Ask a Dietitian

As seen on BCTV September 12/00

September is Arthritis Month

Statistics and Background on Arthritis:

• 1 in 8 people in BC have one of the over 100 forms of arthritis.
• Arthritis can affect people of all ages but its prevalence increases with age.
• 60% of those with arthritis are under 65 years old and in their peak earning years.
• Most types of arthritis cannot be cured or prevented.

Bookstores are full of cookbooks and health books that promise to cure arthritis and whatever else ails you. Unfortunately, these books are often not based on science and full of misinformation. There is no proof that what you eat can either cause or cure arthritis and the many kinds of musculoskeletal disorders, with the exception of gout.

Although diet may not cure or cause arthritis, it can affect your overall health. There is still much research to be done, but scientists believe that there are several ways in which diet might affect your arthritis.

• Some people with arthritis might be sensitive to certain foods that could trigger symptoms, or worsen them.
• A diet high in saturated animal fats and the most commonly used vegetables oils (sunflower and safflower) may contribute to joint and tissue inflammation.
• Diet can make your general health worse, or affect other diseases you have such as heart disease, stroke, diabetes, colon and breast cancer. The worsening of these conditions can affect how your body handles the arthritis symptoms.
• Arthritis can make your diet worse. It can keep you from shopping, preparing, chewing and eating food. Pain and fatigue can ruin your appetite.

There are at least two reasons why some people experience an improvement in arthritis symptoms after a dietary experiment. The first is the cyclical nature of arthritis. Arthritis can go into spontaneous remission, and if this occurs at the same time dietary changes are made, the diet is often attributed to the improved health. The second is the placebo effect, the power of the mind. Can diet actually help control arthritis?

A few studies have shown that eliminating certain foods relieved symptoms for some people, but there was no consistency. Some of the suspect foods include; dairy products, wheat, corn, beef, pork, peanuts, coffee, eggs, foods from the “nightshade” family (potatoes, tomatoes, eggplant and peppers), salt, MSG, nitrates. Because of the cyclical nature of autoimmune diseases it’s not easy to say what, if anything, caused a change in symptoms.

Diet Changes that Might Help

Researchers do know that saturated animal fat and the most commonly used vegetable oils (such as corn, sunflower and safflower oils) break down into arachidonic acids, which are building blocks for the series 2 prostaglandins and leukotrienes that cause pain and inflammation.

One study in Greenland suggests that large doses of omega-3 fatty acids, found in cold-water fish oils, may alleviate inflammation. Omega-3 fatty acids contain ecosapentanoic acid (EPA) and docosahexanoic acid (DHA) and compete with arachidonic acids. EPA and DHA supply the building blocks to make the series 1 and 3 protaglandins and leukotrienes that reduce inflammation. They also help keep your blood thinner and improve circulation. While there is no proof that the oils actually altered the course of arthritis, the study shows fish oils may be useful as a complementary therapy, used within a normal regimen of medications.

One other oil that has shown good results in reducing inflammation is gamma-linolenic acid (GLA), found in concentrated amounts in evening primrose oil and black currant seed oil. GLA helps produce series 1 prostaglandins that fight inflammation.

Can you take fish oil supplements? Yes, but you would need to take a lot of capsules to get enough of these oils. The best method would be to improve your overall diet in addition to the supplements.

What can you do?

• Improve your overall diet, cut down on junk food, fast food, high fat food, alcohol, colas coffee, sugar etc.
• Increase your intake of fruits and vegetables.
• Eat more broccoli and dark green vegetables, especially if you have lupus.
• Explore soy. Green soybeans are high in omega-3 fatty acids.
• Get rid of high linoleic oils such as safflower, sunflower, and corn oils.
• Use high linolenic oils such as olive, canola, or flaxseed oil
• Use more flaxseed in your diet. 1 Tbsp/day. Flax is a good source of EPA and also contains lignans which may help prevent breast and colon cancer.
• Cut your meat, poultry and animal product consumption to no more than 4-6 oz per day. (1-2 decks of cards). Wild game, free-grazing or range-raised meat that is not fattened with feed before slaughter is leaner and lower in omega-6 fatty acids.
• Add a cold water fish to your dinner menu two or three times a week. Sardines in their own oil, mackerel, herring, trout, anchovy, sablefish, salmon, bluefish, mullet. Be sure they are wild. Farm-raised fish are fed a commercial feed that lower the omega-3 levels. Don’t fry it- bake or broil it, with little or no added fat.
• Remember that all fat, good or bad, has calories. Be sure to monitor your daily fat intake so that no more than 20-30% of your calories are from fat.
• Maintain a healthy body weight. Excess body weight will increase the pressure on your aching joints and muscles.
• Exercise regularly.
• Keep a food diary to see if you notice a difference with certain foods.

Watch for the Eating for Energy segment every Tuesday on BCTV’s Noon News Hour!