What should you eat if you have arthritis? A rheumatologist says these foods could help

Arthritis is a common reason why some are unable to carry out their normal daily activities. Photo / 123rf

THREE KEY FACTS

• Osteoarthritis usually starts in a single joint and becomes worse over time while rheumatoid arthritis is an autoimmune disease that occurs when the immune system attacks the lining of the joints.
• All forms of arthritis involve chronic inflammation, which is linked to diet and gut health (even for osteoarthritis).
• Improving your diet can help to reduce inflammation.

As a former consultant rheumatologist, UK doctor Tim Spector understands the toll arthritis can take. Here are the foods he recommends eating to ease your symptoms.

Arthritis can be life-changing. You can’t go up and down the stairs, you can’t run for a bus, you can’t easily get up from a chair. After mental illness, arthritis is the most common reason why someone is unable to carry out their normal daily activities. I worked as a consultant rheumatologist at St Thomas’ Hospital in central London for over 20 years, so I understand the enormous burden it causes.

Arthritis sufferers frequently spend years waiting for a hip or knee replacement and, all too often, become depressed. At the population level, it stops people from working and forces them to claim sickness benefits, harming their sense of independence and the economy.

Right now the NHS doesn’t have the resources to deal with this combined epidemic of obesity and arthritis which is a disaster. What’s more, people don’t realise how closely related these two conditions are.

All forms of arthritis involve chronic inflammation which is a constant stimulation of the immune system. Photo / 123rf

The link between inflammation and arthritis

When working as a rheumatologist, I saw patients with every form of arthritis – there are hundreds of types.

Both osteoarthritis – the most common form, which usually starts in a single joint and becomes worse over time – and rheumatoid arthritis – an autoimmune disease that occurs when the immune system attacks the lining of the joints – are on the rise.

For some patients, arthritis will be brought on by obesity (any extra weight on the joints contributes to their deterioration), genetics, hormone changes caused by menopause or simply the fact that we’re now living longer and more people are getting picked up with the condition.

But we know that there’s something metabolic, not just mechanical, going on.

To some extent, all forms of arthritis involve chronic inflammation which is a constant stimulation of the immune system causing the early morning stiffness that is so common. This inflammation is linked to your diet and gut health (even for osteoarthritis, which used to be thought of as a “wear and tear” disease). This means that improving your diet can help to reduce inflammation, which will ultimately help your joints and symptoms of fatigue and stiffness.

It will also help your mental health. Around 20% of people with osteoarthritis and 40% of patients with rheumatoid arthritis also have depression. Doctors used to think this was because they were in pain and were struggling to cope but we now think inflammation plays a key role in the onset of depression by affecting the brain. Anti-depressants are often prescribed but often don’t work well, whereas anti-inflammatory drugs can make a difference.

The foods to prioritise

It’s important to do what we can to reduce inflammation, whether you have arthritis already or are worried about getting it.

This is because joint replacement is the only real treatment for osteoarthritis and, while there have been some amazing drug breakthroughs for rheumatoid arthritis, these cost tens of thousands of pounds per year and have some side effects.

Small studies suggest that eating an anti-inflammatory diet can improve symptoms. Photo / 123rf

Fruit, vegetables, legumes and seafood

We don’t yet have large-scale dietary studies into arthritis. But small studies suggest that eating an anti-inflammatory diet, such as the high-fibre Mediterranean diet, can improve symptoms. This makes sense, as there will be less stress on the body and the immune system.

I’d recommend trying this approach, which involves putting vegetables, fruits, nuts, herbs, spices, wholewheat carbohydrates, seeds, extra virgin olive oil, legumes and occasional fish or seafood at the centre of your diet.

Fermented foods

Fermented foods are also anti-inflammatory, so add more of them to your plate for your general health but also to reduce your arthritis risk.

This doesn’t just mean feasting on kimchi – cheese, yogurt, sauerkraut, kombucha, kefir, miso paste and soup also count as fermented foods. Aim for at least three small portions a day.

On the other hand, a Western, inflammatory diet – one that regularly includes highly ultra-processed food like sausages, ham, crisps, cookies and fast food – will cause inflammation throughout your body, including in your joints, as will diets that are high in sugar and harmful fat and lacking fibre. It’s worth replacing these foods with healthier alternatives whenever possible.

Improving diet quality should reduce the chance of developing arthritis. Photo / 123rf

The myths to bust when it comes to arthritis and diet

There’s no need to avoid nightshade vegetables – the family that includes tomatoes, peppers, aubergine and potatoes. Some studies in mice in the 1980s showed that there was potentially a link between these foods and arthritis. Then, dairy was the enemy in the 1990s and was linked to arthritis. In a way, these were the original TikTok myths. For most people, they’re total nonsense.

Ultimately, if you improve your diet quality, it should improve arthritis symptoms in people who have it and reduce the chance of developing it in people who are currently arthritis-free. It should also elevate your mood and give you more energy, so mentally and physically you will feel better.

If you ask a rheumatologist about managing arthritis, they’re usually only looking through the lens of the joint, as this is their area of expertise. Having taken a step back and learnt more about gut health and nutrition, I can see that, while there isn’t an arthritis-specific diet, what you eat every day is the most important thing you can control for preventing or easing arthritis symptoms.