Using Foods to Fight Arthritis And Keep Your Bones Strong
Most of us take for granted that we’ll stay strong and healthy, able to do whatever we’d like for years to come. We don’t care what we put inside our body. We drink whatever we want. We eat and drink whenever we want. We misuse our body. But when arthritis enters our lives, even the slightest movement becomes painful, sometimes impossible. Every thing has it’s price. Years of uncontrolled life of eating and drinking costs us. It hurts to shake hands. It’s hard to open a jar or write with a pen, and it feels like we are on a one-way street to the infirmities of old age. We begin to regret for what we did in the past. We think that only if there was a time machine, and we could go back in time to change our food habits. If joint pain has slowed you down, you’ll want to look at the latest from the world of nutrition. Research shows that for a surprising number of people, a few simple diet changes can make joint problems improve—or even disappear altogether. The disease comes in a great many forms, so let’s start with a look at what kind of arthritis you have. Here are the most common types of arthritis:
Rheumatoid arthritis. This causes joint pain and stiffness, usually starting in the hands or the feet. Sometimes the pain spreads to the shoulders, elbows, hips, knees, ankles, and neck. It is an autoimmune disease, meaning that your white blood cells—which are supposed to be fighting against bacteria, viruses, and cancer cells—have begun to attack you. Specifically, they are attacking the tender synovial membranes that line the inside of each joint. As time goes on, this attack damages and deforms the entire joint. For reasons that no one has yet figured out, rheumatoid arthritis affects women about three times more often than men.
Osteoarthritis. This is also called degenerative joint disease and can be thought of as wear and tear on the cartilage that cushions the ends of the bones inside the joints. As cartilage wears away, the bones start to rub against each other, causing pain and making movement difficult. It is very common in older people—ten times more common than rheumatoid arthritis—and usually shows up in the hands and the weight-bearing joints—the hips, knees, feet, and the back. If you have arthritis in the finger joints closest to your nails, it is probably osteoarthritis rather than rheumatoid.
Gout. This occurs when crystals of uric acid form in the joints, sparking inflammation and pain. It comes in acute attacks, usually starting in the big toe and spreading to other joints. Unlike rheumatoid and osteoarthritis, gout strikes more often in men.
Ankylosing spondylitis. This is a form of arthritis in the spine. It leads to stiffness in the lower back and eventually to damage to the vertebral joints. It occurs most often in young men.In this article we will look at how foods can ease your joints, focusing especially on rheumatoid arthritis, where diet changes have brought remarkable results for many people. If you have osteoarthritis or ankylosing spondylitis, please review this section as well, because the same diet changes that often work for rheumatoid arthritis may be helpful to you, too. Then we will look at the important role foods play in gout.
Foods Emerge as a Cause—and a Cure
Over the past two decades, researchers have slowly but surely nailed down evidence that foods play an important role in rheumatoid arthritis and other forms of the disease. First came surprising reports of individuals who were essentially cured after making rather minor adjustments in their diets. In 1981 the British Medical Journal reported the case of a woman who had suffered with rheumatoid arthritis for twenty-five years before discovering that her symptoms were caused by corn. When she carefully avoided corn products, her arthritis simply went away. Several weeks after this remarkable recovery, however, her pain and stiffness returned. It began to look as if her improvement was simply temporary—nothing more than a placebo effect of the diet change. But, as the journal report recounted, researchers then found out that her cook had started using cornstarch as a thickener. When it was removed from the diet, her symptoms again vanished. At about the same time, another research team published the case of an eight-year-old girl with juvenile arthritis that turned out to be caused by dairy products. Even the traces of milk in a chocolate bar were enough to spark pain and stiffness in her hands, wrists, feet, hips, and knees. The disease became so severe that she had to be hospitalized nine times. Her doctors and family were skeptical at first that something as seemingly innocent as cow’s milk could trigger such a serious case of arthritis. But in repeated tests it became clear that avoiding dairy products cured her joint pains, while returning them to her diet meant pain was sure to follow. Many doctors have been slow to accept the diet-arthritis link, despite the fact that they have had little else to offer arthritis sufferers. After all, typical arthritis medicines only relieve pain and stiffness temporarily, doing nothing to stop the progressive joint damage, and many second-line arthritis drugs have major side effects. Recently, however, the scientific evidence has become too strong to ignore. Perhaps most decisive was a carefully executed research study published in Lancet, a prominent British medical journal. The researchers examined twenty-six arthritis patients and documented their symptoms in detail. They then asked them to eliminate certain foods (for a list, see below). The results were quick and impressive. Pain and stiffness melted away, and grip strength returned. It was as if the patients had found a powerful new drug that eased their joints, yet the “drug” was simply a change in diet. The research team checked the patients a year later and found that their improvements were continuing. Not everyone can blame their symptoms on food, but if diet changes go far enough, as many as 60 percent of people get better and, for some, arthritis goes away completely. Shelly was a thirty-nine-year-old mother of three active daughters. She had been diagnosed with osteoarthritis at age twelve. In her late thirties, the disease became particularly acute. Her knees and hips hurt more and more, and she got to the point where she could no longer walk her dog. As she became more and more inactive, she started to gain weight, and she slipped into a depression. When she heard that a diet adjustment might help, she felt annoyed at the need to change yet another part of her life. But she finally decided it was worth a try and started by eliminating dairy products—and that hit the nail on the head. The change surprised everyone in her family. Within three days, she felt better. Her pain went away, she regained her ability to walk normally, and she even danced at her brother’s wedding. She felt that she had suddenly gotten her life back. Nancy, a forty-three-year-old pharmacist, had been suffering with rheumatoid arthritis since she was twenty years old. She had tried many different medications and eventually needed joint surgery. But her arthritis continued to worsen and, by the time she was forty, the pain had become excruciating. Walking was increasingly difficult, and she felt she was on an ever-shrinking tether. From a new doctor, she learned that dairy products and eggs could be arthritis triggers, and she decided to see how she felt without them. The results were dramatic. Within a month she was totally pain-free. Her grip strength improved, and she felt ten years younger. For her, a diet change proved more powerful than all the arthritis drugs.
Foods That Trigger Arthritis
These foods have been commonly found in research studies to trigger arthritis symptoms: dairy, potatoes, nuts and peanuts, tomatoes, meats, wheat, oats, eggs, coffee. Dairy products are the most common trigger, as is also true for migraines. This means all dairy products, including skim or whole cow’s milk, goat’s milk, cheese, yogurt, etc. Similarly, the meat category includes all meats: beef, pork, chicken, turkey, fish, etc. While this list applies principally to rheumatoid arthritis, people with other forms of the disease sometimes benefit from eliminating these triggers, too. You’ll find many recipes that are free of trigger foods. After three weeks, if your symptoms have improved, reintroduce the trigger foods into your diet one at a time, every two days. Have a generous amount of the food you are testing, so you can tell how it affects you. If your joints flare up again, eliminate the offending food, and let your joints cool down again before bringing in another food item. If you would like extra power against arthritis, you should know that medically supervised fasting has shown remarkable results for many people. Whether its value comes from the fact that fasting eliminates all diet triggers (along with all other foods) or from some other biochemical response to fasting is not yet clear. The vast majority of patients improve, often dramatically.
Remember the Tin Man in The Wizard of Oz? He stood with frozen joints until Dorothy loosened him up with a drop or two of oil. Surprising as it may sound, certain natural food oils act like gentle medicines, easing your joints and giving you extra power against arthritis. Don’t even think about them, though, if you haven’t first checked for food triggers. If, for example, your arthritis is triggered by milk products, it is much more effective to eliminate them than to try to counteract their effects by adding oils—or medications, for that matter. How do these oils work? They fight inflammation—which is your body’s natural reactio to injury. You’ll see it every time you burn your finger or scrape your elbow. The injured area gradually swells, turns red, and becomes warm to the touch as increasing blood flow brings in germ-fighting white blood cells and healing nutrients. As we saw earlier, the problem in rheumatoid arthritis is that the white blood cells’battle has mistakenly turned against your joint linings. Instead of killing bacteria, your white blood cell soldiers end up attacking your own tissues.
Borage oil has the highest GLA content (1⁄4 teaspoon supplies 300 milligrams of GLA), meaning it gives you the most benefit for the least amount of oil. You’ll find GLA-rich oils at any health food store, or you can order them from the same source that supplies research teams, a company called Health From the Sun in Sunapee, New Hampshire (800-447-2229).
Alpha-linolenic acid (ALA). This is found in flaxseed oil, and to a lesser extent in canola, wheat germ, walnut, and several other oils. There are also traces of ALA in many vegetables, beans, and fruits. ALA is in the omega-3 family of fats, the group that also includes fish oils. However, you can skip fish and the chemical contaminants they harbor by using flax oil instead. If your diet is rich in vegetables and beans, traces of ALA will end up on your plate naturally, although not nearly as much as you’ll find in flaxseed oil. Green leafy vegetables such as purslane, lettuce, broccoli, spinach, and kale contain significant amounts of ALA, as do navy, pinto, or lima beans, and peas and split peas. Citrus fruits contain ALA, but be careful with them until you are sure they are not pain triggers for you.
On the other hand, if your diet is loaded with meats, dairy products, shortenings, and cooking oils (e.g., corn oil or cottonseed oil), their unfriendly fats get packed into your cells, crowding out the ALA you need. If a doctor were to remove a small fat sample from your thigh and send it to a laboratory, he or she could tell a lot about what you have been eating lately. Chicken fat, fish fat, beef fat, and fryer grease get packed into the membranes of your cells and stay there until other fats push them out. If you were eating lots of vegetables, fruits, and beans, you would likely have little body fat overall, but the fat you did have would be high in healthy ALA and the other omega-3s that are made from it. People on meaty, greasy diets pack these unhealthy fats into their cells and have weaker defenses against inflammation. Allow several weeks to see their full effects. If oils cause loose stools, reduce your dose. Like all supplements, you should use them in consultation with your doctor, and avoid them if you are or may be pregnant. GLA may increase the possibility of miscarriage.
More Power for Healthy Joints
Would you like more power against arthritis? There are other gentle and natural approaches to arthritis you should know about.
Ginger. This has been used for centuries in traditional Indian ayurvedic medicine as an arthritis treatment. Modern science has shown how it works: Ginger blocks the enzymes that spark inflammation. A research team in Denmark reported remarkable results with ginger in twenty-eight patients with rheumatoid arthritis and eighteen with osteoarthritis. The usual dose is 1⁄2 to 1 teaspoon (1 to 2 grams) of powdered ginger each day, mixed into water or added to food. Allow four to twelve weeks for benefits to appear.
Capsaicin. Pronounced “cap say’ a sin,” this is an extract from hot peppers and is sold in drugstores as a cream under the brand names Dolorac and Zostrix, among others. You simply apply it to sore joints twice a day. At first it tingles a bit, but as you continue to use it, the tingling diminishes and joint pain abates. It works by depleting a chemical called substance P that nerves use to transmit pain signals.
Vitamin E. This reduces the pain and stiffness of osteoarthritis, even when used without GLA or ALA. The usual dose is 400 IU each day, or 100 IU if you have high blood pressure.
Weight loss. This is important in preventing and treating osteoarthritis. Researchers have found that every ten pounds of excess weight increase the risk of osteoarthritis in the knees by 30 percent. It is not just that extra weight strains your joints—the joint problems can even show up in your hands. Researchers suspect that body fat works its mischief by producing estrogens, and that these hormones make arthritis more likely. Indeed, women with arthritis often have other signs of excess estrogen, such as uterine fibroids. The healthiest and most effective way to lose weight is to focus on changing the type of food you eat, rather than trying to meet a strict calorie limit.
Check your iron level. You need a small amount of iron in your diet for your red blood cells to carry oxygen. But in excess, iron contributes to joint damage by encouraging the formation of free radicals, unstable molecules that can attack your body tissues. As we have seen, the meat-based diets that are common in Western countries are so high in iron that they push many of us into a mild form of iron overload, especially after menopause. Do you have too much iron stored in your body? If these tests show you have excess iron in your blood, you can gradually bring your iron level back to normal with regular exercise and, by donating blood. This altruistic act gives a person in need the extra iron you are anxious to be rid of. To help keep your iron level in the normal range, get your iron from whole grains, beans, vegetables, and fruits in your diet, rather than from meats. Plants contain iron in a form your body can easily regulate. Heme iron, found in meats, bombards your body with iron that is difficult to get rid of.
Antibiotics against Arthritis?
Antibiotics have emerged as an important, although controversial, treatment for arthritis. Certain bacterial infections—salmonella, campylobacter, or yersinia, which are common contaminants in raw chicken and beef—are well-known causes of joint pain that can linger on long after the initial gastrointestinal illness they often cause is gone. Researchers suspect that other bacteria also are involved in many cases of arthritis. A great resource on antibiotic treatments for arthritis is Dr. Gabe Mirkin, a nationally known progressive physician (800-986-4754, www.DrMirkin.com) Ask your doctor whether antibiotics might help in your case.
Diet Changes for Gout
If you have gout, you will likely need medicines, perhaps even hospitalization. But you should also look at two parts of your diet that can increase the risk of gout. Meats, especially shellfish, sardines, anchovies, and organ meats (e.g., liver and kidneys), and alcohol, especially beer, encourage uric acid to deposit in your joints, causing the misery of gout. Steer clear of these foods and build your diet from vegetables, grains, and fruits. Be sure to stay on your medications during the transition, however, since gout sometimes strikes during times of dietary change. Joint pains can make life miserable. But a great many people have gotten surprising relief from simple adjustments in their eating habits—and all the side effects are good ones. A diet rich in vegetables, fruits, beans, and whole grains will help you lose weight, cut your cholesterol, and build your energy. Steering clear of trigger foods, and adding supplements if you want them, can make a world of difference.
Keeping Bones Strong
Osteoporosis has been called the “silent disease,” deteriorating bones often without warning signs, leaving many older women incapacitated with fractures, in pain, and with significant medical bills. Throughout recent years, physicians and nutritionists have recommended high doses of calcium—mainly through dairy products and supplements—as the primary means of prevention. The U.S. government, in its dietary guidelines, strongly advocates milk drinking. Dozens of celebrities have even joined the promotion, sporting “milk mustaches” in a high-dollar ad campaign urging everyone to drink up, yet the risk for osteoporosis and related bone breaks is not decreasing. Ten million Americans, 80 percent of whom are women, already have the disease, characterized as porous, brittle bones. The National Osteoporosis Foundation estimates that 10 million more individuals are at risk due to low bone mass. One in two U.S. women will have an osteoporosis-related bone fracture in her lifetime. Why is this happening in countries where dairy consumption is so high? The largest study assessing the benefits of calcium for preventing osteoporosis revealed the futility of relying on dairy products to protect bones. The Harvard Nurses’ Health Study followed 77,761 women aged thirty-four to fifty-nine, over a twelve-year period and found that people who consumed 3 or more cups of milk every day had no improvement in reducing the possibility of hip or arm fractures, compared to those who drank little or no milk. In fact, milk drinkers’fracture rates were slightly higher. Clearly there are other factors at work here. Very different from the messages we hear in the media, calcium researchers have continually found that countries with the highest calcium intakes actually have higher, not lower, rates of osteoporosis. The reason may lie in other concomitant dietary characteristics. Where calcium intakes are highest, large dairy industries exist, producing not only large quantities of milk, cheese, yogurt, and butter, but also meat from dairy cattle whose milk production has declined. Where meat consumption is greatest, osteoporosis rates are high. Researchers, and some physicians, now understand the link: excess protein causes calcium loss.There was a time when we knew of no real detriments to loading up on protein. In fact, we thought family dinners had to center around a big steak, chicken, or pork. Now that misinformation has come back to hurt us. Researchers have found that physical activity is vitally important to proper bone development, too. A study of young women found that bone density was significantly affected by how much exercise the girls got in their teen years, the time when girls develop 40 to 50 percent of their skeletal mass. Calcium intake, on the other hand, made no difference. The Penn State researchers focused on hip bone density, a common site for fractures in women with osteoporosis. For six years, eighty-one twelve-year-old girls were evaluated with respect to dietary habits and sports activities while taking part in a calcium supplementation study. Consistent with past studies, intake of calcium above 900 milligrams per day (two glasses of milk) had no lasting effect on bone strength, but regular exercise did. Researchers remind us that while serious athletics and team sports are fine for some, bone-strengthening benefits come simply from walking for thirty minutes each day. Added benefit will be achieved by including regular weight-bearing exercises such as backpacking or walking with hand weights. Don’t let group weightlifting classes scare you away. Visit your local gym and you’re likely to find these classes full of women. You can start with three-pound weights and, in no time, brand-new muscle groups will have you lifting more and more.
Excess Protein Spells Trouble for Bones
A group of Yale researchers looked at hip fracture rates in sixteen different countries, focusing on women over fifty because osteoporosis is particularly aggressive in women after menopause. They found that countries with a high calcium intake happened to be those where Western diets—high in meat and dairy products—were popular. A closer look at meat consumption in these populations revealed that, indeed, the more meat people ate, the more fractures they had. When researchers feed animal protein to volunteers and test their urine, they find it loaded with calcium. Here’s why: When protein is digested, its component amino acids come apart and pass into the blood, making the blood slightly acidic. However, the body is extremely finicky about how acidic the blood gets because even a tiny change in acid levels can derange body chemistry. In the process of neutralizing that acidity, calcium is pulled from the bones and ends up being lost in the urine. A report in the American Journal of Clinical Nutrition showed that when research subjects eliminated meats, cheese, and eggs from their diet, they cut their calcium losses in half. The bone-dissolving effects of America’s meat- and cheeseheavy diet was recently illustrated in a large study from the University of California at San Francisco (UCSF). Researchers divided more than nine thousand women, sixty-five and older, into five groups and found the women who consumed the most acidic foods (protein-rich meats and cheeses) had 3.7 times more hip fractures than those eating the least acidic foods. Another UCSF scientist studied diet and hip fracture rates in thirty-three countries, reporting that differences in ratio of plant to animal food accounted for 70 percent of the variation in fracture rates. The best bone-protecting diet is rich in fruits and vegetables, which are high in potassium. While dairy products do contain calcium, the acid they provide, especially from hard cheeses, adds to bone deterioration. Low-fat, calcium-rich beans, green vegetables, and fortified juices provide calcium and ensure it stays where it belongs.
Limit Caffeine and Salt
Caffeine and salt in the diet pose problems as well. Caffeine, acting as a mild diuretic, causes calcium loss via the kidneys. For postmenopausal women, the effects of calcium loss through soda, coffee, and tea drinking is significant. The same is true of salt. For an average person, cutting sodium in half reduces the daily calcium requirement by about 160 milligrams. Again, it is the body’s need to regulate levels of sodium, just as it regulates protein. When there is too much sodium, the kidneys try to get rid of it, taking calcium along as well. Natural foods from plants, which are high in potassium rather than sodium, have the opposite effect. They help keep calcium in the bones, apparently by reducing calcium loss from the kidneys.
Another Reason to Quit Smoking
Another risk for osteoporosis is smoking. Australian researchers studied forty-one sets of identical twins, all of whom were adult women. They found that if one twin smoked and the other did not, the smoker’s bones were about 10 percent less dense in the spine and about 5 percent less dense in the hip and thigh bones, even though their genes were, of course, the same. This difference can mean a 44 percent increase in the risk of hip fracture.
Vegetarian Bone Builders
The healthiest, most absorbable sources of calcium are found in green, leafy vegetables such as broccoli, which contains 115 milligrams per 100-gram serving. An exception is spinach, which is different from other greens because it has a less-absorbable form of calcium. Beans, lentils, and other legumes are good sources of calcium as well as omega-3 fatty acids, cholesterol-lowering soluble fiber, and complex carbohydrates. As for supplements, the best source is found in calcium-fortified orange juice. It is more absorbable than calcium carbonate supplements. Avoiding meat and other calcium depleters makes it much easier to get, and keep, 400 to 500 milligrams—as recommended by the World Health Organization—in the body each day. Besides substantial protein, meats (including poultry) also contain phosphorus in amounts fifteen times greater than the calcium they provide. The tremendous phosphorous overload encourages calcium loss. You’ll want to avoid overdoing soda consumption as well. Their phosphoric acid and caffeine combination swiftly move calcium out via the kidneys. Swapping meats and other animal products for fruits, vegetables, legumes, and nuts provides added defense from the mineral boron, which also helps keep calcium in the bones.
Get a Little Sunlight
A little sunlight and daily exercise are important in preventing osteoporosis, too. Bones respond to the push and pull of exercise, especially the weight-bearing variety, by becoming stronger and denser. The effect is really remarkable. Take studies done on athletes, for example. Tennis players have significantly greater bone density in the arm they grip their racket with, compared to their less-active arm. Brief periods of time in the sun turn on the body’s natural production of vitamin D, helping the digestive tract to absorb calcium from foods. Vitamin D is also stored in body fat and muscle, accumulating plenty for rainy days.
False Hope in Hormone Replacement Therapy
It has become common practice for physicians to prescribe HRT for their female patients after menopause, but this hasn’t provided the protection many—especially its manufacturers—hoped it would. Researchers have found that even if postmenopausal women take estrogens faithfully, most will still lose bone, albeit at a slower rate. And as they approach their seventies and eighties, the effects of estrogen replacement wane, and many women have fractures in spite of hormone use. Taking HRT increases your risk for gallbladder disease and breast and uterine cancer, frightening prospects, particularly when we know so much about safer approaches, such as the positive effects of vegetable foods on bone strength. Women on low-fat, plant-based diets have lower levels of estrogen in their blood before menopause, are adapted to those levels, and have less of a change at menopause. Instead of a major dip in hormone level, they get more of a gentle readjustment. This is probably one of the major reasons why doctors in Asia report that menopausal symptoms and hip fractures are much rarer than in the West and why vegetarian women going into menopause are more likely to keep strong bones.
Natural progesterone, derived from various plants, most notably wild yams and soybeans, has proved to be a very beneficial treatment option for postmenopausal women, not only in slowing bone loss but also in building bone. One study showed an average bone density increase of 15 percent in a group of a hundred postmenopausal women. And, unlike estrogens, progesterone does not appear to increase cancer risk. Progesterone often reduces hot flashes, eases fibrocystic breast pain, improves thyroid functioning, and encourages weight loss. Despite these profound benefits, progesterone remains overshadowed by heavily marketed prescription drug therapies. As a natural compound it cannot be patented by drug companies, leaving them little financial incentive to market or sell it. On a Western diet, heavy with animal protein, phosphorus, sodium, and caffeine, and aggravated by smoking and inactivity, osteoporosis will continue to be a major health problem. Simply adding extra calcium or hormone preparations to this mix has proved an ineffective defense. Physicians could be making great strides in reducing osteoporosis if they discussed the vitally important research findings with their female patients, especially when they are still young. Prevention is possible, through a diet based on wholesome foods plus daily activity and a few minutes of rejuvenating sunlight. It’s never too late. Start from today. You will feel better than ever. Many people have suffered like you, and they have changed their lives. It’s your turn now.