Arthritis and diet

There is no cure. A balanced diet, exercise, medications, hot and cold packs, and surgery may relieve pain, swelling and stiffness and improve mobility. No single treatment works for everyone or for all types of arthritis. Symptoms can come and go, suddenly making it difficult to evaluate if treatments work. Yet, Americans spend over $1 billion annually on alternative therapies (e.g., herbs, dietary supplements, vitamins).

How can you reduce your risk of arthritis? Can diet help prevent it?

Common types: The most common types of arthritis include:

Osteoarthritis—Degenerative disease affecting large weight-bearing joints (e.g., knees, hips, fingers, feet, back). Breakdown of cartilage that cushions joints. Can lead to bone spurs. Affects over 20 million adults over age 45.

Rheumatoid arthritis—Inflammation in many joints (e.g., hands, feet, wrists, ankles, jaw, neck, shoulder, elbows, knees, hips) leading to crippling stiffness. Caused by abnormal immune response. Affects 2.5 million people (mostly women starting between ages 30 and 50). May cause fatigue, weight loss, fever and muscle wasting.

Fibromyalgia—Affects muscles and their attachment to bones. Causes stiffness, fatigue, disturbed sleep and pain, especially around neck muscles. Affects 3.7 million people (mostly women).

Lupus—Autoimmune disease (body attacks itself) that can damage joints along with the skin, kidneys, heart, lungs and central nervous system. Affects 250,000 people (usually women beginning between ages 18 and 45). Avoiding large amounts of alfalfa seeds and sprouts may be beneficial.

Gout—Inherited metabolic disorder affecting 2.1 million people (mostly men). Body accumulates excess uric acid. Leads to cartilage and joint damage in knees, wrists and big toes. Diet therapy includes weight loss, increasing fluid intake and limiting alcohol, fat, protein, caffeine and high purine foods. The latter include organ meats like liver, fish, sausages, eggs, meats, gravy, beans, spinach, mushrooms, asparagus, cauliflower, oatmeal and chocolate.

Elimination diets: Fasting or avoiding specific foods such as "nightshade" vegetables (e.g., potatoes, tomatoes, eggplant, peppers) will probably not relieve the pain of rheumatoid arthritis. Omitting entire food groups may exacerbate symptoms and cause nutrient deficiencies. For a small percentage of people, avoiding one or two foods (that cause allergic reactions) may slightly improve rheumatoid arthritis.

Vegetarian diets: It's not clear why or if vegetarian diets can improve symptoms of rheumatoid arthritis. Scientific studies had inconsistent results. The types of vegetarian diets (e.g., lacto-vegetarian, vegan) varied, too. Long-term research is needed.

Omega-3 fats: Fish oils containing omega-3 fats (e.g., DHA and EPA) have anti-inflammatory action, which may improve rheumatoid arthritis. But, benefits from supplements may be modest, temporary and slow to appear (12 weeks). Supplements are high in calories and cholesterol and may increase risk of bleeding strokes.

The best food sources of omega-3 fats are coldwater fish (e.g., salmon, sardines, tuna, mackerel and halibut). Less omega-3 fats are available from flaxseed, nuts, beans, canola, olive and soybean oils, green leafy vegetables and tofu.

Gamma-linolenic acid (GLA), an omega-6 fat that acts like an omega-3 fat, may also help reduce symptoms of rheumatoid arthritis. GLA is found in borage seed, currant seed and evening primrose oils.

Vitamins and minerals: "Free radicals" (unstable oxygen molecules) that form in our bodies may worsen inflammation in arthritic joints. Theoretically, antioxidant vitamins (e.g., C, E and beta carotene) and minerals like selenium may provide protection by neutralizing free radicals.

Taking supplements or eating foods containing these antioxidants may reduce cartilage loss and/or slow the progression of osteoarthritis (e.g., vitamin C) and rheumatoid arthritis (e.g., vitamin E). Dietary and supplemental vitamin D builds bones and may also slow cartilage breakdown in osteoarthritis.

Dietary supplements: The National Institutes of Health (NIH) is conducting a large study with glucosamine and chondroitin supplements (alone and together). They may promote cartilage growth or reduce its breakdown, slow progression of osteoarthritis, relieve pain and improve mobility. Long-term safety and benefits of other supplements (e.g. MSM, SAM-e) are also unknown.

What to do: To help prevent and treat arthritis, here are three tips:

For more information, contact the Arthritis Foundation at (800) 283-7800 or visit www.arthritis.org