Is there a special diet for arthritis? There is no quickfix diet that will magically mend the aches and pains of arthritis. But there’s no denying that there is a strong connection between what you eat and how you feel, and that relationship is likely to become more and more apparent the older you get.
What you eat is your body’s fuel, and the type of fuel you provide can affect how your arthritis and, in some cases, your arthritis treatment affects you.
Is There a Food Culprit?
A simple summary of the direct relationship of food to arthritis goes like this: Diet definitely affects gout, weight loss helps osteoarthritis, and high consumption of fish may ease rheumatoid arthritis. Arthritis related to food allergies is rare, and there’s little scientific evidence on any other connection. Here’s a closer look at what we know.
Food is clearly a culprit when it comes to gout. Eating large amounts of purines-chemical substances found in alcohol, liver, kidneys, and brains can trigger attacks of gout. And Reiter’s syndrome, another type of arthritis, apparently can develop from eating food or drinking water contaminated by salmonella or other bacteria. (Everyone who encounters these bacteria does not develop arthritis, however. Those who do seem to have a “malfunction” that causes their immune systems to attack their joints rather than the bacteria.)
Food allergies rarely cause arthritis. Some studies have suggested that in a few hypersensitive people, intolerance to foods such as dairy products, alcohol, or preservatives may make arthritis worse or bring on flare ups. There is little definitive research on this, however, and it’s highly individual. But if you think a certain food is triggering your arthritis, it’s perfectly sensible to experiment with cutting it out.
Others have suggested that vegetables in the nightshade family, which include tomatoes, potatoes, eggplant, and bell peppers, may aggravate rheumatoid arthritis. No studies prove it, however.
But for most of us, dietary goals need not be so specific. The Arthritis Foundation recommends seven basic diet guidelines:
- Eat a variety of foods.
- Stay at a healthy weight.
- Limit fat and cholesterol.
- Eat lots of vegetables, fruits, and grains.
- Limit sugar.
- Limit salt.
- Limit alcohol.
Generally, a good diet is made up of 15 to 20 percent protein (from lean meats or vegetable sources such as soybeans and other legumes), 25 to 30 percent fat (the healthiest fats are vegetable oils such as olive and canola), and 55 to 60 percent carbohydrates (food such as rice, bread, potatoes, and starchy vegetables like peas and corn). In general, most of us eat too much fat and not enough fruits and vegetables.
Boning Up on Calcium
The best sources of calcium are milk and dairy products. You can choose low-fat or fat free cheeses, yogurt, or milk. Other good sources are canned salmon and sardines (if you eat the soft bones as well), calcium fortified orange or grapefruit juice, and broccoli. You can also find smaller amounts of calcium in leafy greens such as kale, collard greens, and turnip greens.
Each serving of cheese, yogurt, or other dairy products equals about 300 milligrams. So if you aim for five servings of calcium rich foods per day, you’ll be getting 1,500 milligrams. If you can’t take in that much in food alone, as many people find hard to do, consider a supplement. For best results in preventing osteoporosis, the National Osteoporosis Foundation suggests a supplement of 1,000 to 1,500 milligrams of calcium for people 65 and older; women not taking estrogen need the higher amount.
Other ways to boost your calcium intake: Add nonfat dry milk to hot cereals, stews, casseroles, meat loaf, or mashed potatoes; use ricotta cheese or cottage cheese as a sandwich filling or spread on toast; replace beef or chicken in stirfry recipes with tofu, or soybean curd; add tofu, or soybean curd, to salads; have low-fat milkshakes instead of soft drinks.
And while you’re upping your intake, you’ll also want to slow your calcium “out-take,” or loss, in the following ways.
Limit coffee. One study showed that middle aged women who drank more than six cups of coffee a day had three times the risk of hip fracture than those who drank less than a cup and a half a day. Caffeine may harm your bones directly, or indirectly by making you urinate more often, which increases the amount of calcium you lose in your urine. It’s wise to cut your coffee intake or consider making the switch to decaf.
Cut back on alcohol. Alcohol can interfere with your ability to absorb and use calcium. Because women’s ovaries are sensitive to alcohol, it can alter the hormonal balance necessary for strong bones. And alcohol’s diuretic qualities may also promote more calcium loss through the urine.
Watch your soda intake. The amount of phosphorus in your diet may affect how much calcium you can obtain from your food. Some studies suggest that large amounts of sodas, which contain phosphoric acid, can limit the calcium you’ll have available. One survey found that women who drank carbonated drinks had more than twice as many broken bones as those who didn’t drink soda. It won’t hurt to limit your soda intake to one can a day or less.
Don’t Forget the Sunshine Vitamin
Vitamin D is important in building bones and keeping them strong. Without enough vitamin D, bone and the cartilage that covers it may not recover fully after an injury or blow. Vitamin D is found in green leafy vegetables such as kale and collard greens and in egg yolks and enriched milk.
Your body can also manufacture vitamin D from exposure to sunlight. This is tricky, as you don’t want to risk sunburn or excessive sun exposure, but researchers estimate that 10 to 15 minutes of sunlight can provide enough sun to help your bones. (It’s best to spend this time outdoors in early morning or late afternoon, thus avoiding the hours when the sun’s damaging rays are strongest.) You can also get the recommended daily allowance of 400 IV from two glasses of enriched milk.
Fatty Acids And You
Neither “fatty” nor “acid” is a word we commonly associate with something good, but some fatty acids play important roles in our health. In your body, they change to substances called prostaglandins, which are crucial in telling different kinds of cells (such as intestinal, kidney, and lung cells) how to function.
Cold-water fish such as salmon, mackerel, and herring are high in omega-3 fatty acids, which convert in your body to prostaglandins that apparently can help prevent heart disease and reduce the harmful blood fats called triglycerides. There’s some evidence that the prostaglandins from omega-3s also slow rheumatoid arthritis. In an Australian study, 23 people who took fish oil daily for three months found that their joints were less sore and they could gnp things more tightly than they could before the study.
Experts recommend eating cold-water fish at least twice a week, and more often if possible. These include mackerel, tuna, salmon, sardines, herring, cod, and bluefish.
Ten Tips To Make Eating Well Easy
Remember this simple rule: It takes three weeks to make something a habit, and some people report that it takes at least six weeks to adjust to low-fat and lower-calorie eating. So if you find yourself wavering, wait it out-it’s worth it. Here are some tips to help.
Allow yourself treats. Eat whatever you crave, but just don’t eat much of it. If you think you will die if you don’t have some chocolate, walk or bike to the store and buy a tiny chocolate bar and eat it. Otherwise you can eat celery until you turn into a giant stalk, but you still won’t be happy.
Pack your lunch. If you work a 9-to-5 job, it’s tough to get a fast, healthy lunch during your brief lunch hour. You’re better off packing your own. A sandwich with low fat meat, water packed tuna, or tofu spread, plus fruit and carrot sticks will fill you up and keep you going all after-noon. You can get a lunch container with ice packs if you don’t want to trust your food to the company fridge.
Try something new. Experiment with low-cal substitutes for your favorite foods. Maybe you can put mushrooms in tomato sauce instead of meatballs and sausage. Eat sherbet instead of ice cream. Savor a graham cracker instead of a cookie (you loved them when you were little).
Read labels. You’ll think twice about devouring fast-food fries when you read the chart on the wall and discover that an order has 25 grams of fata huge chunk of your daily allotment. And when you see the calorie count of those low-fat cookies (remember, low-Jat doesn’t mean lowcalorie), you may put them back on the shelf. Also, foods such as cereal vary greatly in calorie and fat content. If you buy a cereal loaded with nuts and dried fruit, one serving is only a tiny heap. Instead, purchase a basic cereal such as shredded wheat or bran flakes and flavor it with a bit of the ” fancy” kind .
Make special orders. You can enjoy eating out and care for yourself at the same time. Read the menu carefully and ask things like, “Does this chicken come without skin?” and “Can you serve those vegetables without butter?” and say “Dressing on the side, please.”
Use small plates and small bowls. This is purely psychological, but it works. You feel better starting out with a full plate rather than a large one with the food rattling around on it. Likewise, when you have frozen desserts such as sherbet, use a tiny bowl.
Get a decent, digital scale. The other kind encourages too much fudging (Hey, if you lean way to the left, you’ve lost five pounds!). Weigh yourself at regular intervals and record your weight. This keeps you honest and helps you stay aware of your goal.
Never skip meals-especially breakfast! When you wake up, your body is in “low gear” and burning few calories. If you don’t eat, your body thinks you’re starving and stays at that low-calorie-burning rate. Eating actually “revs up” your engine and starts your metabolism burning calories faster.
Substitute when you cook. Instead of frying, broil foods or saute them in broth. Use applesauce instead of Crisco, butter, or margarine and egg substitutes or egg whites instead of whole eggs. Also, in most recipes you can cut the sugar by at least one-third. Forget about using mixes for cakes or muffins, because you can’t adjust the recipe. But for most unyeasted baked goods, it’s surprisingly easy to do things the old-fashioned way: Mix flour and a few other ingredients, and you’re done!
Change how you shop. Avoid or limit high-fat foods such as sunflower seeds, avocados, nuts, crackers, pizza, creamy soups or casseroles, cheese and cream cheese, sour cream, butter or margarine, sausage, and pepperoni. Good choices include low-fat or nonfat salad dressing, low-fat lunch meats, nonfat milk, nonfat or low-fat cheese, egg substitute, water packed tuna, tofu, and canned or dried legumes such as pinto beans, kidney beans, and split peas.
Interactions With Your Medications
Your doctor has undoubtedly warned you about the hazards of side effects from your medications. However, an often overlooked side effect is the effect of medication on your nutrient status.
Here are some common problems that can result and the simple solutions.
Problem: Some antacids can have high levels of sodium, calcium, and magnesium. Too much calcium may cause kidney stones and can interfere with your body’s use of other important minerals such as iron and zinc. It can also cause a dangerous condition called hypercalcemia, which can damage kidney function. Excess magnesium can trigger diarrhea.
Solution: Talk it over with your doctor. Based on your medical history, she will know whether you need to modify your intake of antacids or perhaps have your blood tested to see if they are causing problems.
Problem: Antacids with aluminum or magnesium hydroxide may lower your level of phosphorus, which you need to use calcium.
Solution: Choose another antacid or include lean meat and poultry in your diet for an adequate phosphorus supply.
Problem: Corticosteroid medicines may cause you to lose potassium, absorb less vitamin D, and retain sodium. Potassium and vitamin D are both crucial nutrients.
Solution: Good sources of potassium include prune juice, carrot juice, orange juice, baked potatoes, avocados, bananas, clams, nonfat yogurt, and many raw fruits and vegetables.
You can get vitamin D in enriched milk, tuna, and salmon and through exposure to sunlight. Decrease your salt intake to help compensate for the retained sodium.
Problem: Colchicine, a gout medication, can affect how vitamin B12 is absorbed.
Solution: You can enjoy a boost of vitamin B12 in tuna, oysters, and beef (lean, of course).
Problem: Methotrexate, a common treatment for rheumatoid arthritis, may interfere with your body’s use of folic acid, an important nutrient. This, in turn, can contribute to methotrexate toxicity, which can damage your liver.
Solution: Your doctor will routinely prescribe folic acid supplements if you’re on methotrexate, but you can also find folic acid in wheat germ, liver, oranges, orange juice, eggs, milk, navy and lima beans, spinach, asparagus, and broccoli.
Problem: Grapefruit juice has been found to have a major effect on absorption of several medicines, including cyclosporin for rheumatoid arthritis.
Solution: Ask your doctor whether any of your medications are affected by grapefruit juice. If the answer is yes, switch to orange juice. Better yet, get your nutrients from whole fruit, which is nutritionally far superior to juices.