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The Impact of Diet on Arthritis

By Ronen Marmur, MD PhD FACR | Rheumatology 

The importance of nutrition has been demonstrated by multiple studies that reinforce “we are what we eat.”  In the field of rheumatology, there is growing recognition of the importance of diet and its impact on tissue inflammation and the composition of “healthy bacteria” which play important roles in health maintenance and disease prevention.  What you eat impacts your joints more than you think.  Following are a few diet and lifestyle adjustments that can help fight inflammation, strengthen your bones, and boost the immune system. 

Weight control: Obesity may be associated with increased joint pain and accelerated osteoarthritis in the hips and knees.   Fat tissue releases hormonal factors that cause an increase in joint pain and damage.  Weight loss is the only known medical intervention that decreases joint damage and the progression to joint replacement. Numerous studies show that patients undergoing bariatric surgery leading to significant weight loss may have decreased joint pain and therefore a decreased need for joint replacement.   

Omega-3 Fatty Acid: This fat, contained in fish and some vegetables, has been shown to have an anti-inflammatory effect on joints.   Certain types of fish, such as sardines, salmon, tuna, herring, and anchovies, are rich in inflammation-fighting omega-3 fatty acids, which reduce C-reactive protein and interleukin-6, two inflammatory proteins in the body.  Other sources of omega-3 include flaxseed, green leafy vegetables such as kale, and nuts.

Vitamin D: Vitamin D, which our bodies absorb naturally from sunlight, plays an important role in calcium metabolism and bone health.  Low vitamin D is associated with accelerated osteoarthritis, increased tissue inflammation and increased bone fragility.  If you’re not getting enough sunlight, vitamin D can be taken as a supplement. The recommended daily dose by the Institute of Medicine is 400-800 units per day, with doses to up to 2,000 units per day considered safe.   Vitamin D levels can be measured through a simple blood test.  Levels should be between 30 ng/dl-60 ng/dl.

Fruits and vegetables:  Studies show that consumption of the Mediterranean diet is beneficial to reduced inflammation.  Fish, as mentioned above, combined with a diet rich in vegetables, as well as olive oil, is shown to have protective qualities for our joints.  Olive oil contains heart-healthy monounsaturated fat, antioxidants and oleocanthal, a compound known to lower inflammation and pain.  Choose colored fruits and vegetables, such as carrots, pumpkins, oranges and peppers which are rich in carotenoids.

Supplements:  Dietary supplements derived from cartilage and bone have been used as a folk remedy for arthritis since ancient times.  A modern adaptation of this approach is through the use of glucosamine and chondroitin, found in supplements, for joint pain.  The use of these supplements is supported by scientific studies, but the evidence is weak. We recommend ingesting these supplements only if it helps to reduce pain and increase mobility.  However, keep in mind these supplements are not regulated by the Food and Drug Administration

Foods to avoid: Foods containing high levels of saturated and trans fats, such as processed, packaged snacks (e.g. chips, cookies); high concentrations of fructose; sugar and artificial sweeteners should be avoided. Consumption of these foods increases risk of obesity and inflammation.

Be good to your joints!  Eat healthy and enjoy high fiber, low calorie, nutrient-rich foods.  Also remember that weight control and exercise are important factors leading to decreased joint pain and inflammation.