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The Pain-Free Arthritis Diet
by Harris H. McIlwain, M.D., and Debra Fulghum Bruce, M.S.
authors of Pain-Free Arthritis: A 7-Step Program for Feeling Better Again
Until recently it's been unclear whether changing your diet may influence the symptoms of a chronic illness like arthritis. Nevertheless, new research continues to pour in touting the healing benefits of certain foods. Perhaps these foods aren't the miracle cure many hoped for, but through scientific studies we do know that certain nutrients can boost immune function and decrease inflammation in those with arthritis. Be sure to include the following suggestions in your pain-free diet to further reduce inflammation and pain.
You can now add tea to your list of healing foods. In fact, some experts claim that we should add tea to the list of disease-fighting fruits and vegetables that we should eat daily. Some intriguing information was presented at the Society of Critical Care Medicine in January 2002 on how green tea may help decrease inflammation.
Green tea contains a type of polyphenol known as epigallocatechin-3 gallate, or EGCG, that inhibits the expression of the interieukin-8 gene. This is a key gene involved in the arthritis-inflammatory response. In these findings, researchers theorized that "more may be better" when it comes to green tea reducing the inflammatory response as EGCG shortcircuits the process that leads to inflammation. (If you like black tea, drink up! Black tea is made from the same leaves as green and contains theaflavins, strong phytochemicals that help to protect the body. Though processed differently, black tea may be equally effective and is tolerable for many people.)
Sipping tea instead of other drinks may help to ward off painful fractures. In another revealing study published in May 2002 in the journal Archives of Internal Medicine, scientists found that men and women who drank tea for years had denser bones at three different skeletal sites, regardless of the type or amount of tea they consumed each day. Researchers concluded that drinking tea regularly for at least ten years was estimated to boost bone mineral density by up to 5 percent. This bone-boosting benefit may be attributed to special compounds in tea such as fluoride, phytoestrogens, and flavonoids, a group of antioxidants all working together. (Herbal teas are not "real" tea.) Some key prevention benefits of tea includes the following:
Snack on Grapes
Resveratrol, a phyto-estrogen, or plant-derived, nonsteroidal compound, is present in the skins of grapes, in mulberries, nuts, wine, and other foods. While all wines have some resveratrol, red wine seems to be the best source.
In the past few years, various studies have shown that resveratrol blocks cell inflammation, which is linked to arthritis and other diseases. A team of researchers now concludes that trans-resveratrol blocks the activation of the gene identified as COX-2, which is important in creating the inflammation that causes arthritis pain. This natural food substance is the first compound identified that both blocks the COX-2 gene from being activated and inactivates the enzyme created by that gene. Some believe that trans-resveratrol may turn out to be an improvement on aspirin in fighting diseases associated with COX-2, such as arthritis. For now, snack on grapes. They are low in fat and calories, and add some healing nutrients to your body.
There is a lot of evidence that a diet high in vegetables can help to decrease inflammation in susceptible people. I've had many patients, particularly those with inflammatory types of arthritis, say a modified vegetarian diet (including fish) helps to reduce symptoms. Journal studies over the past five years have shown that a vegetarian diet causes an extensive change in the profile of the fatty acids of the serum phospholipids. These changes may favor production of Prostaglandins and leukotrienes with less inflammatory activity, which is a bonus for those with inflammatory illnesses.
The vegetarian diet may also benefit those with inflammatory diseases because animal sources such as meat, poultry, dairy, and egg yolks contain arachidonic acid, a fatty acid that is converted to inflammatory prostaglandins and leukotrienes. Some holistic nutritionists believe that eliminating animal foods from the diet may significantly reduce inflammation and pain.
Broccoli contains glutathione, a powerful antioxidant and detoxifying agent. In fact, without glutathione, other antioxidants such as vitamins C and E cannot do their job and protect you adequately against disease. Some new findings indicate that people who are low in this antioxidant are more likely to have arthritis than those who have higher amounts. Other glutathione-rich foods include asparagus, cabbage, cauliflower, potatoes, and tomatoes. Fruits with glutathione include avocados, grape- fruit, oranges, peaches, and watermelon.
Feast on Fish
Studies continue to come in touting the benefits of omega-3 fatty acids, contained in fish, as helping to decrease inflammation. In a study published in May 1996 in the journal Epidemiology, scientists found that women who ate two or more servings of broiled or baked fish a week had about half the risk of getting rheumatoid arthritis as women who ate only one serving. Researchers estimate women with the best odds against RA were averaging a minimum 1.6 grams of omega-3 fatty acids daily, or the equivalency of 5 ounces of cooked rainbow trout.
Some research indicates that when fish oils are added to the diet, scientists measure a very significant drop in one of the most inflammatory immune substances - -leukotriene B4, which is an important part of the process of inflammation in many types of arthritis. Researchers suspect that omega-3s may block the production of inflammatory substances linked to autoimmune diseases like rheumatoid arthritis and lupus. In some trials, taking fish-oil supplements for at least twelve weeks resulted in positive improvements in symptoms with less morning stiffness and tender joints.
Another study, published in the January 2000 issue of the American Journal of Clinical Nutrition, confirmed the healing benefits of omega-3 fatty acids. Researchers concluded that patients with rheumatoid arthritis who took dietary supplements of omega-3 fatty acids (EPA or eicosahexacnoic acid) had fewer tender joints and. morning stiffness. The effective dose may be between 3 to 5 grams of the acids daily, although regulated guidelines have not been established regarding supplements of fish oil.
Researchers at Cardiff University in Wales found that cod-liver oil -- the fishy tonic people used to take for "what ails them" -- is effective in treating arthritic joint pain and even slowing or reversing the destruction of joint cartilage. Again, the omega-3 fatty acids in the oil are credited for "switching off" the collagen-degrading enzymes that break down joint cartilage. This leads to a slower progression of cartilage destruction, and reduces inflammation and the subsequent pain.
Because of the mercury content in some fish, including mackerel, swordfish, and tuna, the Food and Drug Administration (FDA) recommends that pregnant or nursing women avoid these fish.
Eat Fish High in Omega-3
Include More Omega-3s
To add even more omega-3s to your daily diet, use canola or flaxseed oil in cooking or salad dressings. Take borage seed oil or evening prim- rose oil-both available at most health food stores in a variety of forms. These oils are high in plant form of omega-3, alpha-linolenic fatty acid. Your body converts this fat to one of the omega-3s found in fish oil.
For years, professional coaches have recommended pineapple to athletes to help heal sports injuries. That's because a key enzyme in pineapple called bromelain helps reduce inflammation. This may benefit those with knee osteoarthritis and rheumatoid arthritis, according to a German study that found bromelain enzymes resulted in a statistical reduction of pain. For those with carpal tunnel syndrome, some findings show eating pineapple is associated with reduced tissue swelling.
Add Olive Oil
A Greek study published in 1999 in the American Journal of Clinical Nutrition reported that eating large quantities of olive oil and cooked vegetables over a lifetime might cut the risk of developing rheumatoid arthritis. Researchers were unsure how olive oil reduces the risk for this inflammatory arthritis, but theorized that it may be due to its high concentrations of unsaturated fatty acids. One in particular, oleic acid, forms chemicals in the body that can decrease inflammation.
Another interesting point researchers made in this study is that raw vegetables did not appear to give as much protection as cooked vegetables. This may be because the heat from cooking breaks down the plant cell walls and increases absorption of healing compounds that may help those with inflammatory arthritis.
In some new findings presented in early 2002 at the American Pain Society, researchers at Johns Hopkins University in Baltimore concluded that a diet rich in soy that reduced pain and swelling in rats may one day be used by humans to manage chronic pain. In the study, scientists found that rats fed a soy-based diet experienced "significantly less" swelling and were able to tolerate more pain than another test group given a milk protein. The pain tolerance was determined by assessing how long rats could endure pressure and heat stimulus before removing their paw from the heat supply. Of course, we have a long way to go before proving the same result in humans, but this study is positive.
Along with the possibility of decreasing pain, soy foods have other great benefits, including being dairy free, low in saturated fat, and excellent meat substitutes. For years, soybeans have played an integral part in the Asian culture with heart disease, breast cancer, prostate cancer, and osteoporosis rates much lower for Asian men and women than for Americans. In addition, isoflavones, phytochemicals found in soy, are close in structure to the body's form of estrogen. While these plant ingredients mimic the hormone estrogen, they appear to have no harmful side effects and may give a bonus in relieving menopausal symptoms and helping to prevent osteoporosis. In a study published in the January 2001 issue of Obstetrics and Gynecology, researchers suggested that a diet rich in soy might help women retain strong bones and reduce the risk of painful and debilitating fractures.
Soy Food - Grams of Protein
Tofu - 10 grams per 1/2 cup
Soy Milk - 7 grams per one 1 cup
Soy Yogurt - 7 grams per one 1 cup
Miso - 2 grams per 1 tablespoon
Black soybeans - 9 grams per 1/2 cup
Green soybeans (edaname) - 11 grams per 1/2 cup
Tempeh - 16 grams per 1/2 cup serving
Textured soy protein - 11 grams per 1/4 cup
Soy nuts - 22 grams per 1/2 cup
Eat Ample Protein
Eat 1 to 1.2 grams of protein per kilogram of body weight (to make up for the protein lost in the inflammatory process).
Include Healing Foods
Tea (green or black)
Increase Flavonoid-Rich Foods
Flavonoids are a family of more than four thousand compounds that include polyphenols and give color to fruits and vegetables. These nutrients are powerful antioxidants and may hold the key to disease prevention. Polyphenols act like antioxidants or rust-proofing agents, which are thought to reduce the cellular oxidation.
Although more studies are needed to claim these nutrients prevent on or disease, try to include flavonoid-rich foods in your in daily diet including green tea, onions, apples, soy, and grapes, among others.
Excerpted with permission from Pain-Free Arthritis: A 7-Step Program for Feeling Better Again by Harris H. McIlwain, M.D., and Debra Fulghum Bruce, M.S. (Published by Henry Holt and Company, LLC; September 2003; $15.00US/$21.95 CAN; 0-8050-7325-6).
Copyright © 2000 Harris H. McIlwain, M.D., and Debra Fulghum Bruce, M.S.
Harris H. McIlwain, M.D., is board-certified in rheumatology and geriatric medicine, specializing in pain-related diseases. He practices medicine in Florida with the Tampa Medical Group and has written thirteen books on health. Debra Fulghum Bruce, M.S., is a writer specializing in health and relationships and the author or coauthor of sixty-four books. She lives in Atlanta, Georgia.
For more information, please visit the author's website at http://www.pain-free-arthritis.com.
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