Diet for Osteoarthritis
by Sue Kira, Naturopath & Clinical Nutritionist
– Inflammation of the tissues in and around the joints, causing pain, stiffness and sometimes immobility
– Damage to cartilage, which is the strong, smooth surface lining the bones and allows our joints to move easily without friction
– Bony growths that develop around the edge of the joints, causing even more pain, stiffness and immobility as well as disfigurement.
Osteoarthritis mostly occurs in the knees, hips and small joints of the hands, base of the big toe and neck, but almost any joint or many joints together can be affected.
Because Osteoarthritis is considered an inflammatory disorder, an anti-inflammatory diet will support the work you may be doing with your health practitioner.
Osteoarthritis is the most common chronic joint disease, causing large amounts of pain, inflammation and disability for many people, particularly those aged over 50.
Some people seem to think that getting arthritis is a natural part of aging – well it’s not really. There are people in their 90’s without arthritis and others in their 20’s with arthritis. It is more prevalent in the aging population but old age is not the cause.
Why do some get arthritis and others don’t? Some postulate that there is too much acid in the body from highly refined foods which increase inflammation, such as a high acid or sugar diet. Some say it’s due to excessive use of the joints or joint injury. Some speculate viral or other infection damage to joints. Excess weight can be another contributing factor. And genetics can contribute to the development of arthritis.
In this article I refer to osteoarthritis. For Rheumatoid Arthritis an Auto-immune supportive diet is recommended, and for Gout Arthritis a Low Purine Diet is suitable.
With an arthritis diet you have plenty of options to eat foods rich in Omega 3 fatty acids from fish and seafood, nuts and seeds as well as good sources of nutrients from fresh vegetables and salads.
It is also advisable to look at removing other things that can increase inflammation such as alcohol, caffeine, additives and cigarettes. Also, ensure that any medication you take suits your body. Most importantly, get good advice from a qualified health care practitioner.
Note: During the early stages of a new diet, you may experience symptoms such as fatigue, headaches or body aches, which may occur because your body is detoxifying. However, if you are unsure about a symptom at any time, check immediately with your medical or health care professional.
Having a diet low in processed foods and rich in fruits, vegetables, fish, nuts and beans is great for your body.
Research confirms that eating these foods can help arthritis by reducing inflammation, as well benefiting your joints and your heart health as a bonus. Losing weight can make a huge difference to manage joint pain.
Whether you call it a Mediterranean diet, an anti-inflammatory diet or simply an arthritis diet, here are some key foods to focus on and why they are so good for joint, cartilage and connective tissue health.
Fish such as wild caught salmon, tuna, sardines, herring, anchovies, scallops and other cold-water fish are good sources of the inflammation fighting omega-3 fatty acids.
Nuts & Seeds such as walnuts, pine nuts, pistachios, macadamia nuts and almonds along with pepitas, sunflower seeds and sesame seeds also have an anti-inflammatory effect because of their good oil status. They are also rich in B6, which also helps to reduce inflammation markers in the body.
Nuts and seeds are a good source of protein, fibre and very satisfying for appetite control and weight loss. But be mindful that a little goes a long way and too many nuts and seeds can pile on the calories/kilojoules, so only a handful a day is sufficient. If you are trying to put on weight, then nuts and seeds are not a problem – go for it.
Fruits and vegetables are loaded with antioxidants. These potent chemicals help to neutralise unstable molecules in the body called free radicals that can damage cells. Compounds such as anthocyanins found in red and purple fruits like cherries, strawberries, raspberries, blueberries and blackberries, purple carrots and purple cabbage have an anti-inflammatory effect to support your joints.
Citrus fruits such as oranges, grapefruits, lemons and limes are rich in vitamin C which not only help to prevent inflammatory arthritis, but also maintain healthy joints by supporting the cartilage and connective tissue.
Vitamin K-rich veggies such as broccoli, spinach, lettuce, kale and cabbage dramatically reduce inflammatory markers in the blood, stops blood from being too sticky and boosts vitamin and mineral levels, including silica.
Silica supports all connective tissue and cartilage and can give you great hair, skin and nails. Be cautious with an over-use of vitamin K rich foods if you are taking blood thinning drugs. Seek medical advice when it comes to adding more of these foods to your diet.
Olive oil is loaded with a natural substance called oleocanthal, which has properties similar to non-steroidal anti-inflammatory drugs, such as ibuprofen, which inhibit the activity of damaging pro-inflammatory enzymes.
Extra virgin olive oil goes through less refining and processing, so it retains more nutrients than processed varieties. So why not splash some olive oil over your salads and vegetables to help reduce pain and inflammation.
While olive oil is not as strong as anti-inflammatory drugs, every bit helps when trying to limit the amount of drugs in your system.
Beans are loaded with fibre and phytonutrients, which help to reduce inflammation found in the blood. Bean varieties, such as red kidney beans and pinto beans have a host of antioxidant and anti-inflammatory compounds, as do many other bean varieties.
Arthritis is ‘inflammation’. Any word that ends in ‘itis’ means inflammation and so the definition of arthritis is that the joints are inflamed.
Inflammation is a natural part of the healing process. However, the problem occurs when inflammation remains in our bodies for far too long, creating havoc.
Inflammation is now considered to be one of the major contributors to numerous disease processes. That’s why it is so important to consider dietary changes that will encourage the body to reduce inflammation.
Two-thirds of our immune system is in our gut to protect us from what goes into our intestines before being absorbed inside our bodies, including our blood. The immune system responds to foods it doesn’t think are right for it, or are not digested properly, and when the immune system reacts, it creates inflammation in the gut.
In an inflamed state the digestive system cannot absorb nutrients properly, so we are left with insufficient nutrients to help the body to heal, regenerate or operate to full capacity.
Foods that we are intolerant to (whether we feel it or not) prime the immune system and create inflammation. When we get pain from inflammation, it might be pertinent to consider ‘what have I eaten to create that pain?’
But instead, many think they are ‘getting old’ or have a condition that needs drugs. In some cases this is true, but it is important to listen carefully to how our bodies talk to us.
“The most pro-inflammatory thing we do every day is to eat. Food can be either inflammatory or anti-inflammatory and the only neutral substance we consume is water.”
This statement was made in a webinar by Dr Thomas O’Bryan about auto-immune conditions including arthritis. He specialises in gluten sensitivity, celiac disease and metabolic disorders.
Probably the worst food offender that stimulates inflammation in many people is gluten. Gluten has been termed the silent killer as it can create inflammation and block absorption of nutrients which then leads to other potentially fatal conditions. (I suggest to read that sentence again).
Gluten free grains such as whole grain quinoa (pronounced kin-waa), brown rice, red rice, black rice, buckwheat (not a wheat) and chia (more a seed than grain) are considered less inflammatory – some would even say anti-inflammatory.
But be aware that for some, all grains can stimulate inflammation. If you are in a lot of pain from arthritis, you may wish to go completely grain free to start with, then later, introduce some of these lesser inflammatory grains back into your diet and see how your body responds.
Other substances in your diet that may create or add to inflammation can include:
– anything you have an intolerance or allergy to
– processed foods
– food additives
– pretty much anything white (there will be exceptions)
– anything containing sugar, high fructose corn syrup or similar
– any caffeine
– all dairy products (which can be an issue for many)
– even certain vegetables (see below)
Nightshade vegetables include eggplants, tomatoes, potatoes and red bell peppers (capsicum). They are nutritious, yummy veggies that can be very good for some people with arthritis, but for others, trigger more pain in arthritic joints.
This is one food group that you will need to feel into for yourself. If you intend to follow an Osteoporosis Diet, I recommend avoiding nightshades for a few weeks and then if things settle for you, try to re-introduce them and see if the pain flares up again. If it does, then try to avoid these foods.
Client name and identifying information changed
Mary came to me with multiple joint pains, but the pain was mainly in her fingers, wrists, elbows and shoulders, plus some in her neck and knees. She played a lot of tennis when younger, so she wasn’t surprised which joints were affected.
Her doctor offered her pain relief but she wanted to see if there was anything else she could do to help prevent the situation from getting worse, as she had witnessed her grandmother with crippling arthritis to the point where she couldn’t use her hands and was on lots of sedative drugs.
A retired woman on a pension, Mary couldn’t afford fish oil and green lipped muscle extracts and other supplements often used to support osteoarthritis naturally. She asked if her diet could be altered to help.
Mary’s diet consisted of a good core of veggies, especially greens and also lots of tomatoes, some fruit and a quality muesli with nuts and seeds to provide good omega fats.
She had a sweet tooth and loved coffee with biscuits, cakes or chocolate daily. She also drank three glasses of red wine each night, which she thought was good for her. She accompanied every meal with either toast or bread and ‘loved’ cheese.
So the first thing we talked about was her high acid diet with the bread, sugar and processed foods. We also spoke about how wine could be a factor and even how tomatoes are a potential problem for some people with arthritis – although more so with Rheumatoid arthritis – but it was worth a shot to see if she could improve by being off them.
I suggested it would be beneficial to do a dietary detox by removing the high acid foods and wine and see how her body responded. Then later, if she had less pain and inflammation, we could re-introduce some of the foods back into her diet to see what she could tolerate or what upset her system or brought back the pain.
She agreed and went on a 12-week gluten free, dairy free, sugar free, nightshade family free (tomatoes, eggplant, capsicum, potato), alcohol and caffeine free diet. Mary kept her core clean diet and added in some more fish meals, and soaked her nuts and seeds to ‘activate’ them so there were easier to digest. She drank peppermint and dandelion teas and the occasional water filtered organic de-caff coffee (once a week with her weekly meetings with friends).
Mary came back to see me one month into the diet and said she had never felt better, had minimal pain, more energy and vitality and her friends said her skin looked better. She looked younger.
She was very pleased with the results and wanted to start to re-introduce some foods, but because she still had some remaining low-level pain, I suggested waiting longer. She agreed, but a month later at a follow-up appointment, she said that she had been ‘naughty’.
She told me that after another two weeks on the clean diet, she had no pain at all, so she took it upon herself to trial some foods and drinks, but got a bit carried away and included everything back that she previously stopped eating and drinking. Within two days all pain was back. Fortunately, she went back to the clean diet and it only took three days for things to settle again.
A month later, we re-introduced foods slowly and found that she was fine with the tomatoes and other nightshades, and coffee was ok if she only had a cup once every two to three days (which produced little tingles in her fingers).
But every time she put any starchy or sugary foods back into her body her joints would strongly react. She was happy that she could still have some low sugar, dairy free chocolate occasionally and the occasional coffee.
Overall, she was delighted to find a balance she could live with and still have something ‘naughty’ now and then.