A very common question that patients ask me is whether a specific diet can help their arthritis and overall joint pain. The short answer is yes, but how much depends on several factors. First, it is important to understand that there are several different types of arthritis, and diet affects each one differently. Second, everyone’s body is unique and their response to specific foods and how it affects their arthritis may differ. But, there is no doubt - diet plays an important role in managing overall joint health, just as much as exercise and supplements.
With osteoarthritis, the most common type of arthritis, a person’s weight can aggravate symptoms and cause the arthritis to worsen over time. Cartilage in the joints naturally becomes weaker as we age and extra stress due to weight and lack of mobility only compounds the effects of arthritis. In these cases, I stress to patients the importance of a well-balanced and healthy diet with moderate exercise to control weight gain. I often tell them, for every pound over your ideal body weight, it puts an extra 4 - 5 pounds of additional weight or stress on your knees and hips. Ideal body weight per person can vary, however. In general, if you are a 5’4’’ woman, your ideal weight is 120lbs, and if you are a 5’4’’ man, it would be 130 lbs. To control weight gain and help inflammation in the joints, a diet filled with vegetables, walnuts, flax seeds, fish, and fruit can help achieve this. Rheumatologist Dr. Richard Panush in “Up to Date”, published by Wolters Kluwer, writes that the Mediterranean diet may show benefits for joint health. It may do so by both reducing your waist line and by providing antioxidants to help manage inflammation.
Another type of arthritis where diet has a definite effect is gout. Gout is a type of arthritis caused by uric acid crystals depositing in joints. It is found mostly in men over the age of 30 (sometimes younger) and women who are post-menopausal. A diet high in purines can increase the levels of uric acid in the blood and cause a painful and sudden arthritis if the crystals deposit in the joints. A classic presentation is the sudden onset of intense pain along with swelling and redness. The big toe is often the target, but other joints can be involved. Foods with high purine levels also increase uric acid levels in the blood. Changing your diet may help prevent attacks. Avoiding sweetbreads, herring, mussels and sardines can be helpful. So, too, can avoiding alcoholic beverages, especially beer, heavy wines and champagne, as well as carbonated sugar drinks. Dehydration is an often-overlooked cause of gout and is the reason why many people develop gout after skiing or other physical activity. Results of a study published in the New England Journal of Medicine indicate that a diet that includes dairy products and vegetables may help to prevent gout. Obesity and overeating, or “binging,” have also been associated with gout.
“Elimination” Diet and Joint Health
For other types of arthritis, such as rheumatoid arthritis, lupus, psoriatic arthritis, Sjogren’s syndrome, and ankylosing spondylitis, some people benefit by trying an elimination diet. In this situation, the patient will try to avoid a specific food group for 1-3 weeks and see if they get relief from their symptoms. For example, they might avoid red meat for a few weeks, then try avoiding dairy and so on. A lot of hype has been given to going gluten free. Some of my patients felt better when they eliminated gluten and so if they are willing, this is the first food group I will ask them to eliminate. This may be especially useful in patients with Sjogren’s syndrome - an autoimmune condition associated with dry eyes, dry mouth, joint pain and fatigue. These patients have a higher incidence of a condition called celiac disease which is an actual allergy to gluten. Eating gluten free can be a challenge, so if there is no dramatic change, I encourage my patients to reintroduce gluten in their diet. If you find it difficult to do the elimination diet, some will do a blood test that tests for food sensitivities. Many of my patients have found this to be helpful while others will find that they are only sensitive to a small number of foods. These commercially available food sensitivity testings have never been studied in a placebo-controlled trial so it is still up for debate whether food sensitivity testing is of clinical value but it is worth looking into.
Adding Supplements to your Diet
A proper diet assists in treating your arthritis by reducing inflammation, minimizing weight gain and improving joint motion. However, this isn’t to say the diet alone is the answer. Many patients find benefit from over-the-counter supplements such as glucosamine sulfate, chondroitin sulfate, boswellia serrata, tart cherries and turmeric. With so many supplements in the market, it is very difficult to pick the right one. Many times patients have told me they have tried a variety of supplements without benefit. However, I have found that choosing the right products with the right quality and dosage is important. I tell my patients to do their homework when it comes time to choosing a joint supplement. Not all ingredients are the same and not all products are the same. Over the years, my patients have benefited from joint health supplements marketed by Wynn Pharm.
Scott Zashin, MD, is a respected arthritis specialist in Dallas, Texas.