Can diet help osteoarthritis?
Did you know diet can actually affect both risk and symptoms of osteoarthritis?
Osteoarthritis (OA) is the loss of cartilage in joints - this cartilage provides a smooth friction free surface for the joints to move. When this cartilage is lost, joints become painful, and also change in shape, eventually often requiring surgery to replace the joint
OA has traditionally been thought to be purely wear and tear ie a natural consequence of ageing. It can also be affected by many other factors - weight, genetics, trauma, occupation, and other diseases
Yet recent research has shown that inflammation may also play a big role in both the symptoms and risk of osteoarthritis - via release of inflammatory chemicals (cytokines and prostaglandins) from the joint tissue, that cause inflammation, pain, and further joint damage.
This may also explain why not everyone with OA changes on xrays have symptoms (it's been consistently proven that the degree of ‘wear and tear’ of joints on xrays correlate poorly with symptoms) - and why dietary changes can help to significantly reduce pain!
One study looking at over 4000 people from the osteoarthritis initiative study, compared the dietary inflammatory index of peoples diets, to their risk of osteoarthritis
It found that people with the most inflammatory diet had 40% more risk of having symptomatic OA.
Another study using the same study population, looked at risk of developing OA over 4 years, related to DII - again the risk of developing painful OA was 43% higher with a higher DII
Saturated fat had an even bigger effect on osteoarthritis risk- eating a diet high in saturated fat intake increased risk of OA by 60%!
BMI also played a factor in this study - thought to be both due to mechanical forces (ie more weight through joints), but also due to obesity increasing the risk of inflammation.
And since we've discovered that inflammation plays a big part in OA, it makes sense that reducing inflammation through diet could help.
The Framingham study was another large longitudinal study that followed over 1000 older people over time. From this they looked at data around diet and osteoarthritis
They found that people who ate high amounts of vitamin c in their diet (ie from citrus, berries, capsicum, and dark green veges) were 3x less likely to have progressive OA (ie it slowed down joint damage).
People who ate high levels of dietary vitamin A (in orange coloured fruit and vege) and E (in seeds and nuts) also had slower progression of OA. However later trials using supplements of these vitamins didn't find the same effect - ie it only worked when they were consumed in whole foods.
As vitamin C, E and A are all antioxidants, which reduce inflammation, so this data makes perfect sense - and foods high in these are also high in other anti inflammatory compounds, such as polyphenols.
So how can you reduce your risk of OA, or improve symptoms if you already have it?
✔️Eating an 'anti-inflammatory diet' helps reduce risk, as above.
✔️Adequate dietary omega 3 has been linked with reduced joint inflammation and cartilage loss, and having a good omega 3 to omega 6 ratio, also appears to help OA.
Increasing dietary omega 3 (oily fish, linseed, chia seeds, walnuts) and reducing omega 6 (refined plant oils) is the best way to do this, although supplementing omega 3 at 450mg/day has also helped OA symptoms in trials
✔️Maintain a healthy body weight - 5% weight loss if you are overweight can improve symptoms by up to 50%, and every 5kg of weight gained above BMI of 25 increases risk of getting OA by 36%
✔️Ginger, tumeric, ASU (avocado soy) and rhubarb extracts have been shown to help symptoms in some studies
✔️Vitamin k plays an important role in bone health, and good dietary intake can help OA symptoms - via dark green veges and brassica (brocolli etc)
✔️Reducing cholesterol levels can also improve OA symptoms - you can do this by reducing animal based dietary fats, and increasing fibre, nuts, and soy (see our cholesterol posts under heart health for more details)
✔️Reducing refined carbs /added sugar also helps by reducing inflammation
Dietary bioactives are compounds in plant foods that may also improve OA symptoms via reducing inflammation - these include
✔️flavinoids (in berries, citrus, grapes, green tea, dark green veges, apples),
✔️caretenoids (in orange fruit and veges)
✔️gluconsinolates (in brassica)
✔️isoflavones (in Soy)
✔️anthocyanins (in berries and grapes)
Having adequate vitamin D levels may also help (plus it helps overall bone health)
So in summary, aim to eat a diet high in whole plant foods, low in saturated fats, added sugar, refined carbs and processed foods, and with enough omega 3
Try eat a rainbow of brightly coloured fruits and veges, don't forget your leafy greens, and try to get some safe sun exposure ☀
And these are all good for overall health too!!
So if you or someone you know has osteoarthritis, why not try these simple things - there's nothing to lose ❤️
https://pubmed.ncbi.nlm.nih.gov/29209774/
https://arthritis-research.biomedcentral.com/.../s13075...
https://nutritionguide.pcrm.org/.../all/Osteoarthritis
https://www.cambridge.org/.../EE498B73B7E764DDF491A55C25B...
https://www.bda.uk.com/resource/osteoarthritis-diet.html