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Rodale
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TODAY
updated 4/18/2007 12:26:24 PM ET 2007-04-18T16:26:24

According to the National Institutes of Health, arthritis affects about one in every five people in the United States. In medical lingo, the suffix –itis means inflammation. Arthritis, then, means any disease that involves inflammation of the joints —and arthritis sufferers truly suffer.

Arthritis is not a single disease, but a category that includes many disorders that involve joints (osteoarthritis and rheumatoid are the most common). Osteoarthritis can wear down the knees and rheumatoid arthritis can twist and deform the fingers.

Many people with these two conditions don’t realize how much nutrition can improve the way they feel.

How food affects arthritis
Because arthritis is a disease of inflammation, the most effective — and logical — treatment is anything that fights inflammation. Medical management of arthritis usually starts with ibuprofen and other anti-inflammatory medications, and nutritional care starts with anti-inflammatory foods.

Before we get into my food specifics, I urge you to lose weight if you’re overweight. Being overweight puts extra stress on the joints, which increases the risk of wear and tear. In fact, every one pound of weight you lose equates to four pounds less stress and pressure on your knees! But there is another reason why being overweight is a problem. Body fat is not just an inert substance, it is metabolically active, capable of producing hormones and chemicals that actually increase levels of inflammation. By losing weight — and avoiding excess calories that can cause weight gain — you’ll automatically reduce the level of inflammation in your body.

When it comes to specific foods should you eat, an anti-inflammatory diet involves avoiding foods that make inflammation worse … and eating plenty of foods that reduce inflammation. To get the most out of nutritional changes, you should adopt both sets of recommendations. 

Foods to avoid
Saturated fats.
This category includes fats in and from animal products, such as fatty beef or pork, poultry skin, ice cream, butter, whole or 2 percent milk, regular cheese, bacon, bologna, salami, pepperoni, beef sausage, and other fatty foods. Saturated fats are also found in coconut oil, palm oil, and palm kernel oil. Instead of these unhealthy saturated fats, choose low-fat or no-fat dairy products, lean cuts of beef and pork, and skinless chicken and turkey.

Trans fats. These are man-made. In an effort to give baked goods a longer shelf life, scientists took common vegetable oil and added hydrogen molecules in the right places. The result was that liquid oil turned solid … and dangerous. Trans fats are thought to be at least as bad as saturated fats in terms of inflammation and other health problems. Maybe worse. Check labels and don’t buy food products with trans fat.

Simple and refined carbohydrates. Sugary foods, white flour baked goods, white rice, bread, crheumatoid arthritis ckers and other refined carbohydrates set up a state of inflammation in the body, causing increases in cytokines and other pro-inflammatory compounds. Limit these foods if you want the best chance of reducing arthritis pain and progression.

Foods to include
Omega-3 fatty acids: The healthiest of fats for people with arthritis or other inflammatory disorders are omega-3 fatty acids, one of the polyunsaturated fats. While other foods increase levels of inflammation in the body, omega-3s actually work to decrease inflammation by suppressing the production of cytokines and enzymes that erode cartilage. More than a dozen studies have demonstrated that omega-3 fish oils can reduce symptoms of rheumatoid arthritis. And although the evidence is less clear about how fish oil affects osteoarthritis, the anti-inflammatory effects of omega-3s are so potent that I recommend an omega-3 rich diet (and in some instances, fish oil supplements) to all my clients with arthritis. I’ve seen some amazing success stories. Some of the best foods for Omega -3 fatty acids include: salmon (wild, fresh or canned), herring, mackerel (not king), sardines, anchovies, rainbow trout, Pacific oysters, omega-3 fortified eggs, ground flaxseeds, walnuts, seaweed, and soybeans

Extra virgin olive oil: Olive oil contains the “good” monounsaturated fat, which protects the body against inflammation because it contains antioxidants called polyphenols. In animal studies, rats with arthritis were fed diets high in various kinds of oils. The researchers found that both fish oil and olive oil prevented arthritis-related inflammation. I recommend using olive oil when cooking, instead of vegetable oil or butter. Don’t load it on — just substitute one for the other in equal or lesser amounts. For the highest antioxidant content, choose “extra virgin” olive oil.         

Antioxidants
Inflammation produces free radicals, those cell-damaging molecules that are formed in response to toxins or natural body processes. Antioxidants, such as vitamin C, selenium, carotenes, and bioflavonoids, protect the body from the effects of free radicals, and are a critical part of an anti-inflammation diet. Research has demonstrated that certain antioxidants may help prevent arthritis, slow its progression, and relief pain. The best are vitamin C, selenium, carotenes (beta carotene and beta cryptoxanthin), and bioflavonoids (quercetin and anthocyanidins).

  • Vitamin C:Some of the best foods include guava, peppers (yellow/red/green), oranges, grapefruits, strawberries, pineapple, kohlrabi, papayas, lemons, broccoli, kale, potatoes and Brussels sprouts.
  • Selenium: Some of the best foods include Brazil nuts, tuna (canned light in water), crab, oysters, tilapia, lean beef, cod, shrimp, wheat germ and whole grains
  • Beta carotene: Some of the best foods include sweet potato, carrots, kale, butternut squash, turnip greens, pumpkin, mustard greens, cantaloupe, sweet red pepper, apricots and spinach.
  • Beta cryptoxanthin: Some of the best foods include winter squash, pumpkins, persimmons, papaya, tangerines, peppers (red chili and red bell), corn, oranges, apricots, carrots, nectarine, and watermelon
  • Quercetin: Some of the best foods include onions (red, yellow, white), kale, leek, cherry tomatoes, broccoli, blueberries, black currants, elderberries, ligonberries, cocoa powder (unsweetened), apricot, apple with skin (*Red Delicious), and red/pruple/black grapes
  • Anthocyanidins: Some of the best foods include blackberries, black currents, blueberries, eggplant, elderberries, rheumatoid arthritis spberries, cherries, boysenberries, red/black/purple grapes, strawberries, plum, cranberries, rhubarb, red wine, red onion, and apples.

Vitamin D: Although we mostly think of vitamin D as important for bone strength, it is also critical for a number of other body functions, including joint health. Studies have shown that getting adequate amounts of vitamin D reduces the risk of both rheumatoid arthritis and osteoarthritis. Among people who already have osteoarthritis, those who have a vitamin D deficiency are more likely to develop worsening disability over time. Getting even the basic daily requirements of vitamin D leads to greater muscle strength, improvement in physical functioning, and preservation of cartilage (that’s at least 400 IU until age 70, and at least 600 IU for folks 70 and older). Some of the best foods for Vitamin D include, wild salmon, mackerel (not king), sardines, herring, milk (skim, 1 percent, low-fat, skim plus), enriched soy milk, egg yolks, and mushrooms.

Spices
Certain spices, such as ginger and turmeric, seem to have anti-inflammatory effects, and therefore should be considered for arthritis treatment. Among the most promising are ginger and turmeric.

  • Ginger: Thishas been shown to lessen the pain of knee osteoarthritis when taken in highly purified, standardized supplement form. Ginger contains chemicals that work similarly to some anti-inflammatory medications, so its effects on arthritis pain are not surprising. However, ginger can also act as a blood thinner, so anyone taking a blood-thinning medication should collaborate with their personal physician while adding foods and beverages seasoned with ginger.          
  • Turmeric: Sometimes called curcumin, is a mustard-yellow spice from Asia. It is the main ingredient in yellow curry. Scientific studies have shown that turmeric may help arthritis by suppressing inflammatory body chemicals. Because of its effects on enzyme related to inflammation, turmeric may have the same mode of action as anti-inflammatory meds.  Note: turmeric is also used as a dye, so use caution when handling it — it can discolor clothing and some surfaces. Dig in and enjoy my curry chicken recipe (Click on my sample menu below for the recipe)

Supplements to consider

Osteoarthritis and rheumatoid arthritis

Multivitamins: If you would like to consider a multivitamin to supplement your healthy diet, I recommend choosing a brand that provides 100% DV of vitamin D (in the form of D3), vitamin C, selenium, and vitamin A (with at least 50 percent coming from beta carotene and/or mixed carotenoids, and no more than 2000 IU coming from retinol). Definitely do not choose mega-dose varieties, because some vitamins — notably vitamin C — can make certain cases of arthritis worse.

Omega-3 fatty acids from fish oil:  Eat foods rich in omega-3s, but for serious arthritis relief, you’ll want to try fish oil supplements. Rheumatoid arthritis studies have used various dosages, from 1.2 grams to 3.2 grams. I recommend you start with a daily dose of 2 grams. If you don’t have any relief after 4 weeks, speak with your physician about increasing to 3 grams. Because fish oil acts as a blood thinner, it should not be taken by people who have hemophilia, or who are already taking blood thinning medications or aspirin (always consult your physician). People with diabetes should talk with their doctors before trying fish oil supplements because they may affect blood sugar.

Osteoarthritis ONLY
Glucosamine plus chondroitin: These nutrients are naturally found in and around cartilage cells, and are thought to strengthen and stimulate growth of cartilage. The amounts generally recommended are 15000 milligrams glucosamine and 1200 milligrams chondroitin sulfate daily. These supplements are available anywhere you buy vitamins, and are sold individually or in pre-packaged combinations. This is a slow-acting treatment — you may not feel any difference for four weeks.

IMPORTANT NOTE: Glucosamine is extracted from shellfish shells (chitin), so if you have an allergy to shellfish, seek your doctor’s advice. If you develop a rash or other symptoms of allergy, discontinue taking it immediately. Plus, these supplements may thin the blood — if you are already taking blood thinners, or if you have a clotting disorder, consult your doctor.

SAMe:Some studies have shown that SAMe (S-adenosylmethionine) may be as effective as nonsteroidal anti-inflammatory medications. Recommended dose of SAMe for arthritis is 1200 milligrams per day. Even though SAMe is generally thought to be safe, it can have side effects, including insomnia, rash, allergy and gastrointestinal problems. To be safe, talk with your doctor before starting treatment with SAMe. For Rheumatoid Arthritis (GLA) — GLA (gamma-linolenic acid). This fatty acid is found in evening primrose oil, borage oil, and black current oil. Studies show that GLA seems to reduce pain, joint tenderness, and morning stiffness of rheumatoid arthritis by suppressing certain inflammatory substances. Recommended dosage is between 1 and 2 grams per day. Because the action of this supplement may interfere with certain medications, always talk with your doctor before taking GLA.

Rheumatoid arthritis:
GLA (gamma-linolenic acid).This fatty acid is found in evening primrose oil, borage oil, and black current oil. Studies show that GLA seems to reduce pain, joint tenderness, and morning stiffness of rheumatoid arthritis by suppressing certain inflammatory substances. Recommended dosage is between 1 and 2 grams per day. Because the action of this supplement may interfere with certain medications, always talk with your doctor before taking GLA.

For more information on healthy eating, visit TODAY nutrition expert, Joy Bauer’s Web site atwww.joybauernutrition.com.


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