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How does diet affect arthritis?

A diet high in fruits helps protect the joints in a variety of ways, supplying nutrients like vitamin C, which is needed for calcium and iron absorption, collagen formation and protection against free-radical damage. The high fiber, water and other nutrient content in plant-based foods also help with weight management, making it easier to avoid obesity, which places unhealthy stress on vulnerable joints. And Harvard researchers have found a link between low fruit consumption and the higher risk of rheumatoid arthritis.

Certain fruits and vegetables also supply particular nutrients with more targeted joint benefits. For example:

  • Pineapple is the only natural source of bromelain, an enzyme that acts as a cleanup crew, digesting dead protein cells in the case of injury or run-of-the-mill microtears that are part of the muscle-building process. Research suggests that the bromelain in pineapples can also help reduce inflammation and relieve muscle soreness.
  • Cherries are a top source of anthocyanins, thought to reduce inflammation and lower blood levels of uric acid, which can crystallize and accumulate in the joints, causing the type of pain along the lines of that associated with gout attacks.
  • Butternut squash is rich in beta-cryptoxanthin, a provitamin A carotenoid. In a study in the American Journal of Clinical Nutrition, subjects with the highest intake of fruit and vegetables containing beta-cryptoxanthin reduced their risk of developing polyarthritis by 50 percent. Other beta-cryptoxanthin sources include oranges, pumpkins, tangerines and papayas.
  • One large red bell pepper can supply 340 percent of your daily vitamin C—and high vitamin C intakes have shown promise in reducing later risk of osteoarthritis of the knee. For 10 years, Australian researchers tracked the diets of 293 healthy adults and then used MRIs to test for osteoarthritic markers. The results showed that those adults with the highest fruit and vitamin C intakes were least likely to develop the kind of bone abnormalities that indicate incipient arthritis of the knees.
  • When broccoli and other cruciferous veggies are eaten, they release a compound called sulforaphane that triggers the body’s own antioxidant defenses. Research suggests that this process may block the COX-2 enzymes which cause inflammation. Broccoli sprouts are one of the most potent sources of these compounds. Other sources include cabbage, cauliflower and Brussels sprouts.
  • Kale holds the line against osteoarthritis due to its high-calcium content, which helps slow bone loss. Other sources include nonfat dairy products, collard greens, soybeans and arugula.
  • Portobello mushrooms are a top vitamin D source, supplying 100 percent of daily requirements in just 3 ounces (85 grams). Other vitamin D sources include oysters, sardines and fortified nonfat milk.
Dr. Alan Gaby
Nutrition & Dietetics Specialist

Research has demonstrated that diet and certain nutritional supplements can improve the symptoms of rheumatoid arthritis. Supplements that have been found to be beneficial include zinc, copper, borage oil, fish oil and ginger root (see chapter 156 of my textbook, Nutritional Medicine. www.doctorgaby.com). Because rheumatoid arthritis can be a serious illness, and because of the potential for drug-nutrient interactions, people with this condition who are interested in using nutritional supplements should be monitored by a nutritionally-oriented doctor.

Dr. Grant Cooper, MD
Physical Medicine & Rehabilitation Specialist

Because of the inflammatory component that exists in osteoarthritis, it is reasonable and perhaps likely that an anti-inflammatory diet including olive oil could decrease the severity of osteoarthritis symptoms and disease progression. A study of rheumatoid arthritis patients showed that people who consumed 6 grams a day of olive oil in capsule form experienced a significant improvement in their arthritis symptoms after six months.

In addition, if you follow these basic principles, you will be healthier and your arthritis symptoms will probably improve:

  • Drink plenty of fluids, mostly water.
  • Eat more fruits and vegetables.
  • Eat more cold-water fish.
  • Eat red meat sparingly.
  • Eat fewer processed foods.

Research substantiates possibly taking 3-4 supplements if you have arthritis. In addition to a multivitamin each day (which everyone should take), you should probably be taking glucosamine, chondroitin, fish oils and cherry supplements. Two other supplements worth considering are avocado soybean unsaponifiables (ASU) and methylsulfonylmethane (MSM).

The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis (A DiaMedica Guide to Optimum Wellness)

More About this Book

The Arthritis Handbook: Improve Your Health and Manage the Pain of Osteoarthritis (A DiaMedica Guide to Optimum Wellness)

According to conventional wisdom, arthritis pain is an inevitable part of aging. Not so, says Dr. Grant Cooper in this practical, accessible guide. For those who do develop osteoarthritic conditions,...

Most of the patients with arthritis I've seen do better eating lots of vegetables and fruits. Here are some more tips for your diet if you have arthritis:

  • Eat at least eight servings of fruits and vegetables. Choose those with bright or deep colors like cherries and berries and sweet potatoes that contain natural anti-inflammatory nutrition. Oranges and tomatoes have been shown to have significant anti-inflammatory effects in some people.
  • Eat fish three times a week, especially wild salmon, if it's available and affordable, but don't fry your fish; frying interferes with the benefits.
  • Choose your oils wisely. Consider supplementing your diet with the natural anti-inflammatory, fish oil. Studies have shown that people with inflammatory arthritis experience a decrease in pain and stiffness of their joints when treated with fish oil. Extra-virgin olive oil also has natural anti-inflammatory benefits, whether raw or cooked. Flaxseed oil and flaxseed meal (ground flaxseed) also have significant anti-inflammatory effects, but should not be cooked, because cooking destroys some of the beneficial omega-3 fats. Other vegetable oils, like corn, safflower or sunflower oils, can increase inflammation and counteract the benefits of anti-inflammatory nutrients in your diet.
  • Drink tea, black or green. Green tea may have anti-cancer effects, but black tea has a better track record in fighting inflammation. You need at least three cups a day, unless you're a smoker, in which case no amount of tea will work for you.
  • Avoid sugar and foods with added sugar and refined carbohydrates. Reduce inflammation by cutting out white flour products, white rice and white potatoes. Several studies have shown that consuming foods of this type aggravates inflammation. Instead, eat high fiber foods like whole grains and legumes. Studies have shown that high fiber diets are anti-inflammatory.

There is no scientific evidence to show that the development of arthritis is related to diet, either the presence or absence of foods. Naturally, if you eat certain foods and arthritis symptoms seem to worsen, avoid that food, but make sure you are still getting a balanced diet and eating a wide variety of healthy foods. The food-arthritis link is often related to a discussion of food allergies and arthritis. Food allergies occur when your immune system mistakenly believes that something you ate is harmful. To protect you, the immune system makes antibodies against that food. The antibodies set off a chain reaction that causes symptoms. Once antibodies are made against a particular food, the body instantly recognizes that food the next time it is consumed, and the cycle begins again.

While research continues in this area to see if certain foods can be identified that make arthritis worse, no good evidence exists at this time. That said, adequate bone building nutrients throughout life (calcium, vitamin D, vitamin K, protein and others) will ensure that your bones start off as healthy as they can be.

All chronic conditions can be treated in some way that lessens the damage and aging that the condition would have caused if not treated. For arthritis, treatment means getting pain relief so you can continue to exercise and strengthen the muscles around the joint. It also means having the right diet and taking the right amount of vitamin C, calcium and vitamin D, so that bone reconstruction is more normal. (In these ways, osteoarthritis can be less of a hazard.)

And here is an herbal remedy that should become mainstream. The push that one doctor started for glucosamine and chondroitin sulfate has been shown in four randomized studies. Since 95 percent of us will have osteoarthritis by the time calendar age 80 occurs, we have almost made this a RealAge (physiological age) benefit for all people. But the data are only for those with the diagnosis of osteoarthritis. This combination of "herbs" not only decreases pain substantially in over 50 percent of osteoarthritis patients by 3 months, but it slows, and even reverses some of the clinical and radiologic symptoms and evidence of joint disease.

Diet can play a role in arthritis; there are certain foods that promote inflammation in the body, making arthritis symptoms worse. Watch as rheumatologist Natalie Azar, MD, discusses which foods fight inflammation, and which are more inflammatory.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.