Diet and Arthritis is a guest post by Brian J. McGrory, MD, MS, a hip and knee replacement surgeon at Maine Medical Center. The connection between diet and arthritis is powerful.
One of the common questions that patients have when hip or knee arthritis is diagnosed is “How can I decrease my pain and stiffness other than by having surgery?” As an orthopaedist, I always pursue non-surgical management first. Only when all non-surgical measures fail to give relief is surgery indicated.
There are a number of measures that patients can pursue to minimize arthritis symptoms. One measure that does not receive a lot of attention is following a certain diet. One of the reasons that this is true is that we only partially understand how our diet interacts with all of the mechanisms that our body uses to remain in balance. Another is that changes are gradual, so the symptom relief is often hard to recognize, particularly with a degenerative disease like arthritis. Finally, some patients may respond to certain dietary changes, while others may not.
Diet and Arthritis
What is known is that certain foods have an overall inflammatory effect on our immune systems. Experiments show that certain measures of inflammation are reliably increased or decreased by certain dietary changes. It therefore makes sense that if we incorporate those changes in our lifestyle, that we can expect that our body’s inflammatory state will change.
One example of foods that are good for a patient with arthritis are foods with a low glycemic index. Glycemic index is the blood glucose-raising potential of the carbohydrates in different foods. In the simplest terms, foods that elevate our insulin response very rapidly are the foods that have a propensity to support an inflammatory state. That state affects our whole body, including joints that have arthritis. This does not mean that a specific diet caused the arthritis, but rather that the diet is possibly aggravating the inflammation and therefore the symptoms from the affected joint. Processed carbohydrates like sugar and bleached flour products are examples of foods that should be avoided. Instead, complex carbohydrates like those in fruits and sprouted or whole grain breads are better.
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Another area that should be considered is fats. Diets high in saturated and trans fats are pro-inflammatory. On the other hand, some studies have found that adherence to a Mediterranean-style diet—a diet high in monounsaturated fats—may help reduce inflammation. A Mediterranean diet emphasizes olive oil, fruits and vegetables, nuts, beans, fish, and whole grains. Higher intakes of the omega-3 fatty acids have also been generally associated with decreased markers for inflammation. The ratio of omega-6 to omega-3 fatty acids in the typical Western diet is about 15-20:1, yet it is estimated that humans evolved on a diet with an omega-6 to omega-3 fatty acid ratio of about 1:1. Decreasing this ratio will likely reduce the prevalence and severity of various inflammatory conditions. If you enjoy beef and eggs in moderation, grass fed beef and non-caged chicken eggs often have better ratios of omega-6 to omega-3 fatty acids.
Micronutrients such as magnesium and vitamins like B6, C, D, E may also play a role in the body’s inflammatory response. I therefore recommend that patients take an adult multivitamin regularly.Diet should be a part of a comprehensive program to decrease pain and increase function and independence in patients with arthritis of the hip and knee. Regular physical activity is important in reducing inflammation as well as one’s risk for obesity and chronic diseases associated with inflammation. That will be the topic for the next installment of our ongoing series on arthritis.
Diet and Arthritis ©2014 Brian McGrory All Rights Reserved