As you get older, one of the things that can start to happen is that you experience aches and pains. If your aches and pains are a regular feature of your life, it’s definitely worth asking your doctor or physio for advice. Sometimes that regular twinge you are getting is something more serious, but don’t let the possibility of ‘something more serious’ prevent you from getting it checked out. If it’s nothing but creaking joints, that’s great. If it’s something else, well we can work on that, too.
You may have guessed that the ‘something else’ I am thinking about is arthritis. In aid of World Arthritis Week, I want to share some of my top tips for using food to help alleviate some of the symptoms of arthritis.
What are the different types of arthritis?
There are 2 types of arthritis: osteoarthritis and rheumatoid arthritis.
Osteoarthritis is the type of arthritis associated with wear and tear of cartilage within joints. It is more commonly (but not exclusively) linked to the ageing process.
Under the age of 45, it’s more common in men, and over the age of 45, it’s more common in women. By the time they get to 50, 80% of people will have symptoms associated with this type of arthritis, which starts as a stiffness in the hips, back, knees or other joints. The joints then become increasingly swollen and inflexible.
Rheumatoid arthritis is an autoimmune problem, triggered by genetics, or a bacterial or viral component, and possible also environmental or lifestyle factors. About 80% of sufferers are women. The body – for whatever the reason – develops antibodies against its own tissue, and it attacks the cartilage and connective tissue. Over time, joints become inflamed and enlarged.
What you need to know to manage your arthritis
There are a number of factors that are important in managing arthritis:
How good your digestion and detoxification are
Blood sugar balance
Levels of essential fats
The key to improving the symptoms of arthritis is to work on the underlying causes rather than just treating the symptoms.
Digestion + detoxification and arthritis
The scene for inflammation – even if that inflammation is elsewhere in the body, e.g. the joints – is often set in the digestive tract. If the gut environment is disturbed (a disruption in the normal balance of bacteria), this can lead to bacterial infection, parasites, intestinal permeability (aka ‘leaky gut’), and allergies and intolerances.
What then happens partially digested food proteins get into the bloodstream, along with other toxins and microbes, putting greater pressure on the body’s detoxification processes. Once the liver starts to become over taxed, any dietary or environmental toxins may cause further inflammation.
A programme that works on creating a good gut environment is ideal. Probiotics and prebiotics can be very helpful, as can food intolerance testing (see below).
Blood sugar balance and arthritis
There is a big link between inflammation and how well your body responds to insulin, the hormone produced in the pancreas to control blood sugar levels. If your body has a reduced sensitivity to insulin (or you are diabetic), sugar (glucose) or insulin stay in the blood, and too much of either is toxic, triggering inflammatory reactions.
Learning to balance your blood sugar levels plays a key role in managing the symptoms of arthritis. This is achieved through eating adequate amounts of protein at every meal and snack, increasing the amount of non-starchy vegetables, and considering the quality and the quantity of the starchy carbohydrates you eat.
All my nutrition plans are based on a blood sugar balancing diet, also known as low glycaemic load (low GL) diet. A low GL diet is easy to follow, focuses on real foods (not weird things you can only buy at health food shops), keeps you feeling full, and helps you manage your cravings.
Inflammation and arthritis
In pretty much every circumstance, joint problems are linked to inflammation and sometimes also to problems with the immune system (autoimmunity).
The body produces chemical agents in the body to either switch on or reduce inflammation.
Prostaglandins are one of the main chemicals in this process, and these are the easiest to manipulate with diet. There are 3 different types. 1 and 3 are anti-inflammatory and 2 is pro-inflammatory (causes inflammation and promotes pain).
Omega-6 fats can convert into either type 1 or type 2 prostaglandins. Eating a diet high in omega-6 polyunsaturated animal fats (found in meats and dairy produce – particularly non-organic) has the body producing more of these less desirable type 2 prostaglandins. Sugar and insulin can also redirect the conversion of plant omega-6 fats down the pro-inflammatory pathway.
Omega 3 fats and arthritis
Omega-3 fats, on the other hand, can only go down the route towards the anti-inflammatory type 3 prostaglandin. Omega-3 polyunsaturated fats are found in foods like walnuts, flaxseeds, hemp, chia seeds, and oily fish. Monounsaturated fats, e.g. avocado and olive oil, are neutral and not involved in inflammatory processes.
Reducing animal proteins and dairy products can bring symptomatic relief.
Free radicals, antioxidants and arthritis
There’s another group of chemicals called ‘free radicals’. These are highly reactive oxygen molecules that rely on other molecules in the body to stabilise them.
You might have heard of free radicals in skin care commercials. They are linked to accelerated ageing, cancer and other diseases. What helps keep these unstable molecules in check are antioxidants (again, something often talked about in skincare).
Antioxidants are found in large amounts in brightly coloured fruit and vegetables. The different colours tend to indicate the type of antioxidants produced – all are good.
What we know about antioxidants is that they have a synergistic effect – eating a variety of different ones (by eating a large range of different coloured fruit and veg) has a greater effect than eating the same volume of the same type.
Bottom line? Eat a LOT of vegetables and low sugar fruits like berries (which have some of the highest antioxidant levels of all fruit).
Some so-called 'superfoods' are also astonishingly high in antioxidants, like super greens spirulina, chlorella and wheatgrass, and the fruity baobab and lucuma. And you'll almost certainly have heard of turmeric, which has been used medicinally for millennia and is enjoying something of a moment right now, appearing in lattes and the like. While I believe in getting as many foods naturally into the diet, you'd likely struggle to eat a therapeutic dose on a daily basis and may, therefore, be worth taking a turmeric supplement.
If you have rheumatoid arthritis, talk to me about whether the more restrictive autoimmune paleo diet would work for you. This further cuts out all grains, nightshade foods (like potatoes, peppers, tomatoes, and aubergines) and other foods thought to play a role in causing an inflammatory environment.
Eat plenty of essential fats if you have arthritis
Omega 3 fatty acids (found in oily fish, seeds like flax and chia, and walnuts) also have plenty of research to support their anti-inflammatory credentials.
Food allergies + intolerance and arthritis
Many people with inflammatory conditions have allergies or intolerances, some of which may be due to leaky gut, where food proteins are able to get through the gut lining, triggering an allergic response. Common offenders are dairy products, yeast, wheat and gluten, other grains, eggs, beef, chilli, coffee and peanuts. If you experience arthritis – or in fact any other inflammatory condition, there may be mileage in having a food intolerance test. Ask me for details.
Foods to avoid if you have arthritis
Foods to reduce if you have arthritis
Foods to increase if you have arthritis
Vegetables of all kinds (eat a rainbow)
Sources of vegetable protein
Specific foods to increase if you have arthritis
USEFUL RESOURCES – click the book for more details. I've found these are really helpful in working with clients.