Millions of people suffer from painful and swollen
joints associated with arthritis. In the past, many doctors told arthritis
patients that dietary changes would not help them. However, this
conclusion was based on older research with diets that included dairy
products, oil, poultry, or meat.1,2 New research shows that foods may be a
more frequent contributor to arthritis than is commonly recognized. It is
clear that, at least for some people, a healthier menu is the answer.
Different Types of Arthritis
Arthritis is actually a group of different diseases.
Osteoarthritis is a gradual loss of cartilage and overgrowth of bone in
the joints, especially the knees, hips, spine, and fingertips. Over 20
million Americans, mostly over age 45, suffer from osteoarthritis, which
seems to be the result of accumulated wear and tear. Although it can cause
painful episodes, it is characterized by only transient stiffness and does
not cause major interference with the use of the hands.
Rheumatoid arthritis, which affects over 2 million
people, is a more aggressive form of the disease. It causes painful,
inflamed joints, which sometimes become damaged.
Rheumatoid arthritis is one of medicine's mysteries.
There were no medical reports of the disease until the early 1800s. Some
have suspected that a virus or bacterium may play a role, perhaps by
setting off an autoimmune reaction. Genetics may also be a factor, in that
it may influence susceptibility to the disease.
The Role of Diet
For years people have suspected that foods are an
important factor in the development of rheumatoid arthritis. Many notice
an improvement in their condition when they avoid dairy products, citrus
fruits, tomatoes, eggplant and certain other foods.
Initially, the evidence was anecdotal. A woman from the
Midwest once suffered from painful arthritis. Today she is a picture of
health, thin and athletic, and her arthritis is totally gone. It seemed
that dairy products were to blame for her arthritis, for when she
eliminated them from her diet, the arthritis disappeared completely.
Another woman, from Wisconsin, also found that her
arthritis was clearly linked to dairy products. Although she had been
raised on a dairy farm, she learned that staying away from dairy products
was the key to relieving her symptoms.
A 1989 survey of over one thousand arthritis patients
revealed that the foods most commonly believed to worsen the condition
were red meat, sugar, fats, salt, caffeine, and nightshade plants (e.g.,
tomatoes, eggplant).3 Once the offending food is eliminated completely,
improvement usually comes within a few weeks. Dairy foods are one of the
principle offenders, and the problem is the dairy protein, rather than the
fat, so skim products are as much a problem as whole milk.4
An increasing volume of research shows that certain
dietary changes do in fact help. For example, polyunsaturated oils and
omega-3 supplements have a mild beneficial effect, and researchers have
found that vegan diets are beneficial.5 One 2002 study looked at the
influence of a very low-fat vegan diet on subjects with moderate-to-severe
RA. After only four weeks on the diet, almost all measures of RA symptoms
decreased significantly.6 The journal Rheumatology published a study that
found a gluten-free vegan diet improved the signs and symptoms of RA.7 An
uncooked vegan diet, rich in antioxidants and fiber was shown in another
study to decrease joint stiffness and pain in patients with RA.8 Some
research studies have looked at fasting followed by a vegetarian or vegan
diet. A review of multiple research studies concluded that this dietary
treatment might be useful in the treatment of RA.9
Vegan diets dramatically reduce the overall amount of
fat in the diet, and alter the composition of fats. This in turn can
affect the immune processes that influence arthritis. The omega-3 fatty
acids in vegetables may be a key factor, along with the near absence of
saturated fat. The fact that patients also lose weight on a vegan diet
contributes to the improvement.
In addition, vegetables are rich in antioxidants, which
can neutralize free radicals. Oxygen free radicals attack many parts of
the body and contribute to heart disease and cancer, and intensify the
aging processes generally, including of the joints.
Iron acts as a catalyst, encouraging the production of
these dangerous molecules. Vitamins C and E, which are plentiful in a diet
made of vegetables and grains, help neutralize free radicals. Meats supply
an overload of iron, no vitamin C, and very little vitamin E, whereas
vegetables contain more controlled amounts of iron, and generous
quantities of antioxidant vitamins.
As well as being helpful in preventing arthritis,
antioxidants may also have a role in reducing its symptoms. Some arthritis
treatments, including non-steroidal anti-inflammatory drugs, work at least
in part by neutralizing free radicals. For the most part, however,
vitamins and other antioxidants will be of more use in preventing damage
before it occurs, rather than in treating an inflamed joint.10
A diet drawn from fruits, vegetables, grains, and beans
therefore appears to be helpful in preventing and, in come cases,
ameliorating arthritis.
The Four-Week Anti-Arthritis Diet (adapted from Foods
That Fight Pain, by Neal Barnard, M.D.)
For four weeks, include generous amounts of foods from
the pain-safe list in your routine.
At the same time, scrupulously avoid the major triggers.
It is important to avoid these foods completely, as even
a small amount can cause symptoms.
Foods that are not on either list can be consumed, so
long as you are emphasizing the arthritis-safe foods and scrupulously
avoiding the major triggers.
You may well experience benefits earlier than four
weeks, but for some people it can take this long for chronically inflamed
joints to cool down.
Pain-Safe Foods
Pain-safe foods virtually never contribute to arthritis
or other painful conditions. These include
Brown rice
Cooked or dried fruits: cherries, cranberries, pears,
prunes (but not citrus fruits, bananas, peaches or tomatoes)
Cooked green, yellow, and orange vegetables: artichokes,
asparagus, broccoli, chard, collards, lettuce, spinach, string beans,
summer or winter squash, sweet potatoes, tapioca, and taro (poi)
Water: plain water or carbonated forms, such as Perrier,
are fine. Other beverages � even herbal teas � can be triggers.
Condiments: modest amounts of salt, maple syrup, and
vanilla extract are usually well-tolerated.
After four weeks, if your symptoms have improved or
disappeared, the next step is to nail down which one or more of the
trigger foods has been causing your problem. Simply reintroduce the foods
you have eliminated back into your diet one at a time, every two days.
Have a generous amount of each newly reintroduced food,
and see whether your joints flare up again. If so, eliminate the food that
seems to have caused the problem, and let your joints cool down again.
Then continue to reintroduce the other foods. Wait at least two weeks
before trying a problem food a second time. Many people have more than one
food trigger.
It is not recommended to bring meats, dairy products, or
eggs back into your diet. Not only are they major triggers, but they also
encourage hormone imbalances that may contribute to joint pain, and also
lead to many other health problems.
Avoid Major Arthritis Triggers
1. Dairy products*
2. Corn
3. Meats**
4. Wheat, oats, rye
5. Eggs
6. Citrus fruits
7. Potatoes
8. Tomatoes
9. Nuts
10. Coffee
*All dairy products should be avoided: skim or whole
cow�s milk, goat�s milk, cheese, yogurt, etc.
**All meats should be avoided: beef, pork, chicken,
turkey, fish, etc.
Other Approaches
For some arthritis patients, supplements of certain
essential fatty acids have been helpful. They should be thought of as a
medicine, rather than a food. A typical regimen would include a tablespoon
of flaxseed oil with 500 mg of blackcurrant oil (or three capsules of
evening primrose oil) twice each day. If it is helpful, it should be
reduced to the lowest effective dose. Some people also benefit from an
herb called feverfew, taken two to three times per day. (Caution: Do not
take feverfew if you are pregnant.)
These supplements are available in health food stores.
References
1. Panush RS, Carter RL, Katz P, Kowsari B, Longley S, Finnie S. Diet
therapy for rheumatoid arthritis. Arthritis and Rheumatism 1983;26:462-71.
2. Lithell H, Bruce A, Gustafsson IB, et al. A fasting and vegetarian
diet treatment trial on chronic inflammatory disorders. Acta Derm Venereol
1983;63:397-403.
3. Sobel D. Arthritis: What Works. New York, St. Martin's Press, 1989.
4. Skoldstam L, Larsson L, Lindstrom FD. Effects of fasting and
lactovegetarian diet on rheumatoid arthritis. Scand J Rheumatol
1979;8:249-55.
5. Skoldstam L. Fasting and vegan diet in rheumatoid arthritis. Scand J
Rheumatol 1986;15:219-23.
6. McDougall J, Bruce B, Spiller G, Westerdahl J, McDougall M. Effects
of a very low-fat, vegan diet in subjects with rheumatoid arthritis. J
Altern Complement Med. 2002 Feb;8(1):71-5.
7. Hafstrom I, Ringertz B, Spangberg A, von Zweigbergk L, Brannemark S,
Nylander I, Ronnelid J, Laasonen L, Klareskog L. A vegan diet free of
gluten improves the signs and symptoms of rheumatoid arthritis: the
effects on arthritis correlate with a reduction in antibodies to food
antigens. Rheumatology (Oxford). 2001 Oct;40(10):1175-9.
8. Hanninen, Kaartinen K, Rauma AL, Nenonen M, Torronen R, Hakkinen AS,
Adlercreutz H, Laakso J. Antioxidants in vegan diet and rheumatic
disorders. Toxicology. 2000 Nov 30;155(1-3):45-53.
9. Muller H, de Toledo FW, Resch KL. Fasting followed by vegetarian
diet in patients with rheumatoid arthritis: a systematic review. Scand J
Rheumatol. 2001;30(1):1-10.
10. Merry P, Grootveld M, Lunec J, Blake DR. Oxidative damage to lipids
within the inflamed human joint provides evidence of radical-mediated
hypoxic-reperfusion injury. Am J Clin Nutr 1991;53:362S-9S.
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