While the types of drugs that are suggested for different types of arthritis (such as osteoarthritis, rheumatoid, gout, etc.) may be different, the lifestyle and dietary recommendations are often the same, as they all try to reduce inflammation. This week I will review some dietary choices that can improve arthritis pain and prevent worsening of arthritis symptoms. I will be focusing on osteoarthritis, the most common form of arthritis. It affects an estimated 50 million people in the U.S. It is a large source of disability nationally with almost one-third of individuals with the condition reporting significant disability due to their symptoms. Some studies suggest that African-Americans deal with higher levels of arthritis pain compared to whites, making strategies for the management and improvement of arthritis symptoms especially important to our community.
There are many risk factors that increase the chances of developing arthritis. Some of these risk factors are fixed and others can change. Increasing age, previous injury, being female and a strong family history are the most common fixed risk factors. However, there is a wide range of risk factors that can change such as dietary factors, muscle weakness and deconditioning, being overweight, being a smoker and high levels of depression and stress. In this article I will focus on dietary factors.
Inflammation, a common disease pathway
Inflammation is increasingly a common recognized underlying cause of arthritis and many other chronic conditions (e.g. heart disease, diabetes, Alzheimer’s). Many of the medication treatments for arthritis are aimed at trying to decrease this inflammation. However, if one does not address the underlying causes for this inflammation, just taking a pill is not likely to be effective in the long run. There is increasing understanding that our diet can do a lot to influence inflammation in the body. While symptom improvement can often be seen within days of changing one’s diet, these benefits will only be maintained if a person keeps to the principles of an anti-inflammatory diet. In addition, one must work to address other lifestyle issues that contribute to inflammation (not smoking, limiting alcohol intake, getting adequate sleep and stress management).
There is a lot of information available regarding an anti-inflammatory diet. What follows are the basic elements of an eating plan to reduce inflammation:
Eat vegetables (a lot of them)
It is estimated that fewer than 10 percent of Americans eat three servings of vegetables per day. Eating a diet high in vegetables and fruit is associated with less severe arthritis changes. For optimal health of joints (and also weight control and increased energy), one should work up to eating between six and 10 servings of vegetables per day. How does one do this? This can be achieved by eating vegetables at all meals and incorporating them for snacks. To make this more affordable, choose vegetables that are in-season or frozen.
Eat healthy fats and avoid bad ones
Fat is an essential part of our diet and we need it for the healthy functioning of our cells. However, the wrong types of fats promote inflammation. The two main essential fats that our body needs are called omega-3 and omega-6 fats.
Omega-6 fats are very abundant in the American diet but studies suggest that having too much of this fat can increase inflammation. One study showed that individuals with worse knee inflammation had higher levels of omega-6 fats in the blood. To restore balance it is important to limit our intake of omega-6 fats and increase the inflammation-reducing omega 3 fats. The best sources of omega-3 are coldwater fish like salmon, mackerel, anchovies, sardines and herring. Try to eat at least a couple of servings per week. If one is not able to eat fish one can take a fish oil supplement. Flax seeds are also a rich source of omega-3 fats. A person can add them to cereal or grind them up in smoothies or use flax oil in salad dressings. People should store flax seeds and oil in the refrigerator. Pumpkin seeds and walnuts also contain some omega-3 fats.
Ways to avoid or decrease omega 6 fats include avoiding processed foods that often contain high amounts of (pro-inflammatory) fats such as corn, soy and vegetable oil. Avoid trans-fats at all costs, trans-fats are found in processed foods and are called things like hydrogenated or partially hydrogenated (please read labels).
Eat your grains whole
Choose whole grains over processed ones and consider choosing options other than bread and other wheat products, as some people are very sensitive to these. Good options include brown rice, oatmeal (not instant) and quinoa.
Cook with spices and seasonings that have anti-inflammatory properties. These include cayenne, turmeric, ginger, oregano, cloves and cumin. Also don’t forget the onions and garlic. Use them generously in your cooking.
I hope that these suggestions are helpful and that together we further explore the benefits of an anti-inflammatory diet. Within a few days our joints will be thanking us. No matter what age or health status, people are sure to reap benefits in health and functioning.
Dr. Winbush is a family physician practicing at NorthPoint Health and Wellness Center. She has a strong interest in wellness and patient education to help individuals feel empowered to optimize their health and functioning.