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Arthritis sufferers, be flexible Better nutrition can improve joint health

When your joints are happy, you don't even know they're there. But if they're inflamed with arthritis, the condition can be painful and debilitating. Although the first line of defense for arthritis is medication, research is unfolding about the effects of diet on joint health.

"Managing arthritis is about lifestyle and overall diet pattern coupled with quality medical treatment by a rheumatologist," explains Lona Sandon, M.Ed., R.D., a rheumatoid arthritis sufferer and national spokesperson for the American Dietetic Association. "Changes in arthritis symptoms that may relate to overall dietary pattern are not likely to happen overnight.

"Some people may find that over time -- three to six months -- a plant-based, Mediterranean-type diet may help them feel better."

These diet and lifestyle changes may help soothe arthritis symptoms:

> Fruits and veggies

Certain plant foods have been deemed "anti-inflammatory," as they can ease the pain and swelling of osteoarthritis (OA.) A 2010 study in BMC Musculoskeletal Disorders found that a plant-based diet of fruits and cruciferous vegetables like broccoli, cauliflower and kale, along with alliums, such as garlic, onions and leeks, showed some improvement with OA of the hip.

Eating fruits and vegetables not only keeps body weight in a healthy range, but a compound in alliums, called diallyl disulphide, appears to fend off degrading protein enzymes present with OA.

> Healing ginger

Ginger has been a topical remedy for alleviating arthritis symptoms for thousands of years in China. Including ginger in the diet has proven helpful in managing osteoarthritis symptoms in some, but not all, studies; be aware, however, that the high doses necessary to soothe painful, swollen joints can cause gastrointestinal discomfort and interfere with medications such as blood thinners.

> Green tea

Potent plant compounds in green tea leaves called catechins, specifically epigallocatechin-3-gallate (EGCG), have anti-inflammatory and antioxidant effects that appear to stave off oxidative damage in joints. A 2010 review in Arthritis Research and Therapy showed that EGCG protects cartilage from breaking down and maintains the integrity of collagen in the presence of joint disorders. Although more research is needed, green tea shows enough promise that it may be worth drinking at least three to four cups a day.

> Mediterranean diet

Dietary patterns that show promise in lowering inflammation, according to a 2010 review in the Journal of the American Dietetic Association, are low in saturated fat from red and processed meat, and plentiful in fruits and vegetables, beans, legumes, fish and olive oil -- like the Mediterranean diet.

"Arachadonic acid found mostly in red meats appears to be proinflammatory. Olive oil combined with fish oil may even have a synergistic effect. Omega-3 fatty acids and phytonutrients found in fish, fruits, vegetables, whole grains and teas can act in similar ways to anti-inflammatory drugs to block inflammatory pathways," explains Sandon.

Eating a plant-based diet, which contains more beneficial unsaturated fats and antioxidants, appears to alleviate some of the joint pain -- but not necessarily stiffness -- according to the review.

> Omega-3 fats

Fish oil, specifically the omega-3 fatty acids EPA and DHA, has an anti-inflammatory effect on joints, according to dozens of clinical trials. A 2010 study in BMC Musculoskeletal Disorders found positive effects using krill, a zooplankton crustacean rich in omega-3s, on an animal model of arthritis.

Krill oil's omega-3 fats may be more easily absorbed by the body than fish oil, plus it has the added bonus of astaxanthin, a compound with antioxidant and anti-inflammatory effects. But Sandon warns, "Studies show that very high levels of six to 10 grams -- 600 to 1,000 mg -- of fish oil per day are needed to get a clinical effect of less joint stiffness, tenderness, pain or swelling."

> Food allergies

One theory ties food allergies to rheumatoid arthritis (RA). A 2006 study in the journal Gut found that the intestines of people with RA contain more antibodies for proteins from cow's milk, cereal, eggs, fish and pork than people without RA. The immune complexes that are formed to potential allergens circulating throughout the body are believed to get lodged in arthritic joints.

However, this theory needs more research. Use caution when eliminating certain foods, as this may not be effective at treating arthritis and also pose a risk for nutritional deficiencies.

"People with arthritis, particularly RA, are at greater risk of nutrient deficiencies due to the disease itself, to fatigue, to loss of functionality to prepare food, and to the medications used to control symptoms," explains Sandon. Instead of an elimination diet, experts encourage keeping a food and symptom journal for a month to identify patterns that can be shared with your health care practitioner.

> Move more

Physical activity is one of the cornerstones for keeping joints healthy and happy, as well as keeping weight in check. Get at least 150 minutes of physical activity, such as walking, running, biking, dancing and strength training, each week.

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