Arthritis -- inflammation of the joints -- is the most common cause of disability in the U.S., affecting 43 million people and limiting physical activity in almost 19 million every year. (1)
Arthritis medications are among the most highly prescribed drugs in the world. Although they may be effective at controlling symptoms, they have considerable side effects.
The most commonly used over-the-counter-drugs, called NSAIDs, examples of which include Advil, Motrin, Aleve and aspirin, have serious side effects. According to the CDC, NSAID's account for an estimated 7,600 deaths and 76,000 hospitalizations in the U.S. every year. (2)
Nutrition and supplements are underutilized weapons in the battle against arthritis.
First, there are nutritional supplements like fish oil and Borage oil that have been shown to allow reduction of NSAID use in patients with rheumatoid arthritis, one of the most crippling types of arthritis. Fish oil may even work better in combination with extra-virgin olive oil, as I explain below.
Second, there are supplements like Colostrum and Glutamine (an amino acid) that have been shown in research studies to help decrease the risk of stomach damage in people taking NSAIDs. Detailed research on how these supplements may help protect against NSAID side effects can be found at Pill Advised, a free web application that I've created to bring important research findings to a wider audience.
Nutrition is another vital tool in fighting arthritis. Unfortunately, there are a lot of myths about what to eat, and what not to eat, for arthritis. I'll try to dispel some of these and present the findings.
On November 5, 2010 I presented a review of the scientific data on the relationship between diet and inflammation at Morristown Memorial Hospital's Fourth Annual Nutrition and Supplements in Clinical Practice Conference.
Because I've found these dietary principals extremely beneficial for my patients with arthritis, I'm providing a summary here.
1. Eat at least 8 servings of fruits and vegetables every day.
Choose those with bright or deep colors like cherries, berries and , sweet potatoes. Many people believe that citrus fruits and nightshade vegetables, like tomatoes and peppers, cause arthritis, but I have found that oranges and tomatoes, in fact, have anti-inflammatory effects in people. NOTE: Food allergy can trigger arthritis for some people, and if there is a food that makes your joints hurt or swell, you should avoid it, no matter how healthy it would be for someone who's not sensitive to it. Most of the patients I've seen do better eating lots of vegetables and fruits. Tomatoes, incidentally, seem to have more of anti-inflammatory effect when they're cooked or juiced, but most other vegetables and fruits are better if they're fresh.
2. Choose your oils wisely.
Extra-virgin olive oil has anti-inflammatory benefits, whether raw or cooked. Recent research has identified the antioxidant called oleocanthal, which is only found in extra-virgin olive oil. Oleocanthal is a natural inflammation-fighting compound with potency strikingly similar to that of the drug ibuprofen in inhibiting an enzyme that causes pain and inflammation. Studies have shown that people with arthritis experience a decrease in pain and stiffness of their joints when treated with fish oil. Even better pain management results have been observed when, in addition to fish oil, extra-virgin olive oil is part of the diet.
Flaxseed oil and flaxseed meal (ground flaxseed), also have significant anti-inflammatory effects, but should not be cooked, because cooking destroys some of the beneficial omega-3 fats. Other vegetable oils, like corn, safflower or sunflower oils, can increase inflammation and counteract the benefits of anti-inflammatory nutrients in your diet.
3. Eat fish three times a week.
Especially wild salmon, if it's available and affordable, but don't fry your fish. Frying can interfere with the benefits. You may want to supplement your diet with fish oil, but check with your doctor. The amount of fish oil you need is not fixed; it varies from about a teaspoon (4000 milligrams) to a tablespoon (12,000 milligrams) each day, depending upon what else is in your diet. The more meat, poultry, egg yolk or dairy fat you eat, the greater your need for fish oil, because these foods contain arachidonic acid, a pro-inflammatory omega 6 fatty acid. The more you use vegetable oils other than extra-virgin olive oil, the more fish oil you need.
4. Avoid sugar and foods with added sugar and refined carbohydrates.
Skip white flour products, white rice and white potatoes. Several studies have shown that consuming foods of this type aggravates inflammation. Instead eat high fiber foods like whole grains and legumes. Studies have shown that high fiber diets are anti-inflammatory. Don't worry about carrots. All the publicity given to the Glycemic Index of foods (the tendency for a food to raise blood sugar) has given carrots a bad rep. The carotenoids in carrots, antioxidants that create the orange color and the fiber, make carrots an anti-inflammatory food. Carrots, like tomatoes, are also more nutritious cooked than raw.
5. Drink tea, black or green.
The notion that green tea is healthier than black tea has not been borne out by clinical trials in humans. Green tea may have anti-cancer effects, but black tea has a better track record in fighting inflammation. You need at least three cups a day, unless you're a smoker, in which case no amount of tea will work for you.
6. Use anti-inflammatory spices in preparing your food.
Ginger and turmeric have excellent anti-inflammatory effects, although human clinical trials with these spices are much more limited than for the other principles listed. My book, "The Fat Resistance Diet," has recipes using these spices and applying these anti-inflammatory principles. Get free recipes and a one day meal plan at www.fatresistancediet.com.
My patients with arthritis find that this is a great way to eat. The food's delicious and they feel better. Another benefit: you may find that you lose weight without trying.
Now I'd like to hear from you...
Are you impacted by arthritis? Do you take any medications or supplements for it? Do they work? Does what you eat, or not eat, make a difference?
Please let me know your thoughts by posting a comment below.
Leo Galland, M.D.
Leo Galland, MD is a board-certified internist, author and internationally recognized leader in integrated medicine. Dr. Galland is the founder of Pill Advised, a web application for learning about medications, supplements and food and how they interact. Join the Pill Advised Facebook page.
The information here is based upon principles in my upcoming article being published in print in the scientific journal, Nutrition in Clinical Practice, December issue, where a list of scientific references supporting the principles listed above can be found.
2) Robyn Tamblyn, PhD; Laeora Berkson, MD, MHPE, FRCPC; W. Dale Jauphinee, MD, FRCPC; David Gayton, MD, PhD, FRCPC; Roland Grad, MD, MSc; Allen Huang, MD, FRCPC; Lisa Isaac, PhD; Peter McLeod, MD, FRCPC; and Linda Snell, MD, MHPE, FRCPC, "Unnecessary Prescribing of NSAIDs and the Management of NSAID-Related Gastropathy in Medical Practice," Annals of Internal Medicine, September 15, 1997, 127:429-438.
This information is provided for general educational purposes only and is not intended to constitute (i) medical advice or counseling, (ii) the practice of medicine or the provision of health care diagnosis or treatment, (iii) or the creation of a physician--patient relationship. If you have or suspect that you have a medical problem, contact your doctor promptly.
The Morning Email helps you start your workday with everything you need to know: breaking news, entertainment and a dash of fun. Learn more