What is it?
Arthritis is the general medical term that designates inflammation in the joints or a disorder characterized by such inflammation. Dietary therapies for osteoarthritis (OA) and rheumatoid arthritis (RA) -the two most common forms of arthritis-fall into three main categories:
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The conventional treatment strategy focuses on weight reduction and a balanced diet to relieve the tension of damaged joints and slow down the progression of arthritis.
Some dietary supplements analyzed in clinical trials have been shown to be beneficial for some patients.
Approaches to alternative medicine are supported by dietary adjustments (including elimination diets) and / or traditional plant remedies to treat arthritis.
The role of diet and nutrition in the types of arthritis OA and AR has been studied since the 1930s, but despite this, there is little consensus on the details of adequate dietary therapy for these disorders. What has been clear, after decades of studies, is the importance acquired by the reduction or maintenance of weight for the treatment of patients with arthritis OA. Another of the agreed findings for both types of arthritis is the need to consume a nutritionally balanced diet and follow healthy eating patterns.
What benefits does it provide?
Osteoarthritis
- The reduction of weight in overweight people and with OA can lead to a remarkable relief of their discomfort and an improvement in the mobility of the affected joints.
- The benefits of dietary supplement intake vary from one patient to another, depending on the joints specifically affected and the degree of erosion of the cartilage.
Rheumatoid arthritis
- The benefits of introducing dietary adjustments, or the intake of dietary supplements to alleviate the effects of RA, vary considerably from one patient to another.
- Maintaining a balanced diet is important in preventing the nutritional deficiencies that sometimes occur in patients with RA due to the side effects caused by the medication.
- It has been possible to associate a deficiency of vitamin B6 with the development of RA, and supplements of vitamin B6 can reduce the levels of inflammation.
What risks do you pose and what precautions should be taken?
- Before starting any type of diet or supplement regimen it is important to consult with the doctor.
- Before starting any kind of dietary treatment for joint pain, consult a doctor to obtain an accurate diagnosis of the type of arthritis that causes the pain. If there is a suspicion of AR arthritis, it is essential to follow a systemic treatment as soon as possible to minimize potential long-term health damage.
- Check with your doctor before taking any dietary supplement, as it may interact with certain medications (with prescription and without it). Chondroitin sulfate, for example, may prolong the bleeding time in some people, especially if taken with aspirin.
- Buy dietary supplements only from trusted brands that can support the quality of their products.
- Do not stop taking any medication prescribed by your doctor without your consent.
- If you follow a diet fundamentally vegetarian, do not forget that iron deficiency can develop.
- In the case of patients with RA with a healthy weight, it is not recommended to lose weight. Excessive weight loss, especially caused by stopping many foods or following fast diets, can worsen the symptoms of AR arthritis.
Dietary supplements
- People with diabetes should check their blood sugar levels more often if they take glucosamine, since it is an aminosaccharide.
- Those who take blood thinning medications should periodically check their blood clotting time if they take chondroitin sulfate.
- In some people, glucosamine and chondroitin sulfate cause intestinal gas or mild diarrhea. In some people, the unsaponifiables of avocado and soy (ISA), cause nausea and skin rashes.
- In some people, vegetable oils that contain gamma linolenic acid (FFA) can cause intestinal gas, bloating, diarrhea and nausea. In addition, these oils may interact with other medications, especially blood thinners.
- Some preparations of borage oil contain ingredients called pyrrolizidine alkaloids (AP); These can damage the liver or worsen liver diseases. Only borage oil should be used with certification that proves to be free of pyrrolizidine alkaloids.
- Evening primrose oil can interact with a group of tranquilizers used in the treatment of schizophrenia, known as phenothiazines. This group of medicines includes chlorpromazine and prochlorperazine.
- In some people, fish oil can affect the rate of blood clotting and cause nausea or fishy odor on the breath.
- Fish oils with high levels of vitamin A can cause vitamin A toxicity in some people.
- People who take fish oil supplements should normally take them for several months to notice their beneficial effects.
How does it work?
Osteoarthritis
Weight reduction
- The best dietary recommendation that conventional medicine approves for patients with OA is to maintain a healthy weight. A few extra pounds can increase the pressure on damaged joints.
- Although some doctors recommend trying a vegetarian or vegan diet as a safe way to lose weight for patients with OA, most of them consider appropriate any low calorie and nutritionally adequate diet that goes well with the particular patient.
Alterations in the diet
- Some people believe that elimination diets can help reduce the symptoms of OA, although there is no scientific evidence of the effectiveness of any of these diets.
- Dong's diet requires the patient to eliminate all fruits, red meat, alcohol, dairy products, herbs and all foods containing additives or preservatives from their diet.
- The belladonna elimination diet requires eliminating all forms of belladonna from the diet, including various herbs, potatoes, tomatoes, peppers and aubergines.
- There is no clinical evidence that people with OA benefit from the elimination of these foods, and vegetables with belladonna may even help reduce the symptoms of arthritis.
Dietary supplements
To treat the discomfort caused by OA and / or to slow the rate of cartilage deterioration, the intake of some dietary supplements is usually recommended:
- Chondroitin sulfate is a compound that is naturally present in a protein in the body that provides elasticity to cartilage. The supplement form is a derivative of animal or shark cartilage.
- Glucosamine is a form of aminosaccharide which is thought to contribute to the formation and repair of cartilage. It can be obtained from the shell of crab, shrimp or lobster.
- Some naturopaths recommend the ingestion of extracts of cassava, devil's claw, hawthorn berry, cranberry and cherry. It is believed that these extracts reduce inflammation in the joints and promote the formation of cartilage.
- Some doctors recommend increasing the daily intake of vitamins C, E, A and B6, necessary to preserve the cartilaginous structure.
- The unsaponifiables of avocado and soy (IAS) are a compound obtained from fractions of avocado oil and soybean oil left over after the soap making process. They contain one part of avocado oil and two of soybean oil.
Rheumatoid arthritis
Dietary treatment of RA mainly accompanies pharmaceutical treatment, since the disease can not be treated by applying only nutritional changes.
Alterations in the diet
- A well-balanced and healthy diet can help prevent nutritional deficiencies generated by certain medications.
- There are indications that patients with RA may benefit from reduced consumption of red meat or switch to a vegetarian or vegan diet.
- Another adjustment in the diet that seems to benefit some people with RA is to stop cooking with oils with a high content of omega 6 fatty acids (which increase inflammation) and replace them with oils with a high content of omega 3 fatty acids (which reduce inflammation). ). The recommended oils are olive oil, rapeseed oil and flaxseed oil.
Dietary supplements
Among the dietary supplements most commonly recommended for patients with RA include:
- Fish oils Cold-water fish oils appear to reduce inflammation and relieve joint pain in some patients with RA. The recommended daily dose is 1 to 2 teaspoons. Eating fatty fish (such as salmon, trout and sardines) may also help reduce the risk of heart disease, which is higher in people with arthritis.
- Vegetable oils. Different studies suggest that vegetable oils with a high content of gamma-linolenic acid (GLA) reduce inflammation of the joints. These vegetable oils include evening primrose oil, borage oil and black currant oil. The recommended daily dose is usually 200 to 300 mg (0.2 to 0.3 g).
- Green Tea. It is believed that the intake of four glasses of green tea a day can benefit people with RA, thanks to the effect it produces in reducing the inflammation of the joints.
What is a typical meal?
- In general, foods to fight arthritis consist of a variety of healthy foods, including different fruits, vegetables, whole grains, semi-skimmed dairy products and lean meats. A healthy meal could include, for example:
- A turkey sandwich with lettuce and tomato on wholemeal bread
- Carrot sticks
- Apple
- Water or skimmed milk
What do the experts think?
- Doctors recommend weight loss as a positive way to decrease joint pain and improve the overall health of people with OA.
- There are no clinical studies demonstrating that OA patients can benefit from an elimination diet.
- Regarding dietary supplements, the results are varied. A comprehensive study of glucosamine and chondroitin sulfate supplements, the GAIT study (Glucosamine / Chondroitin Arthritis Intervention Trial), showed that the combination of these two supplements seemed to benefit a small subgroup of patients with OA with moderate pain to severe. In people with mild discomfort only, the glucosamine / chondroitin supplement did not produce pain relief other than a simple placebo effect.
- After reviewing 35 studies on medicinal herbs used to treat OA, it was concluded that, although the IAS are possibly beneficial, it is necessary to carry out a more exhaustive study that can determine what those benefits are.
Rheumatoid arthritis
- Few quality studies have been published regarding dietary treatments to treat RA in people.
- Some studies indicate that patients with RA can benefit from a vegetarian, vegan or Mediterranean diet.
- It is possible that fish oil supplements are encouraging, however, it is necessary to conduct more studies in this regard. Fish oils appear to reduce the risk of heart attacks in patients with RA, and relieve joint pain and inflammation.
- It has been discovered that green tea and turmeric help reduce inflammation of the joints in animals, although there are no scientific studies on the subject in humans.