is unclear - it may just have made the vegetables taste good enough to ensure a high consumption.
Many people with arthritis avoid foods from the nightshade family (tomatoes, eggplant, capsicum, potato), but there is no good evidence they cause or make arthritis worse. However, a small number of people with rheumatoid arthritis may be sensitive to amines, which are found in tomatoes, eggplant and capsicum.
There is no evidence that the acidity of citrus fruits or pineapple has any adverse effect. In any case, the acid in these foods is weak in comparison with the acid normally found in the stomach.
The take home message
1. If you have osteoarthritis, lose any excess weight.
2. Avoid fried or fatty foods, added sugars, fats and alcohol if you need to lose weight.
3. Include plenty of vegetables and fruit, some nuts and some seafood in your diet.
4. Get as much exercise as you can. Consider swimming or aquarobics, or cycling as they do not put stress on the joints. A physiotherapist may be able to help.
5. If you have rheumatoid arthritis, try to follow a well-balanced diet and include seafood and/or fish oil capsules. Your doctor will advise about appropriate medications. ☼