Eating Away at Arthritis

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Some of the medical therapies to help manage Arthritis are called into question due to warnings for people struggling with Arthritis.Arthritis Therapy

For the millions of people struggling with the chronic pain, stiffness and joint swelling of Arthritis, recent warnings about heart risk associated with anti-inflammatory drugs have called into question some of the medical therapies to help manage Arthritis.

With warnings attached to some drugs and others pulled from the pharmacy shelves entirely, many arthritis sufferers are turning to complementary medicine, taking a more holistic approach to their condition, as well as to general health and well-being.

During the Arthritis Foundation's National Arthritis Month, UW Health's director of Integrative Medicine spoke with arthritis sufferers Wednesday about a host of ways to "stack the deck in favor of well-being."

"It's much more complicated than just one pill or just one shot," said David Rakel, MD, adding that what works for one person might not work for another. "If we get too focused on just the pill... we're missing the boat."

From social support to nutrition to spirituality, there are several factors that influence our well-being and healing, Dr. Rakel says. Adjusting one's diet can be particularly beneficial in reducing the inflammation that aggravates chronic conditions such as arthritis.

The changing American diet

Over the past century, the evolution of the American diet has actually promoted such inflammation through increased consumption of more animal products, including meat and dairy as well as oils rich in trans-fatty acids, says Dr. Rakel.

In the 1950s, Americans became concerned that consumption of saturated fats from animal products was leading to clogged arteries and heart disease. So, with "good intentions," the food industry developed new oils and food preservation techniques that allowed for longer shelf lives for many baked products, Dr. Rakel said.

But with these new oils - in the form of "trans-fatty" acids and partially hydrogenated oils, Americans began consuming high levels of omega-6 fatty acids. In general, omega-6 fatty acids lead to the production of more inflammatory chemicals in our bodies.

In recent decades, the ratio of omega-6 fatty acids to the healthier omega-3 fatty acids in the Western diet has soared to about 25:1. But to reduce inflammation in the body, that ratio needs to be reduced to 4:1, says Dr. Rakel.

Dr. Rakel recommends several strategies to begin shifting to a diet targeted to reduce inflammation, including:

Reduce saturated fats

  • Major building blocks of inflammatory agents in the body come from arachidonic acid, which we consume in the form of animal foods. Studies of inflammatory conditions such as rheumatoid arthritis have shown that symptoms improve in people who eat small amounts of meat and dairy products, Dr. Rakel says.

  • "Arachidonic acid is the fuel to the fire of inflammation," he said. "We don't want a lot of it in our bodies because it actually fuels inflammation."

  • However, not all animal products are culprits. Several types of cold-water fish have shown anti-inflammatory benefits, including salmon, mackerel, sardines and herring - due to their high content of the more beneficial omega-3 fatty acids.

Reduce omega-6 fatty acids

  • This includes reducing consumption of margarine and several types of oils, including partially hydrogenated corn, cottonseed, grapeseed, peanut, safflower, sesame, soybean and sunflower oils.

  • To reduce omega-6 fatty acids in your cooking, use monounsaturated oils, such as olive or canola oil. When shopping, keep in mind that omega-6 fatty acids are often used in any products that have a long shelf life, such as crackers, pastries and potato chips.

  • Do most of your shopping around the periphery of the supermarket and don't spend too much time at the red meat and dairy counters, Dr. Rakel advises.

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Increase omega-3 fatty acids

  • Eating more cold-water fish is one way to boost omega-3s in your diet. But there are also several non-meat sources, including flax seeds or oil, walnuts and green, leafy vegetables.

Flax and fish oil

Because flax spoils very quickly once it's ground up, Dr. Rakel suggests buying flax in seed form and grinding the seeds in a coffee grinder. The flax can then be used in a variety of ways, for example, you can take a tablespoon and sprinkle it on salads or mix it into smoothies.

Several other plant sources can also help reduce inflammation in the body.

"All of those things that make you smell seem to be really good for us," Dr. Rakel joked, listing onions and garlic among the list of plant sources that can have a "positive effect on the inflammatory cascade." Others include apples, red pepper, ginger, rosemary and the spice turmeric, which can be purchased in supplement form.

Fish oil is another way to increase your intake of omega-3 fatty acid, but Dr. Rakel warns that too much of it can do more harm than good.

"There's a therapeutic dose here," he says. "To prevent heart attack, one gram a day is a great dose. But if you have inflammatory arthritis, I don't recommend more than four grams a day."

If you take any supplements, you should always inform your doctors, Dr. Rakel stressed. Supplements might interact with your prescription drugs, potentially reducing their effectiveness.

Exercise and arthritis

From acupuncture to journaling, there are several other so-called "alternative" ways to help people cope with chronic diseases such as arthritis. Exercise can also help, by keeping joints moving and restoring and preserving strength and flexibility.

It's a technique that 70-year-old Sandy Porter has been using for several years to help manage her osteoarthritis. Porter is an enthusiastic participant in arthritis classes held in the 92-degree warm water pool at the aquatic center at UW Health's Research Park Clinic.

"I've been doing it for years and I think it's absolutely saved my life," says Porter.

The soothing warmth and buoyancy of warm water create a safer environment for relieving arthritis pain and stiffness and improving range of movement. The water supports joints while providing mild resistance to help build muscle strength.

Porter also enjoys the social aspect of the warm water class, which allows her to interact with others going through the same types of aches and pains associated with osteoarthritis.

"It's really been like a support group - although sometimes we talk too much in class," Porter said with a laugh.

Learn more

  • Participate in free events on May 25 at the UW Health Sports Medicine Center to celebrate national Senior Health and Fitness Day and to learn more about class offerings, from aqua aerobics to Pilates.

  • Find out more about UW Health's Integrative Medicine,Sports Medicine and Rheumatology and Arthritis services.

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MADISON - Copyright 2005 University of Wisconsin Hospital and Clinics Authority

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