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Arthritis Today

The Ultimate Arthritis Diet

Stock your fridge and pantry with Mediterranean staples to fight pain and inflammation.

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One of the most common questions people with any form of arthritis have is, "Is there an arthritis diet?" Or more to the poin, “What can I eat to help my joints?”

The answer, fortunately, is that many foods can help. Following a diet low in processed foods and saturated fat and rich in fruits, vegetables, fish, nuts and beans is great for your body. If this advice looks  familiar, it’s because these are the principles of the so-called Mediterranean diet, which is frequently touted for its anti-aging, disease-fighting powers.

There’s good science behind the hype. Studies confirm eating these foods lowers blood pressure and protects against chronic conditions ranging from cancer to stroke. It helps arthritis by curbing inflammation – which benefits your joints as well as your heart. Another bonus: Eating more healthy, whole foods commonly found in  Mediterranean cuisine – and fewer packaged foods – can also lead to weight loss, which makes a huge difference in managing joint pain.

Whether you call it a Mediterranean diet, an anti-inflammatory diet or simply an arthritis diet, here’s a look at the key foods – and a breakdown of why they’re so good for joint health.

Fish

How much: Health auth­orities like the American Heart Association and the Academy of Nutrition and Dietetics recommend three to four ounces of fish, twice a week. Arthritis experts claim more is better.

Why: Some types of fish are good sources of inflammation-fighting omega-3 fatty acids. A study of 727 postmenopausal women, published in the Journal of Nutrition, found those who had the highest consumption of omega-3s had lower levels of two inflammatory proteins: C-reactive protein (CRP) and interleukin-6.

More recently, researchers have shown that taking fish oil supplements helps reduce joint swelling and pain, duration of morning stiffness and disease activity among people who have rheumatoid arthritis (RA). Some of these patients even discontinued using nonsteroidal anti-inflammatory drugs (NSAIDs) without experiencing a disease flare.

Why are omega-3s such a hot commodity? Because most Americans aren’t getting enough. “Our ancestors consumed a balanced ratio of omega-3 to omega-6 fats. Today, people often ingest 10 to 20 times more omega-6s than omega-3s,” says Tanya Edwards, MD, medical director of the Center for Integrative Medicine and Wellness Institute at the Cleveland Clinic. A glut of inexpensive omega-6-rich vegetable oils have infiltrated packaged, processed foods and restaurant kitchens – and too many omega-6s could trigger inflammation and exacerbate disease. Research has shown that increasing our ratio of omega-3 to omega-6 fatty acids – eating more fish and less fast-food, for example – helps mitigate chronic diseases, including RA.

Best sources: Salmon, tuna, sardines, herring, anchovies, scallops and other cold-water fish. Hate fish? Take a supplement. Studies show that taking 600 to 1,000 mg of fish oil daily eases joint stiffness, tenderness, pain and swelling.

Nuts & Seeds

How much: Eat 1.5 ounces of nuts daily (one ounce is about one handful).

Why: “Multiple studies confirm the role of nuts in an anti-inflammatory diet,” explains José M. Ordovás, PhD, director of nutrition and genomics at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University in Boston.

A study published in The American Journal of Clinical Nutrition found that over a 15-year period, men and women who consumed the most nuts had a 51 percent lower risk of dying from an inflammatory disease (like RA) compared with those who ate the fewest nuts. Another study, published in the journal Circulation, found that subjects with lower levels of vitamin B6 – found in most nuts – had higher levels of CRP and oxidative damage.

More good news: Nuts are jam-packed with inflammation-fighting monounsaturated fat.

In addition to taste and texture, nuts boast protein and fiber. Even though they’re relatively high in fat and calories, studies show that noshing on nuts promotes weight loss, because their protein, fiber and monounsaturated fats are satiating. “Just keep in mind that more is not always better,” says Ordovás.

Best sources: Walnuts, pine nuts, pistachios and almonds. In towns along the Mediterranean, you’ll see these nuts mixed into everything from salads and pilafs to main dishes and desserts.

Fruits & Veggies

How much: Aim for nine or more servings daily.

Why: Fruits and vegetables are loaded with antioxidants. These potent chem­icals act as the body’s natural defense system, helping to neutralize unstable molecules called free radicals that can damage cells.

“Our bodies produce 10 to 15 different oxidants every day,” says Dr. Edwards. “That oxidation process produces infla­m­mation, which in turn produces more oxidants in the body.” Fruits and vegetables can defuse those rogue molecules. “The darker, more brilliant the fruit or vegetable, the more antioxidants it has,” explains Dr. Edwards.

Just be sure your plate sports many colors of the rainbow, since different colors neutralize different oxidants. “The anthocyanins in cherries, for example, contain enzymes that [appear to] mimic the effects of [NSAIDs] without the side effects,” says weight loss coach and nutritionist Jonny Bowden, PhD, author of The 150 Healthiest Foods on Earth (Fair Winds Press, 2007). A compound in the allium family of vegetables (onions, garlic, leeks and shallots) called diallyl disulphide also appears to fend off degrading protein enzymes present in people with osteoarthritis.

Other research suggests that eating vitamin K-rich veggies like broccoli, spinach, lettuce, kale and cabbage dramatically reduces inflammatory markers in the blood.

Best Sources: Colorful fruits and veggies like blueberries, blackberries, cherries, strawberries, spinach, kale, broccoli, eggplant and bell peppers

Olive Oil

How much: Two to three tablespoons daily

Why: Olive oil is made up largely of healthful, monounsaturated fat. It’s anti-inflammatory, heart-healthy and it’s tasty, too. But having the right type of fat isn’t the oil’s only value. In fact, experts claim at least half of its health benefits come from the olives, not the oil.

“What makes olive oil so healthy is that it’s a delivery system for antioxidant compounds called polyphenols in the olives,” says Bowden.

Ever notice a scratchy sensation in the back of your throat after dipping your bread in olive oil? That’s the phenolic compound, oleocanthal, one of the most concentrated anti-inflammatory compounds in olive oil. “This compound inhibits activity of COX enzymes, with a pharmacological action similar to ibuprofen,” says Ordovás. Inhibiting these enzymes dampens the body’s inflammatory processes and reduces pain sensitivity. So it’s no wonder this oil has been linked with a reduced risk of a variety of chronic diseases.

Best sources: Extra virgin olive oil. It goes through less refining and processing, so it retains more nutrients than standard varieties.

Beans

How much: About one cup, twice a week (or more)

Why: Beans are loaded with fiber, a nutrient that helps lower CRP, an indi­cator of inflammation found in the blood. At high levels, CRP could indicate anything from an infection to RA.

But fiber isn’t the only reason beans help fight inflammation. In a study recently published in the Journal of Food Composition and Analysis, scientists analyzed the nutrient content of 10 common bean varieties in southern Italy and identified a host of antioxidant and anti-inflammatory compounds, including quercetin, genistein, soysapogenin and oleanolic acid.

Another reason beans are an essential part of an arthritis-friendly diet: They are a great (and inexpensive) source of protein, with about 15 grams per cup, and protein is important for overall health, especially for muscle health. Protein helps prevent muscle shrinkage due to age or inactivity, and stronger muscles make it easier to keep joints moving. (Movement is medicine!)

This vegetarian source of protein fills you up, meaning less post-meal snacking – and potentially less weight on your joints. Beans also digest very slowly, providing sustained energy and preventing the blood-sugar roller coaster commonly associated with high-carb and/or processed foods. Many bean varieties also boast folic acid, which benefits the heart, as well as immune-boosting minerals like magnesium, iron, zinc and potassium.

Best Sources: Red beans, small red kidney beans and pinto beans rank among the U.S. Department of Agriculture’s top four antioxidant-containing foods. Other beans you may want to add to your rotation: black beans, garbanzo beans and black-eyed peas.

Should You Avoid Nightshades?

Nightshade vegetables, including eggplant, tomatoes, red bell peppers and potatoes, are hallmarks of Mediterranean cuisine. Each of these disease-fighting power­houses boasts maximum nutrition for minimal calories. They also contain solanine, a chemical that has been branded the culprit in arthritis pain.

According to Tanya Edwards, MD, medical director of the Center for Integrative Medicine and Wellness Institute at the Cleveland Clinic, there’s no scientific evidence to suggest that nightshades trigger arthritis flares. In fact, some experts believe these vegetables contain a potent nutrient mix that helps inhibit arthritis pain.

Eggplant, for example, boasts anti-inflammatory anthocyanins, plus a hefty dose of fiber – all for only 35 calories per cup. Tomatoes are a rich source of the antioxidant lycopene, which has been shown to help neutralize free radicals. Red peppers are loaded with immune-boosting vitamin C (which also helps your body absorb iron). And potatoes are packed with potassium, which can help keep blood pressure in check, among other health benefits.

However, many people do report significant symptom relief when they avoid nightshade vegetables. If you notice that your arthritis pain flares after eating them, Dr. Edwards suggests you do a test: “Eliminate all nightshade vegetables from your diet for a few weeks. If you notice less pain, perhaps you should avoid these powerful foods.”

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