Diet and Arthritis

Arthritis is a painful condition caused by inflammation of the joints and comes in many different forms including rheumatoid arthritis (RA) and osteoarthritis (OA).

• Rheumatoid Arthritis is a chronic inflammatory disorder which may affect many tissues and organs, but mainly attacks the joints.
• Osteoarthritis involves degrading of the joints - including both bone and cartilage. Symptoms of OA include joints pain, stiffness, inflammation, and locking of joints.

There is a lot of information online about how certain nutrients can help with arthritis. However, there is no strong evidence available that experimenting with your diet and excluding particular foods will improve your arthritis. However, following the simple dietary advice below can improve your overall health and may reduce your symptoms.

BE A HEALTHY WEIGHT

Being overweight can increase the symptoms of arthritis, as it places extra stress on the joints. Losing weight can reduce the pain and inflammation of arthritis. For more information on achieving a healthy weight, take a look at the healthy weight, weight loss and dieting section of our website.

FOLLOW A MEDITERRANEAN DIET

This diet has already been shown to be good for your heart. However people with arthritis can often find the Mediterranean diet helps their symptoms including reduction in swollen and tender joints, the duration of morning stiffness and improved general well-being. This diet includes:

- plenty of whole grains,

 - fruit (2 or more portions) each day,

- vegetables (4 or more portions) each day,

- oils (especially monounsaturated oils like sunflower and olive oil),

- nuts and seeds.

INCLUDE OMEGA - 3 FATS AND FISH OILS IN YOUR DIET

People with rheumatoid arthritis have an increased risk of heart disease. See our fact sheets on diet and heart health for further information. As well as reducing the risks of heart disease, omega-3 fats have been shown to help reduce general inflammation, reduce the duration of morning stiffness, and reduce joint pain and stiffness. Symptom relief can take up to 3 months. Omega 3 fats can be found in fish with darker flesh such as;

• sardines,
• fresh tuna,
• salmon,
• mackerel
• trout,
• herring

Two to three portions (~140g) of these oily fish per week gives maximum benefit. If you do not eat fish you could consider taking omega 3 supplements. Supplements should contain 500- 1000mg of EPA and DHA per capsule. Fish oils can interact with some medicines. Always seek medical advice before starting these supplements.

TOP UP YOUR CALCIUM AND VITAMIN D

Calcium and Vitamin D are important for bone health, and particularly so with arthritis, as there is an increased likelihood of developing osteoporosis.

Foods rich in calcium include: milk, cheese or yoghurts, tinned sardines and pilchards, fortified breakfast cereals, soya drinks and green leafy vegetables.

TOP TIP! Low fat milk contains just as much calcium as full fat milk.

Because of lack of sunlight, slight deficiency of vitamin D is common in Ireland in the winter months. FSAI 2011 recommends that everyone under the age of 50 takes a 5mcg supplement, and a 10mcg supplement over the age of 50.

BOOST YOUR IMMUNE SYSTEM

Some nutrients can help promote your immunity:

• Vitamin C is a powerful anti-oxidant that protects you from infection by stimulating the formation of antibodies and boosting immunity. 5 portions of fruit & vegetables every day should meet your body’s vitamin C needs.
• Vitamin E can help improve immune function. This can be found in fortified cereals, green leafy vegetables, nuts, seeds, vegetable oils such as sunflower or safflower oil, hazelnuts, peanut butter, or spinach to obtain vitamin E
• Zinc helps the immune system work properly and helps wounds heal. Zinc can be found in poultry, seafood, milk, nuts, red meat and legumes (beans, peas, lentils).

DIETARY MYTHS

There are lots of myths surrounding diet and arthritis. There is a common belief that acidic foods and nightshade vegetables (e.g. potatoes, tomatoes, aubergine) will lead to an increase in symptoms. There is no evidence to support this.

EXCLUSION DIETS AND FOOD INTOLERANCE

Excluding food groups can lead to nutritional deficiencies. If you think that eating a certain food might be linked to your symptoms, ask your GP to refer you to a dietitian. A dietitian will advise on making safe and sensible dietary changes that will not damage your health. You can also find a dietitian on the home page of our website.

ALTERNATIVE AND COMPLEMENTARY PRODUCTS

Glucosamine sulphate and chondroitin: It is thought that these popular supplements may slow cartilage breakdown in osteoarthritis. However, currently there is little evidence to support their use. As a general rule of thumb, if no improvement is notable after 2 months of taking either/both of these supplements, they will probably not help, and should be discontinued.

There is little evidence available to support the following foods to relieve arthritis:

• Green tea extract
• S-adenosylmethionine (SAMe)
• Ginger
• Willow Bark
• “Devil’s claw” (Harpagophytum procumbens)
• Cetyl myristoleate (CMO)
• Cayenne
• Avocado Soybean mix (ASU)
• Extract of New Zealand green- lipped mussel

You should check with your GP or pharmacist before commencing any of these products.

Updated by Ruth Quinn, Dietitian, October 2016. Review date: October 2019© 2016 Irish Nutrition and Dietetics Institute, INDI. All rights reserved. May be reproduced in its entirety provided source is acknowledged. This information is not meant to replace advice from your medical doctor or individual counselling with a dietitian. It is intended for educational and informational purposes only.

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