There are approximately 10 million people in the UK alone suffering from some form of arthritis. This disease of the musculoskeletal system presents itself in a wide range of form, with over 100 different classifications.
In general, arthritis symptoms include joint inflammation, stiffness, pain, and impaired function. There are a wide range of joints and surrounding tissues that can be affected, eventually leading to joint instability, deformation, and lack of mobility if not properly managed.
Unfortunately, at this stage there is no 100% cure for any type of arthritis, including the prevalent osteoarthritis and rheumatoid arthritis.
Nevertheless, there has been significant research into combination therapies that are making living with arthritis more manageable. In addition to medications, occupational therapy, and natural supplements, more people are subscribing to an arthritis diet consciously eating more of some foods and less of others.
How Important Is Diet For Arthritis?
Like many diseases, our diet affects our body’s ability to deal with arthritis. There are some foods which exasperate symptoms, while others can help to alleviate symptoms. By paying attention to the types of foods consumed, it’s possible to better manage arthritis.
There are several key dietary recommendations for people with arthritis:
- Maintain a well-balanced diet to support general health. A poor diet will not only negatively affect arthritis symptoms, it may also accelerate the progression of the disease and make the body more susceptible to other health problems.
- Avoid fasting or crash diets that place added strain on the body
- Increase calcium intake to minimise the risk of developing osteoporosis
- Maintain healthy fluid intake, drinking plenty of water.
- Keep bodyweight within a healthy range. Too much weight places extra stress on the joints, especially the hips and knees.
While these are good general guidelines, any arthritis diet should also focus on reducing inflammation, strengthening bones and cartilage, and reducing oxidative stress by elevating antioxidant intake.
The Problem With Inflammation
One of the key considerations in any arthritis diet plan is to avoid foods that promote inflammation. This especially applies to people already diagnosed with rheumatoid arthritis, psoriatic arthritis, gout, lupus, or ankylosing spondylitis.
Rheumatoid Arthritis (RA) is an inflammatory type of arthritis that usually affects knees. Rheumatoid arthritis of the knee the auto immune disease. The body’s immune system mistakenly attacks healthy tissue.
Rheumatoid Arthritis
After osteoarthritis, rheumatoid arthritis is the most common form of arthritis in the UK, affecting approximately 400, 000 people. Symptoms of this disease usually start to present themselves when the patient is aged between 40 and 50, although adults of any age can be affected. Rheumatoid arthritis affects more women than men1.
Although the exact cause of rheumatoid arthritis is not fully understood, it’s known that the immune system has an abnormal response that promotes joint inflammation, attacking cartilage and other tissues around the joint. This progressively damages the joint and causes stiffness and discomfort, ultimately impeding function and movement
Gout
This form of inflammatory arthritis develops in response to an abnormal build-up of uric acid. The body is unable to effectively expel this substance, leading to crystallisation and deposition within the joints. Gout is typically associated with the big toe; however the ankles, insteps, fingers, knees, wrists, heels, and elbows may also be affected.
Psoriatic Arthritis
People that have the skin condition psoriasis are at risk of developing psoriatic arthritis. Although there are variations in symptoms, inflammation is very common and can cause significant pain and discomfort.
Lupus
There are several classifications of lupus, although they all related to tissue swelling associated with an abnormal auto-immune response. Systemic lupus erythematosus is especially detrimental to joint health.
Ankylosing Spondylitis
Predominately associated with the spine, ankylosing spondylitis is a chronic inflammatory arthritis characterised by back stiffness and pain. Over time it can lead to ankylosis. Often other parts of the body are also affected by inflammation including the hip, shoulders, ribs, and hand and feet joints.
What Causes Inflammation?
One of the underlying causes of these arthritic diseases is inflammation. When joints become inflamed they attract more inflammatory agents and white blood cells that cause further irritation. This causes the synovium (joint lining) to swell and leak into the surrounding tissues.
This swelling causes the joints to become stiff, restricting movement and causing pain and discomfort. As a result the cartilage and bone can start to breakdown and thin, further aggravating the joints and leading to disease progression.
By gaining greater control over inflammation, it’s possible to reduce swelling. This will naturally reduce pain and discomfort, improving mobility and slowing joint degradation.
Controlling COX-1 & COX-2 with NSAIDs
One of the major underlying causes of joint inflammation are the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). These enzymes trigger the release of prostaglandins, key hormones that elevate inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are prescribed to block COX-2, acting as inhibitors to inflammation. However, long-term use of these drugs has detrimental side effects.
There is now a large shift towards natural compounds that can help reduce inflammation in combination therapies to treat arthritis.
Preventing Inflammation With An Arthritis Diet
The relationship between diet and arthritis inflammation is a very important consideration in any patient’s diet plan. Food contains different nutrients and other compounds that can impact inflammation both positively and negatively.
Some substances will aggravate inflammation, while others can help to minimise inflammation. Understanding which foods to avoid and which foods to include in your diet for arthritis can make a significant difference.
Strengthening Bones and Joints
Many people that suffer from arthritis are also at risk of developing osteoporosis. Therefore, any arthritis diet foods should contain nutrients that support the strengthening of the joints and bones.
Calcium, vitamin K2 (menaquinone), vitamin D, phosphorus, magnesium, and manganese are all important nutrients that support healthy bones and joints.
Calcium is essential for maintaining bone mass. However, for the body to effectively utilise calcium it needs the support of other nutrients.
Increasing Antioxidant Availability
Research shows that there is increasing evidence that oxidative stress plays a major role in the degradation of joints affected by rheumatoid arthritis16. Chronic inflammation is closely linked to elevated reactive oxygen species (ROS) that cause cellular damage17.
Not only does oxidative stress promote inflammation, it also has a direct impact on the joints by attacking important components of the structural tissue, such as proteoglycans, and stoping their synthesis18. Therefore, any rheumatoid arthritis diet plan should include plenty of antioxidants to try and reduce free radical activity.
An easy way to naturally increase dietary antioxidant intake is to eat an assortment of colourful vegetables and fruits each day. These foods are rich in anti-inflammatory antioxidants such as vitamin E, A, and C.
Other key antioxidant is the trace element selenium, which can be found in lean meats, seafood, poultry, peas, beans, eggs, seeds, and nuts. Copper, zinc, manganese, and iron are also important nutrients that can have antioxidant benefits due to their associated enzymatic activity with superoxide dismutases.
Antioxidant Therapy
The use of antioxidant therapy for the treatment of rheumatoid arthritis has been a subject of many recent studies. Antioxidants such as vitamin E and superoxide dismutase have been successfully used in therapy to treat inflammation in animal experiments19,20.
In human clinical studies, high doses of vitamin E over several months have been shown to support better disease control in patients suffering from rheumatoid arthritis21.
Other research has demonstrated that combination therapies using antioxidants together with conventional drugs22, or with omega-3 fatty acids23 can reduce the symptoms of inflammation and offer relief to people affected by rheumatoid arthritis.
While patients participating in these studies were given antioxidants via supplements, there is also evidence that natural dietary intakes of antioxidants can also help with the treatment of rheumatoid arthritis. For example, patients that adopt a Mediterranean-type diet naturally increase antioxidant intake and subsequently experience less rheumatoid arthritis activity24.
Other studies have also found that a healthy dietary antioxidant nutrient intake can reduce free radical formation and enhance the antioxidant activity in rheumatoid arthritis patients25. Certain micronutrients, such as beta-cryptoxanthine and zinc, together with a diet rich in cruciferous vegetables and fruit can have a protective role against the development of rheumatoid arthritis26.
Dietary Supplements
In addition to eating antioxidant rich foods there are plenty of supplements available that are enriched with essential nutrients that can reduce oxidative stress and associated inflammation. These joint care supplements are an important aspect of an rheumatoid arthritis diet plan.
What Foods Should You Avoid With An Arthritis Diet?
Everybody will react differently to various foods and there is no “perfect” arthritis diet. However, many people with arthritis should foods that are known to irritate inflammation.
Watch this short video for the 5 worst foods for arthritis
References
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- “Geusens, P. et.al. (2005). Long-term effect of omega-3 fatty acid supplementation in active rheumatoid arthritis. Volume 37, Issue 6, (pp. 824-9).” ↩
- “Yan, Y. et.al. (2013). Omega-3 fatty acids prevent inflammation and metabolic disorder through inhibition of NLRP3 inflammasome activation. Immunity, Volume 38, Issue 6, (pp. 1154-63).” ↩
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- “Huang, et.al. (2010). Vitamin B6 supplementation improves pro-inflammatory responses in patients with rheumatoid arthritis. European Journal of Clinical Nutrition, Volume 64, (pp. 1007-13).” ↩
- “Kanpen, M. et.al. (2013).Three-year-low-dose menaquinone-7 supplementation helps decrease bone lose in healthy postmenopausal women. Osteoporosis International. Volume 24, Issue 9, (pp. 2499-507).” ↩
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- Wruck, C. et.al. (2011) Role of oxidative stress in rheumatoid arthritis: insights from the Nrf2-knockout mice. Annuals of Rheumatoid Diseases, Volume 70, Issue 5, (pp. 844-50).” ↩
- “Altidag, O. et.al. (2007). Increased DNA damage and oxidative stress in patients with rheumatoid arthritis. Clinical Biochemistry, Volume 40, Issue 3-4, (pp.167-71).” ↩
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- “Mazzon, E. et.al. (2001). Amelioration of Joint disease in a rat model of collagen induced arthritis by M40403, a superoxide dismutase mimitic. Arthritis Rheum, Volume 44, (pp.2909-210. ↩
- “Behaska, A. et.al (2002). Mechanism of vitamin E inhibition of Cyclooxygenase activity in mocrophage from old mice: role of peroxynitrite. Free Radical Biology Medicine, Volume 32, (pp. 503-11).” ↩
- “Helmy, M. et.al, (2001). Antioxidants as adjuvant therapy in rheumatoid disease. A preliminary study. Arzneimittel-Forschung, Volume 51, Issue 4, (pp. 293-298).” ↩
- “Jaswal, S. et.al. (2003). Antioxidant status in rheumatoid arthritis and role of antioxidant therapy. Clinica Chimica Acta International Journal of Clinical Chemistry, Volume 338, Issue 1-3, (pp. 123-9).” ↩
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- “Hagfors, L. et.al. (2003). Antioxidant intake, plasma antioxidants an oxidative stress in a randomized, controlled, parallel, Mediterranean dietary intervention study on patients with rheumatoid arthritis. Nutrition Journal, Volume 30, (pp. 2-5).” ↩
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