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Can diet or supplements relieve your arthritis aches and inflammation?

One of every five U.S. adults has been diagnosed with arthritis, a group of diseases and conditions that share a constellation of common symptoms including pain, aches, stiffness and swelling in or around joints. Although there are more than 100 types of arthritis, the two most common forms, by far, are osteoarthritis (OA) and rheumatoid arthritis (RA).

In the quest for relief, a growing number of sufferers seek complementary therapies, such as diet and herbal supplements. In fact, 80% of rheumatoid arthritis sufferers say they have used complementary medicine for arthritis pain. But can changing your diet or taking supplements really help ease the pain and swelling of arthritis? EN weighs in.

The Inflammation Factor. A common theme of many chronic diseases, including arthritis, is uncontrolled inflammation. In a healthy immune system, the inflammatory process repairs damage and protects the body against infection. But in arthritis and other inflammatory diseases, an overactive immune response leads to the breakdown of tissues, which causes pain.

Some vitamins, minerals and phytonutrients, like flavonoids, appear to help protect against inflammation. In fact, eating more fruits and vegetables has been linked to less risk of osteoarthritis.

Omega-3 fatty acids found in fatty fish and fish oil supplements are gaining attention for their potent anti-inflammatory action. According to the results of at least 13 double-blind, placebo-controlled studies, supplementation with an average of 3.3 grams of omega-3 fatty acids a day significantly reduces the symptoms of rheumatoid arthritis.

The antioxidants vitamin A, vitamin C and selenium are purported to defend against the oxidative stress of arthritis, but a recent review in Rheumatology says there is no convincing evidence that any of them are effective.

Seeking Relief Through Supplements. While some supplements offer real promise for treating the symptoms of arthritis, others are little more than snake oil, while still others are potentially harmful. The Arthritis Foundation specifically warns against supplements that contain large doses of alfalfa, copper salts or zinc.

Moreover, supplements seldom offer the same benefits as drug treatments so should never take their place. And because they may interact with other medications, it's important to discuss all supplements with your doctor before starting them. Take a look at the wide range of scientific evidence behind popular supplements (see chart, below).

The Best-Odds Arthritis Diet. The field of alternative arthritis care is crowded with myths and unproved treatments. A recent Internet search for the term "arthritis diet" yielded more than three million results. Dubious diets such as the "immune power" diet or low-calorie/low-fat/low-protein diets can be unhealthful. And any diet that cuts out an entire food group is not recommended.

But that doesn't mean you should rule out diet changes when it comes to managing your arthritis symptoms. Information is beginning to trickle in on what the optimal anti-arthritis diet might look like. Some studies suggest that vegetarian diets may help because higher intakes of meat are associated with an increased risk of inflammatory arthritis or RA. However, recent findings from the Nurses' Health Study found no link between meat intake and RA.

Other studies indicate that the Mediterranean Diet, which focuses on healthful fats like olive oil, as well as fruits, vegetables, whole grains and fish, may protect against the development or severity of RA. Some of the benefits of the Mediterranean Diet may be because it contains more omega-3 fatty acids than the typical Western diet.

Other Nutrient and Food Links. There's evidence suggesting that a low intake of vitamin D is linked to both OA and RA. The average vitamin D intake of OA sufferers is only 20% of the Recommended Dietary Allowance of 400 International Units (IU) for people 51 to 70 years of age and 600 IU for people 71 and older, according to Louise Gagne, M.D., epidemiologist at the University of Saskatchewan.

Maintaining a healthy weight is another important part of managing arthritis. Studies have shown that losing weight--by decreasing calories and increasing exercise--improves function in people with arthritis.

One study found that certain foods like milk or shellfish may trigger "allergic" RA-like arthritis symptoms in some people; avoiding these foods may have short-term benefits.

EN's Bottom Line. For arthritis relief, the Arthritis Foundation suggests a balanced and varied diet that meets your nutritional needs while maintaining a healthy weight. EN specifically recommends meals chock-full of fruits, vegetables, nuts, legumes, whole grains and fish as the best diet to help control inflammation and manage arthritis pain. And don't forget to take a multi to help meet daily nutrient needs.

--Sharon Palmer, R.D.
EN Reviews 15 Alternative Arthritis Remedies

Selected Arthritis
Supplements                            Scientific Findings

PROBABLY EFFECTIVE

Fish oil                    Significantly reduced RA symptoms in 13
 (omega-3 fatty acids)      double/blind, placebo/controlled studies.
                            Average dose in studies. 3.3 g/day EPA +
                            DHA combined.

SAMe                        Relieved symptoms in several double/blind
  (S-adenosylmethionine)    studies with more than 1,000 people. A
                            well/designed study found 1,200 mg/day as
                            effective as the prescription drug
                            naproxen (Naprosyn).

POSSIBLY EFFECTIVE

Avocado/soybean             Significant improvement in OA symptoms in
  unsaponifiables (ASU)     one double/blind trial using 300 and 600
                            mq/dav.

Boswellia                   Anti/inflammatory properties effective
                            against RA, based on review of unpublished
                            double/blind trials, but a more recent
                            study found no benefit. Typical dose is
                            300/400 mg 3x/day; some studies up to
                            1,200 mg 3x/day.

Chondroitin sulfate         Benefited OA sufferers in a few placebo/
                            controlled studies and small trials. A
                            large, well/designed study using 1,200 mg/
                            day found no benefit.

Ginger                      Contradictory results for OA in two small
                            double-blind studies.

GLA (gamma-linolenic        Significantly fewer RA symptoms in one
  acid) in evening          double/blind study using 2.8 g/day GLA;
  primrose/borage oils      similar results in other small studies.

Glucosamine                 Effective against pain and symptoms of OA
                            in several placebo-controlled, double-
                            blind studies. A well-designed study used
                            1,500 mg-day, but four recent studies
                            found no benefit. Helpful against RA
                            symptoms in one double-blind placebo-
                            controlled study.

MSM                         Helpful against OA in two small double/
  (methylsulfonylmethane)   blind, placebo/controlled studies.
                            Benefits in one study with 3 g/twice a
                            day. Effective against RA in one study in
                            mice.

Vitamin E                   Reduced RA pain in a placebo/controlled,
                            double/blind study using 600 mg 2x/day.

PROBABLY NOT EFFECTIVE

Green-lipped mussel         Benefits for OA in only two of five
                            controlled studies.

Probiotics                  No more benefits than placebo for RA in
                            one small study with Lactobacillus GG.

White willow                Helpful for OA in one double/blind,
                            placebo/controlled trial with 240 mg/day
                            of salicin (the active ingredient in white
                            willow and aspirin), but no benefit for RA
                            or OA in two recent studies.

NOT ENOUGH EVIDENCE

Copper                      No evidence of benefit for OA or RA.

Turmeric                    Benefited RA when combined with other
                            supplements in two studies, but no
                            evidence it benefits RA by itself.

RA = rheumatoid arthritis; OA = osteoarthritis
g = grams; mg = milligrams
EPA = eicosapentaenoic acid; DHA = docosahexaenoic acid
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Author:Palmer, Sharon
Publication:Environmental Nutrition
Article Type:Report
Geographic Code:1USA
Date:Aug 1, 2007
Words:1157
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