Friday, July 23, 2010

Arthritis cannot be cured by diet, but some dietary changes may help

No special diet or ‘miracle food’ can cure arthritis, but some conditions may be helped by avoiding or including certain foods or supplements. Arthritis is a general term describing over 100 different conditions that cause pain, stiffness and (often) inflammation in one or more joints. Everyone with arthritis can benefit from eating a healthy, well-balanced diet.

For example, osteoarthritis and rheumatoid arthritis seem to respond to an increased dietary intake of fish oils, while gout benefits from avoidance of alcohol and offal meats. The supplements glucosamine and chondroitin may help symptoms of osteoarthritis, but not other forms of arthritis.

Always seek the advice of your doctor or dietitian before changing your diet. You may be restricting your food intake unnecessarily or taking too much of products (such as mineral supplements) that may have no impact on your condition at all. Some supplements can also interact with other medications.

General recommendations
General dietary recommendations for a person with arthritis include:

* Eat a well-balanced diet.
* Avoid crash dieting or fasting.
* Increase dietary calcium to reduce the risk of osteoporosis in later life.
* Drink plenty of non-alcoholic fluids.
* Keep your weight within the normal range, by reducing the amount of dietary fats you consume.

Dietary modification for gout
Uric acid is a waste product that is normally excreted from the body in urine. Gout is a type of arthritis characterised by the build-up of uric acid in the joints (such as the big toe), which causes inflammation and pain.

Dietary changes that may help to ease the symptoms of gout include:

* Restrict or avoid alcohol.
* Restrict or avoid offal meats, such as liver, kidneys and brains.
* Restrict or avoid shellfish, such as prawns and scallops.
* Restrict or avoid some seafoods including sardines, herrings, mackerel and anchovies.
* Restrict or avoid products containing yeast, such as beer and Vegemite.
* Drink plenty of non-alcoholic fluids.
* Make sure you don’t overeat on a regular basis.
* Take your time when eating.

Rheumatoid arthritis and osteoarthritis
Fish oils that contain omega-3 fatty acids have been found to help reduce the inflammation associated with some forms of arthritis, such as rheumatoid arthritis.

The omega-3 fatty acids seem to work by reducing the number of inflammatory ‘messenger’ molecules made by the body’s immune system. There may be additional health benefits to eating foods rich in omega-3 fatty acids, including a lowered risk of asthma and prostate cancer.

Foods rich in omega-3 fatty acids include:

* Oily fish (such as salmon and sardines)
* Linseeds and linseed (flaxseed) oil
* Canola (rapeseed) oil
* Walnuts
* Some fish oil supplements.

Ask your doctor before taking any supplements, to ensure the correct dosage. Fish liver oils (such as cod liver oil) contain high levels of vitamin A and should not be taken in large doses.

Other supplements
The supplements glucosamine and chondroitin are popular. Yet evidence about their success in treating arthritis is limited.

Studies show that glucosamine and chondroitin, taken either separately or in combination, may relieve pain for people with osteoarthritis (OA), where there has been a breakdown of cartilage. There is no evidence that these supplements are effective for any other forms of arthritis.

Glucosamine and chondroitin may interact with other medications, including warfarin, and should only be taken after consultation with your doctor.

Obesity may worsen arthritis symptoms
If you are overweight or obese, the extra load on your joints may be exacerbating your arthritis symptoms, especially if your affected joints include those of the hip, knee or spine. There is also a clear link between being overweight and an increased risk of developing osteoarthritis.

To lose excess weight you must be active, but this can be difficult for people with arthritis due to pain or stiffness. See your doctor, dietitian or health professional for information and advice. Weight reduction strategies may include:

* Switch to a diet that is high in nutrition, while low in kilojoules.
* Experiment with different sorts of activities – for example, it may be possible to enjoy swimming or some kinds of low impact exercises.
* Limit your exercise activities to unaffected joints – for example, if your hands are affected, you may be able to comfortably ride on a stationary bicycle.

Current evidence for dietary cures is sparse
Gout can be helped by avoiding some foods. However, there is no substantial scientific evidence that other forms of arthritis can be helped by avoiding particular foods, unless that person has specifically shown intolerance to them.

There is no evidence that acidic foods (such as lemons), ‘nightshade’ foods (such as tomatoes, potatoes and eggplants) or dairy foods trigger arthritis symptoms. These foods all contain important nutrients and avoiding them may be a health risk.

As research reveals more connections between diet and health, it is possible that stronger connections between particular foods and arthritis may emerge.

Tips for managing arthritis and diet
If you think a particular food may aggravate your arthritis, it can help to keep a diary of your food intake and symptoms. After a month, you may have some idea about which food could be provoking symptoms. You could then try removing that food from your diet for two weeks.

Don’t cut out a whole food category – for example, all dairy products – and make sure you are getting the vitamins and minerals that this food provides from other sources. It is important to let your doctor know that you are doing this.

Remember that remission may be coincidental
The symptoms of arthritis, particularly the inflammatory types, can change for no apparent reason. Don’t assume any improvement in your symptoms is due to what you eat or avoid. Be guided by your health professional.

Where to get help

* Your doctor
* An Accredited Practising Dietitian, Dietitians Association of Australia
* Arthritis Foundation of Victoria Tel. (03) 8531 8000 or 1800 011 041

Things to remember

* Arthritis is a general term describing over 100 different conditions that cause pain, stiffness and (often) inflammation in one or more joints.
* No special diet or ‘miracle food’ can cure arthritis, but some conditions may be helped by avoiding or including certain foods.
* Fish oil can ease the symptoms of inflammatory types of arthritis, such as rheumatoid arthritis.
* The symptoms of gout can be eased by avoiding alcohol and offal meats, and by drinking plenty of water.

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