Diet in Arthritis
by Manjit Saluja

SUMMARY POINTS:

Every life form in this universe requires energy to survive and grow. The earth needs the right amount of sunshine, moisture, rain and seeds to flourish. Similarly it is food that enables human beings to live, rejuvenate, function and of course to perpetuate the race. But food besides being a source of fuel and energy to human beings also helps to alleviate any imbalance that results in disease in our body.

Though diet may not be curative but managing arthritis with the right kind of diet is simple. It can be done with easily available foods. They can help in reduction of pain and improve the quality of life of patients. As for other diseases, there isn't any established diet plan, but each patient can weigh the advantages and disadvantages of each food by their own personal experience.

Certain food helps to fight and reduce pain. There are some foods which strengthen the bones. Having a nutritious, balanced diet is the key to good health. Healthy eating is including more of good foods that would help in maintaining your weight. Any patient visiting the rheumatologist has a similar question that what should I eat/ avoid to reduce my pain? What is good for one person may be bad for other person. Patient has to decide which food has to be eliminated from the diet. Some patients of RA feel that there are some foods that make symptoms such as stiff & painful joints, better or worse. However there is no scientific evidence-

The most common questions are as follows:

Q1. Does  change in diet help in reducing my arthritis?

A well balance nutritious diet which will provide your body with all the vitamins, & minerals is essential. It is very important that you maintain your weight.

Q2. What vitamins & minerals do I need?

A healthy balance diet including lots of fruits & vegetables will provide all the necessary vitamins that are required by your body. For arthritis patients calcium, vitamin D & iron are important.

Q3. What is the role of Calcium in our body?

Calcium helps in  bone health. Lack of calcium in  women after menopause results in a condition called osteoporosis. Osteoporosis is a condition in which the bones become hard, brittle & fragile. This is the most common reason for a broken bone in the elderly. Hence it is required that you include calcium rich foods such as dairy products (milk, cheese, paneer & curds) in your diet. Taking a calcium supplement may also help.

Q4. Why is it necessary to take an iron supplement for patients with Rheumatoid arthritis?

Anaemia after occurs with rheumatoid arthritis. Certain drugs also cause anaemia. Hence patients should always include good sources of iron in the diet such as green leafy vegetables.

Soyabeans are the richest iron content pulses. Sprouting chickpeas, cowpeas, green gram in order to make an iron-Vitamin C combo will do wonders. Soyabeans are also rich in calcium, magnesium & selenium. Soyabean is a complete protein food. Black currants, raisins & dried dates serve as healthy snacks, & adds to the iron. Tea and coffee decreases iron absorption in a meal & should be consumed after a gap of atleast 1 hour. Iron supplement should be taken only under the advice of a physician. Too much iron is also very harmful.

Q5. What role does vitamin C and D play in arthritis and arthritis symptoms?

Vitamin D: This vitamin is required to absorb, process calcium bone development, immune functioning & alteration of inflammation. Research has found that vitamin D may play a significant role in joint health, and that low levels may increase the risk of rheumatologic conditions such as arthritis.

Vitamin D is easily produced when your skin is exposed to sunlight. Hence it is also called the sunshine vitamin. Going out in the sun for 15 mins, between 10am – 2.00 pm  would help your body produce enough Vitamin D naturally.  Excess vitamin  D can cause the body to absorb more calcium which is harmful& leads to increased risk of heart disease & kidney stones. 

Vitamin C: Vitamin C is a key for both, preventing inflammatory arthritis and maintaining healthy joints. Some studies have shown that vitamin C is important for building connective tissue. Rather than taking supplement, it is  recommended to get it through a healthy diet. Vitamin C also helps the stomach in iron absorption, hence include amla, guava, citrus fruits, sprouts, papaya in your diet.

A study showed  people who consumed the least amount of fruits and vegetables were twice as likely to develop inflammation in the joints. It was seen in a study that patients with arthritis ate fewer fruits vegetables. People who got the least vitamin C in their diet had 3 times the risk of developing inflammatory arthritis than those who got most (Annals of Rheumatic diseases, Vitamin C linked to lower RA risks) Vitamin C is a powerful antioxidant & helps in fighting infection & may work to control inflammation. Eating fruits & vegetables to get daily dose of Vitamin C naturally is encouraged. Vitamin C is a key player in formation of joint cartilage.

Q6. The effect of  Potassium in pain in Rheumatoid arthritis?

National Health and Nutrition Survey III (USA) data showed a low potassium level in patients of Rheumatoid arthritis than in people with no RA symptoms. Potassium is critical to 'pain'  In addition, RA sufferers have inappropriately low cortisol levels, which suppress inflammation, thus allowing inflammation levels to remain high. Hence it is essential to ensure that you are getting a great deal of Potassium in your diets since studies have continually shown that this element is so critical to pain reduction – and this has been confirmed by a recent study conducted in our center titled “The effect of potassium supplement on pain in rheumatoid arthritis”-This clinical research interventional controlled study was primarily designed to evaluate the role of potassium in reducing pain in RA. There was a significant reduction in mean pain  in the potassium enriched diet, food based and augmented (by addition of oral rehydration salt) potassium supplement powder to increase the daily potassium intake.  The patients improved significantly for several clinical and laboratory measures of efficacy including pain. The proportion of patients with at least 50% reduction in pain over the study period was significantly  more in Potassium rich diet plus enriched potassium supplement powder.

Bananas, masaumbi  are known to be one of the fruits richest in potassium together with coconuts, melons,. In the diet, good sources are cereals, pulses, fruits and vegetables such as Ragi, Green gram dal, Chawli, Matki, Dhania and Jeera are some of the excellent sources of potassium.

Q.7. Role of omega -3 fatty acids in improving symptoms of Rheumatoid arthritis?
Omega-3 fatty acids are considered as good fat. Some studies have shown that treatment with omega-3 fatty acids has been associated with improvement in Rheumatoid arthritis. They may help reduce inflammation in your body including inflammation caused by arthritis. Good source of omega-3s is fish. For vegetarians you make sure you eat flaxseeds, walnuts.

Simple choices make a difference. Whenever you go to the market keep it in mind that fresh is best, that's when the nutrients are at their highest and keep these healtier choices while eating out also.

We all should eat healthy, but when our food can help treat swelling and inflammation it makes more sense to eat healthy. Combined with your doctors treatment, a diet rich in omega acids and antioxidants could keep inflammation down so you can start living pain free.

Do Not take your decision alone:  harmful interactions are possible of certain vitamins and minerals along with RA medicines. Always confirm with your treating doctor before taking any new vitamin or mineral supplement to your diet.

A healthy diet alone can't make your Rheumatoid Arthritis  go away. But striking the right balance of nutritious foods and vitamins and minerals may help decrease common symptoms of this painful condition.

But remember your diet mantra should be Moderation is, for most things, the best.

References:

1)www.arthritisresearchuk.org/arthritis-information 

2)http://Webmd.com/rheumatoid –arthritis

3)The effect of potassium supplement on pain in Rheumatoid arthritis- Study conducted in Center for Rheumatic Diseases by Toktam Kianifard guided by Dr Arvind Chopra.