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5 July, 2009

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Arthritis and diet

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. There is no special diet or ‘miracle food’ that cures arthritis, but some conditions may be helped by avoiding or including certain foods. 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.

Always seek the advice of your doctor or dietitian before changing your diet in an attempt to treat arthritis. You may be restricting your food intake unnecessarily, or overdosing on products (such as mineral supplements) that may have no impact on your condition at all.

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. Some of the dietary recommendations 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 and anchovies
Drink plenty of non-alcoholic fluids
Make sure you don’t overeat on a regular basis
Be sure to take your time when eating.

Rheumatoid arthritis and osteoarthritis
Fish oils that contain omega-3 fatty acids have been found, in various studies, to help reduce the inflammation associated with some sorts of arthritis. These forms of arthritis, like rheumatoid arthritis and osteoarthritis, are characterised by inflammation.

The fish oil seems to work by reducing the number of inflammatory ‘messenger’ molecules made by the body’s immune system. There may be additional benefits to eating fish once or twice every week - researchers from around the world have discovered that the regular consumption of fish can reduce the risk of diseases ranging from childhood asthma to prostate cancer.

Obesity may worsen arthritis symptoms
Being overweight does affect people with arthritis. Joints affected by arthritis are already under strain. If you are overweight or obese, the extra load on your joints may be exacerbating your 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
There is no substantial scientific evidence that would support a person with arthritis avoiding particular foods, unless that person has specifically shown intolerance to them (the exception is gout). However, as research reveals more connections between diet and health, it is possible that stronger connections between particular foods and arthritis may emerge.

With some foods - such as tomatoes, potatoes, eggplants and peppers - there is much anecdotal evidence (stories about individuals), but again there is no strong scientific evidence.

If you think a particular food may aggravate your arthritis, it can be useful to keep a food diary. After a month, you may have some idea about which food could be provoking symptoms. You could then try eliminating that food from your diet for two weeks to see what happens. Don’t cut out a whole food category, 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 wax and wane for no apparent reason. If you are experimenting with a dietary change, don’t automatically assume the remission or reduction of symptoms was due to what you did or didn’t eat. Be guided by your health professional.

Where to get help

Your doctor
An accredited practising dietitian, contact the Dietitians Association of Australia
Arthritis Foundation of Victoria Tel. (03) 8531 8000

Things to remember

Arthritis is a general term describing over 150 different conditions that cause pain, stiffness and (perhaps) inflammation in one or more joints.
There is no special diet or ‘miracle food’ that cures 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 and osteoarthritis.
The symptoms of gout can be eased by avoiding alcohol and offal meats, and by drinking plenty of water.
There is a link between being overweight and an increased risk of developing osteoarthritis.

You might also be interested in:
Ankylosing spondylitis.
Arthritis.
Arthritis - juvenile.
Arthritis and exercise.
Arthritis and water exercise.
Gout.

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