Both old and young people are affected by arthritis, and there are over 100 types. Photo / 123rf
Lowering inflammation in the body is key to reducing arthritis flare-ups. Here are the worst dietary culprits.
For the 10 million people living with some form of arthritis in the UK, symptoms including stiffness, pain and swelling can be particularly hard to live with. Both old and young people are affected and there are over 100 types of arthritis, including rheumatoid arthritis, psoriatic arthritis, fibromyalgia and gout, with osteoarthritis being the most common. All types involve some degree of inflammation.
Diet plays an important and often misunderstood role in managing arthritis. “There are some surprising dietary culprits that may exacerbate arthritis symptoms, but it’s crucial to understand that the impact of these foods can differ markedly from one individual to another and even fluctuate in the same person over time,” says Dr Taher Mahmud, a consultant rheumatologist and the director of the London Osteoporosis Clinic.
Inflammation occurs when substances from the body’s white blood cells are released into affected tissues to protect your body from foreign invaders. It’s this release of chemicals that increases the blood flow to the area of injury, and may stimulate nerves and cause pain. So avoiding foods that trigger this response is your top priority if you suffer from arthritis. According to Arthritis Action, eating healthily can help maintain muscle and bone strength, thereby improving arthritis symptoms, so it’s in your interests to be informed about diet.
Dr Mahmud recommends keeping a food diary and being curious about the foods that may trigger your inflammation. “Inflammation is a generic term, so this could refer to foods that irritate the gut, or foods that have a negative impact on your system, or cause extra stress, or a change in your insulin response, or a metabolic inflammation,” he says. “There are different definitions of inflammation, but the net result is if you have a particular food and it gives you symptoms, then you want to identify what that might be”.
Fats in general are bad news for arthritis sufferers. “For one thing, you should avoid high-fat fried foods because of the risk of increasing obesity, putting pressure on your joints, but also because of the inflammatory effect of these foods,” says Professor Rajarshi Bhattacharya, a consultant orthopaedic surgeon at the Cleveland Clinic. Several studies have shown that saturated fats trigger adipose inflammation, which worsens arthritis inflammation. This means you should reduce your consumption of meat, butter and cheese.
Fried foods also tend to have high levels of omega-6 fatty acids and often contain trans fats, both of which can trigger inflammation.
According to the Arthritis Foundation, being just 10 pounds (4.5kg) overweight puts an extra 15 to 50 pounds of pressure on your knees. This makes it more likely that you’ll develop osteoarthritis or make the disease worse if you already have it. So start by cutting out the sweet treats.
“Sugar is a major culprit for increasing your weight,” says Bhattacharya. “Furthermore, sugar is processed, and any processed food causes an increase in inflammation and arthritis by causing the body to produce cytokines, which are inflammatory proteins.”
If you need a sugar hit, fruits such as oranges, cherries, strawberries and grapes all have anti-inflammatory properties.
“Processed meats – such as sausages and deli meats – and red meats are high in saturated fats, which can promote inflammation,” says Mahmud. People who eat a lot of processed and red meats may have higher levels of interleukin-6 (IL-6), C-reactive protein (CRP), and homocysteine – all of these are markers of inflammation.
“What’s more, limiting refined and highly processed foods will improve your overall health,” Mahmud says. “Processed foods can affect your weight and blood pressure, so in terms of metabolic effect, this can lead to a whole system of distress and less resilience to conditions like arthritis.”
Research has found that a low-fat vegan diet improves rheumatoid arthritis symptoms, such as the degree of pain, joint tenderness, and joint swelling. Diets rich in vegetables, fruits, and fibre are associated with lower BMI, have anti-inflammatory properties and help reduce pain and inflammation.
Another problem with processed and red meats is that they are high in advanced glycation end products (AGEs). These are molecules created through reactions between sugars and proteins or fats. They occur in high-protein, high-fat animal foods that are fried, roasted or grilled, such as bacon, fried chicken and steak. An accumulation of AGEs in the body can lead to oxidative stress and inflammation and is linked to arthritis. Other foods high in AGEs include mayonnaise, cream cheese and butter.
“Seafood like scallops and mussels cause inflammation as they are high in purine,” says Bhattacharya. Purines are substances in foods that the body converts to uric acid, which can form painful crystals in and around joints and trigger gout attacks – a very painful type of arthritis. Instead of seafood, go for freshwater and oily fish, like salmon and sardines, which contain omega-3 fatty acids, good for reducing inflammation.
“Other foods that are high in purine include high-fructose corn syrups (found in many breakfast cereals), alcohol, organ meats like liver and red meat,” Bhattacharya says.
“Although not everyone is sensitive to gluten, if you have coeliac disease or gluten sensitivity, you may experience increased inflammation when consuming foods containing gluten,” Mahmud says. Gluten is the name for proteins found in wheat, barley and rye, so bread, cereal, beer and pastry are major culprits. Try gluten-free options, and check ingredient lists on processed foods, as it’s often used as a thickening agent.
“Foods high in refined carbohydrates, such as white bread, white rice, pasta and pastries, can also contribute to inflammation,” Mahmud says. Opt for wholegrain alternatives.
“With alcohol, our simple view is to avoid it altogether. Of course, some people with arthritis might find they’re fine with a little alcohol, but for those who have gout, alcohol leads to uric acid getting deposited in the tissues, resulting in a flare,” Mahmud explains. Beer and cider are particularly problematic.
“Hydrogenated oils such as sunflower oil, soya oil and peanut oil are high in omega-6, which has been linked to inflammatory chemicals in the body,” Bhattacharya says. Instead, go for flaxseed oil, which is the best oil source of omega-3 fatty acids that help to reduce inflammation.
Tomatoes, potatoes, peppers and aubergines all contain solanine, which some believe may exacerbate arthritis pain and inflammation. “While scientific evidence is mixed, experimenting with reducing these vegetables can help determine if they affect your symptoms,” Mahmud says. However, pulses are good for general health as they contain a lot of antioxidants, and kidney beans in particular help reduce inflammation in the joints, as do nuts and seeds, which contain iron and zinc.
“Limit your intake of high-fat dairy foods, like cheese and butter, which are known to cause weight gain, but also are high in saturated fat and big inflammation triggers,” Bhattacharya advises. However, he adds, some fermented dairy foods, such as yogurt, are OK. Kefir and aged cheese are also safe to eat.
“Salt can cause an increase in inflammatory components in the body,” says Bhattacharya, which is another reason to avoid highly processed foods that tend to be heavy on the salt content. However, garlic is an excellent anti-inflammatory ingredient.