As you get older, one of the things that can start to happen is that you experience aches and pains. If your aches and pains are a regular feature of your life, it’s definitely worth asking your doctor or physio for advice. Sometimes that regular twinge you are getting is something more serious, but don’t let the possibility of ‘something more serious’ prevent you from getting it checked out. If it’s nothing but creaking joints, that’s great. If it’s something else, well we can work on that, too.
You may have guessed that the ‘something else’ I am thinking about is arthritis. Here I want to share some of my top tips for using food to help alleviate some of the symptoms of arthritis.
There are 2 types of arthritis: osteoarthritis and rheumatoid arthritis.
Osteoarthritis is the type of arthritis associated with wear and tear of cartilage within joints. It is more commonly (but not exclusively) linked to the ageing process.
Under the age of 45, it’s more common in men, and over the age of 45, it’s more common in women. By the time they get to 50, 80% of people will have symptoms associated with this type of arthritis, which starts as a stiffness in the hips, back, knees or other joints. The joints then become increasingly swollen and inflexible.
Rheumatoid arthritis is an autoimmune problem, triggered by genetics, or a bacterial or viral component, and possible also environmental or lifestyle factors. About 80% of sufferers are women. The body – for whatever the reason – develops antibodies against its own tissue, and it attacks the cartilage and connective tissue. Over time, joints become inflamed and enlarged.
There are a number of factors that are important in managing arthritis:
The key to improving the symptoms of arthritis is to work on the underlying causes rather than just treating the symptoms.
Digestion + detoxification
The scene for inflammation – even if that inflammation is elsewhere in the body, e.g. the joints – is often set in the digestive tract. If the gut environment is disturbed (a disruption in the normal balance of bacteria), this can lead to bacterial infection, parasites, intestinal permeability (aka ‘leaky gut’), and allergies and intolerances.
What then happens partially digested food proteins get into the bloodstream, along with other toxins and microbes, putting greater pressure on the body’s detoxification processes. Once the liver starts to become over taxed, any dietary or environmental toxins may cause further inflammation. A programme that works on creating a good gut environment is ideal. Probiotics and prebiotics can be very helpful, as can food intolerance testing (see below).
Blood sugar balance
There is a big link between inflammation and how well your body responds to insulin, the hormone produced in the pancreas to control blood sugar levels. If your body has a reduced sensitivity to insulin (or you are diabetic), sugar (glucose) or insulin stay in the blood, and too much of either is toxic, triggering inflammatory reactions.
Learning to balance your blood sugar levels plays a key role in managing the symptoms of arthritis. This is achieved through eating adequate amounts of protein at every meal and snack, increasing the amount of non-starchy vegetables, and considering the quality and the quantity of the starchy carbohydrates you eat.
All my nutrition plans are based on a blood sugar balancing diet, also known as low glycaemic load (low GL) diet. A low GL diet is easy to follow, focuses on real foods (not weird things you can only buy at health food shops), keeps you feeling full, and helps you manage your cravings.
In pretty much every circumstance, joint problems are linked to inflammation and sometimes also to problems with the immune system (autoimmunity). The body produces chemical agents in the body to either switch on or reduce inflammation.
Prostaglandins are one of the main chemicals in this process, and these are the easiest to manipulate with diet. There are 3 different types. 1 and 3 are anti-inflammatory and 2 is pro-inflammatory (causes inflammation and promotes pain).
Omega-6 fats can convert into either type 1 or type 2 prostaglandins. Eating a diet high in omega-6 polyunsaturated animal fats (found in meats and dairy produce – particularly non-organic) has the body producing more of these less desirable type 2 prostaglandins. Sugar and insulin can also redirect the conversion of plant omega-6 fats down the pro-inflammatory pathway.
Omega-3 fats, on the other hand can only go down the route towards the anti-inflammatory type 3 prostaglandin. Omega-3 polyunsaturated fats are found in foods like walnuts, flaxseeds, hemp, chia seeds, and oily fish. Monounsaturated fats, e.g. avocado and olive oil, are neutral and not involved in inflammatory processes.
Reducing animal proteins and dairy products can bring symptomatic relief.
There’s another group of chemicals called ‘free radicals’. These are highly reactive oxygen molecules that rely on other molecules in the body to stabilise them.
You might have heard of free radicals in skincare commercials. They are linked to accelerated ageing, cancer and other diseases. What helps keep these unstable molecules in check are antioxidants (again, something often talked about in skincare).
Antioxidants are found in large amounts in brightly coloured fruit and vegetables. The different colours tend to indicate the type of antioxidants produced – all are good.
What we know about antioxidants is that they have a synergistic effect – eating a variety of different ones (by eating a large range of different coloured fruit and veg) has a greater effect that eating the same volume of the same type.
Bottom line? Eat a LOT of vegetables and low sugar fruits like berries (which have some of the highest antioxidant levels of all fruit).
If you have rheumatoid arthritis, talk to me about whether the more restrictive autoimmune paleo diet would work for you. This further cuts out all grains, nightshade foods (like potatoes, peppers, tomatoes, and aubergines) and other foods thought to play a role in causing an inflammatory environment.
Levels of essential fats
Omega 3 fatty acids (found in oily fish, seeds like flax and chia, and walnuts) also have plenty of research to support their anti-inflammatory credentials.
Many people with inflammatory conditions have allergies or intolerances, some of which may be due to leaky gut, where food proteins are able to get through the gut lining, triggering an allergic response. Common offenders are dairy products, yeast, wheat and gluten, other grains, eggs, beef, chilli, coffee and peanuts. If you experience arthritis – or in fact any other inflammatory condition, there may be mileage in having a food intolerance test. Ask me for details.
Specific foods to increase
Sarah Ballantyne, The Paleo Approach
Patrick Holford, Say No To Arthritis.
Dale Pinnock, Medicinal Cookery