Diet for Arthritis

Reduce fat intake

A healthy diet should include a small amount of unsaturated fats and limit the amount of saturated and transfat. Most people eat more saturated fat than they actually need. Choosing the right amount and types of fats can lower your risk of developing arthritis, decrease inflammation and help you achieve and maintain a healthy body weight.

Here are some guidelines to help consume less fat:

• Fill up on vegetables, fruits and whole grain bread and cereals that are naturally lower in fats.
• Eat fish and skinless poultry more often.
• Bake, broil and grill instead of frying foods.
• Pick low fat dairy products (e.g. skim, 1 or 2% milk, low fat yogurt, light cheese).
• Choose lean cuts of meat. Trim visible fat off before cooking.
• Use oils and soft-tub margarines sparingly.
• Check the labels of foods like cookies, chocolate, pastries and savoury snacks – this can help you reduce the amount of “hidden fats” you consume.

Eat more whole grains and plant based foods

Besides being a great source of antioxidants, vegetables, fruits and whole grains are a great way to get dietary fiber. They are relatively filling and help achieve a healthy weight.

Antioxidants may play a role in reducing inflammation in rheumatoid arthritis and decreasing the progression of cartilage breakdown in osteoarthritis.

The key is to choose the right kinds of carbohydrates:

• Complex carbohydrates—the “good carbs”—have not been stripped of their fiber and nutrients. Because they’re rich in fiber, they keep you full longer and help with weight control. Good sources of complex carbs include whole grains such as whole grain brown rice, stone ground whole wheat, millet, or quinoa, as well as beans, other legumes, fruit, and vegetables.
• Simple carbohydrates—the “bad carbs”—have been stripped of their fiber and many of their nutrients. Simple carbs lead to a dramatic spike in your blood sugar, followed by a rapid crash. These carbs are much less efficient at filling you up and keeping you energized and over time they contribute to weight gain. Simple carbs include white flour, white rice, white pasta, white sugar and sugary foods.

Reduce sugar and salt intake

Sugar contains ’empty’ calories and has no other food value so it can be cut back without losing any nutrients. There is little nutritional difference between white table sugar and brown sugar, honey, syrup, cane sugar, raw sugar or any other type of sugar – so beware. Limit or avoid adding sugar to drinks and cereals. Although artificial sweeteners contain few calories, it is better to get used to food being less sweet. Dried fruit like raisins or dates can be used to sweeten cereals; unlike sugar and artificial sweeteners, they also provide vitamins, minerals and fibers.

It is recommended that we do not exceed 2300 mg of sodium per day. Sodium causes your body to retain water and can affect your blood pressure. Many foods now come with low or no-salt added choice, which makes it easier to maintain a low-sodium diet. Limit your intake of foods that are high in sodium like sauces, gravies, processed food, pre-prepared food and canned food.

Drink alcohol in moderation

Excessive alcohol consumption can have adverse effects on your health, including weakened bones which can lead to osteoporosis. Alcohol adds unwanted pounds with extra, empty calories. It can also increase the uric acid in the body, upping your susceptibility to gout marked by pain and inflammation. Alcohol does not mix well with certain medications used in treating in arthritis. Stomach problems also are more likely if you drink alcohol and take aspirin or other non-steroidal anti-inflammatory drugs (NSAIDs). Large amounts of alcohol combined with acetaminophen can damage the liver. If you are taking any medication, check with you doctor or pharmacist about drinking alcohol, even in moderation.

Omega-3 polyunsaturated fatty acids

One of the most exciting, recent discoveries is that certain foods and food supplements really can help arthritis. The effects are fairly specific to different types of arthritis which is why it is important to know what type of arthritis you have been diagnosed with. Omega-3 polyunsaturated fatty acids, particularly as found in cold waterfish and the oil produced from them, can be helpful for inflammatory arthritis (which includes rheumatoid arthritis, reactive arthritis, psoriatic arthritis and ankylosing spondylitis; it also includes gout, but cold water fish should generally be avoided if you have gout because of the high purine content).

Gout is the only type of arthritis that can be substantially controlled by changing your diet and lifestyle. As people who are overweight and /or obese have an increased risk of having gout, achieving a healthy weight can decrease the risk of gout.

Gout is a very painful type of inflammatory arthritis that is caused by the crystallization of uric acid in the joints, causing inflammation. Many dietary and lifestyle factors can contribute to the development of gout. These include eating purine-rich foods such as red meat and seafood. Alcoholic drinks like beer can also lead to gout. Alcohol consumption plays a role in triggering gout flares because alcohol limits the clearing of uric acid from the kidneys. In addition, beer acts as a source of purines. The dehydrating effects of alcohol can also limit the uric acid clearing from the kidneys; therefore staying hydrated can aid this process.

Eating purine-rich foods and drinking alcohol can trigger an individual’s gout flares. If these are triggers to flaring your gout, it would be best to avoid them. The table below lists the purine content in food:

Purine Content of Foods
Highest	Sardines, anchovies and herrings, kidneys, liver and sweetbreads, yeast, alcohol and beer.
Moderate	Shellfish and other seafood, red meat, poultry and their broths, beans, peas and lentils, spinach, oatmeal, wheat germ and bran.
Low	Fruit and most vegetables, nuts and fats of all kinds, most breads, cereal and cereal products, milk, cheese, eggs, sugars, syrups, and sweets.

Uric acid levels are not affected by so-called ‘acidic food’ like oranges or tomatoes – so you can eat these safely.

Many arthritis patients are sensitive to several foods. The mechanism by which food sensitivity is involved in arthritis remains unknown. Some evidence implicates the gut flora. Some of the commonly used drugs for arthritis increase the permeability of the gut, causing it to become “leaky”, allowing larger molecules of foods to pass through than would normally be the case, causing food sensitivity. Many studies have shown that 30-40% of rheumatoid arthritis (RA) patients can improve substantially by using an elimination diet to identify foods that precipitate symptoms and the avoiding of these foods. Some studies have shown, that gluten and/or dairy products may be involved in this food sensitivity at some arthritis patients.

Elimination diets typically involve entirely removing the suspected food from the diet for a period of time from two weeks to two months, and waiting to determine whether symptoms resolve during that time period. If symptoms resolve after the removal of a food from the diet, then the food is reintroduced to see whether the symptom reappear.

Some people feel that cutting out ‘acidic fruit’ such as oranges, lemons and grapefruit helps arthritis. Others believe that vegetables from the so-called nightshade family (which includes several foods – potatoes, tomatoes, sweet and hot peppers and eggplants) are bad for arthritis. There is no scientific evidence that leaving out either of these groups of fruits and vegetables helps arthritis, and such diets may have the undesired effect of reducing the beneficial antioxidants in the diet.

Food sensitivity is highly individual, and varies from person to person. Elimination diet should be done under the supervision of your doctor to eliminate the risk of nutrient deficiency.

Food intolerance tests which test for IGG Antibodies against 200 foods are available at our center