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August 3, 2011 ·
DIET AND ARTHRITIS
By Shona Wallace
Until recently, the diet of people living with arthritis was not thought to affect their
illness. However, in reality, what we eat plays a major role in the general health of all of
us, and there is convincing scientific evidence that the food we eat could help diseases of
the joints. Joints, which are at the spaces separating the ends of bones, are capsules filled
with fluid. The ends of the bones are a rubbery tissue called cartilage. Arthritis happens
when the normal processes going on in the joint go wrong. Here, I write about two
different types of arthritis: osteoarthritis and rheumatoid arthritis.
In osteoarthritis, the breaking down and rebuilding of the joint cartilage leads to aching
joints which become sorer with use. Researchers have not come to definite conclusions
yet about the diet that is best for an osteoarthritis patient, but what follows are some of
the possibilities raised by research in the last few years.
OBESITY
There is strong evidence that being very overweight (obesity) increases the chances of
getting osteoarthritis, and that if you are overweight, losing weight improves the
symptoms of osteoarthritis. Scientists believed this was because the large weight load
strained the joints, but as obese people also develop more osteoarthritis of the hand than
non-obese people, there may be a metabolic cause. The best way for a very overweight
person to lose weight is to ask their GP for a consultation with a dietician. The important
things are to cut down on fats and oils (they have the highest number of calories per gram
of any food), avoid oily or sugary snack foods, and eat more vegetables, bread and
cereals.
ANTIOXIDANT NUTRIENTS: VITAMIN C AND
VITAMIN E
Osteoarthritis is more common in older people, and antioxidant nutrients are thought to
protect against diseases of aging, so some scientists believe that eating plenty of vitamin
C and vitamin E could lower our chances of getting osteoarthritis. This has not been
scientifically proven, but some experiments on people who already have the disease have
shown that vitamins C and E can reduce joint pain and reduce the risk of progression to a
worse stage. Scientists do not yet know exactly why these vitamins can help
osteoarthritis. They may mop up potentially damaging molecules called reactive oxygen
species, which are produced in the joint. Also vitamin C seems to be needed for the
building of new healthy cartilage, and vitamin E might act by reducing inflammation. To
eat vitamin C, try fresh fruit, especially blackcurrants, strawberries and oranges. Also
there is a lot of vitamin C in fruit juice, green leafy vegetables, and green peppers.
Vitamin E is found in extra virgin olive oil, wheat germ oil and other vegetable oils.
VITAMIN D
Vitamin D is very important for bones, and recent research suggested that people with not
enough vitamin D had worse progression of their osteoarthritis. This is probably because
vitamin D is necessary for the health of the bones on either side of the diseased joint, but
it is also possible that the vitamin may be used by the joint cartilage itself. We get most
of our vitamin D from sunlight, but you can eat it in the form of cod liver oil, herring,
kippers, sardines or tuna. Some margarine and milk is fortified with vitamin D. It tells
you on the packet.
In rheumatoid arthritis joints become inflamed. It usually affects more than one joint,
causing pain, swelling and stiffness in the mornings. There are other changes that affect
the rest of the body also. The cause of rheumatoid arthritis is one of the big areas of
research in medical science, but the effect of diet on the disease receives only a little
attention from researchers.
FISH OILS AND PLANT OILS
Fish oils contain substances known as n-3 fatty acids. Most oils and fats in the modern
Western diet contain a different kind of fatty acid called n-6 fatty acids. So a diet rich in
oily fish like mackerel or tuna, or with a supplement of fish oil tablets, has a higher
proportion of n-3 fatty acids compared to n-6 fatty acids. Experiments show that this
reduces joint tenderness and swelling in rheumatoid arthritis. Oil from the evening
primrose flower contains an n-6 fatty acid which also is thought to improve rheumatoid
arthritis. You can buy this in the chemist. Flax seed oil is an alternative. It’s a good idea
to talk to your doctor before starting to take oils as supplements.
GLUCOSAMINE/CHONDROITIN
These are commonly used because people believe that they can improve joint pain. The
scientific evidence has never been conclusive, but since there are very few reports of
adverse events people thought that it was reasonable to try them. However recent largescale
scientific studies of glucosamine and chondroitin failed to find evidence that they
are of real benefit.
OVERALL DIET
Studies carried out in America on the health of people with rheumatoid arthritis, and
comparisons with the rest of the population, showed that on average, rheumatoid arthritis
patients eat too little vitamin B6, folic acid, zinc, copper and magnesium, and they
generally eat too much fat and too little fibre. Also researchers found that the illness had
made a quarter of the patients malnourished. So we can see that it’s very important for
people with rheumatoid arthritis to pay attention to their whole diet, eating plenty of fruit
and vegetables, bread and cereal, and possibly taking a vitamin and mineral supplement
to give the right daily amounts of nutrients.
Although much of the research described here is quite new, and work is still going on to
find ways that osteoarthritis and rheumatoid arthritis can be improved by changing diet, it
has been known for some time that what we eat can make a big difference to our health.
You can get more advice on eating a healthy diet from your doctor.
ABOUT THE AUTHOR
Dr Shona Wallace is a Research Scientist with a PhD in human nutrition.
FURTHER READING
• Fighting Fat, Fighting Fit by Janet Marshall, with advice from Dr Mark Porter and
recipes by Ainsley Harriott, published by BBC Worldwide.
• New Eat for Life Diet by Janet Marshall, published by Vermillion.
USEFUL ORGANISATIONS
• Arthritis Research Campaign (ARC), Copeman House, St Mary’s Court, St
Mary’s Gate, Chesterfield, Derbyshire S41 7TD, tel. 012446 558033,
www.arc.org.uk
• Arthritis Care, 18 Stephenson Way, London NW1 2HD, tel. 020 7380 6564/7,
www.arthritiscare.org.uk
Diet and Arthritis © Shona Wallace. All Rights Reserved.
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