What is arthritis?
Arthritis is a chronic or recurrent inflammatory joint disorder caused by factors that trigger inflammation resulting in pain, swelling, joint effusion, restriction of movement, and culminating in cartilage destruction and joint deformity.
At least one hundred different forms of arthritis have been identified, the most common being osteoarthritis. Different types of arthritis have different symptoms, but in general a person with arthritis will feel pain and stiffness in the joints, muscles, or soft tissues surrounding the joints. As is the case with most medical conditions, early diagnosis and treatment is important. A person who seeks early medical advice for arthritis has a better chance of reduced joint damage, and will be able to control the symptoms of arthritis more successfully.
Common symptoms of arthritis:
- Pain or tenderness in a joint
- Joint stiffness, swelling, warmth, redness of the joint
- Difficulty using or moving a joint normally
‘Rheumatism’ is a term people use to describe a number of problems affecting the joints, muscles or soft tissues of the body, rather than a specific disease. People often use ‘rheumatism’ to describe osteoarthritis, rheumatoid arthritis, bursitis, fibrositis, lumbago, sciatica or tendonitis.
Conventional medical treatments doctors use to treat arthritis
While no cure for arthritis is available, a number of medical treatments can help to manage symptoms and slow disease progress. As with most medical disorders, the best chance for stopping or slowing joint cartilage damage is through early diagnosis, early treatment, and good management.
Three key characteristics of osteoarthritis:
- Mild inflammation of the tissues in and around joints
- Damage to cartilage, the smooth surface that lines the bones and enables joints to move without friction
- Bony spurs that develop around the edges joints.
Treatment depends on which joint is affected and involves medication and exercise. Analgesics minimise joint pain, and non-steroidal anti-inflammatory medication and corticosteroids help reduce joint inflammation.
If a person is overweight or obese weight loss through a reduction in calorific intake will improve osteoarthritis symptoms.
In severe cases, if movement is very restricted and the joint misaligned, joint replacement surgery may be necessary.
New medical research into cartilage replacement could replace surgical joint replacement in the future. Osteochondral grafting, autologous chondrocyte implantation, and mesenchymal stem cell regeneration are three newly developed techniques that aim to restore articular cartilage.
Osteochrondral grafting involves harvesting a plug of bone and cartilage from a healthy joint and then transplanting the plug to the joint crippled by arthritis. This technique is currently used to treat knee injuries.
Autologous chondrocyte implantation can be used to improved arthritic knees or after knee injury. The treatment involves harvesting healthy cartilage cells that are cultivated and then implanted at the knee joint.
Mesenchymal stem cell regeneration is an experimental treatment that harvests bone marrow, which is implanted to create new cartilage to cover the joint affected by arthritis.
Nutritional medicine treatment for arthritis
Arthritis is a general term for conditions that joint pain and inflammation as the principle symptom. Typical treatment involves pain-reducing medication and anti-inflammatory drugs. There is growing scientific rationale for the use of dietary supplements as adjuncts in the treatment of inflammatory discorders, such as arthritis.
In the past, many doctors believed that diet modification would not help symptoms and they told arthritis patients that dietary changes would not benefit them. However, this conclusion was based on older research with diets that included many of the products that researchers now believe contribute to inflammation, such as dairy products, alcohol, poultry, or meat.
While there is no definitive arthritis diet, increasing anti-inflammatory foods and limiting foods that may trigger joint pain will reduce symptoms and improve well being. At least for some people, a healthier diet is the answer to less pain and stiffness.
The generation of free radicals within the body is an important factor in the development and on-going condition of arthritis. Oxidation occurs when oxygen reacts with certain molecules to form free radicals, which are highly chemically reactive towards other substances.
While many free radicals are necessary for human health, such are killing bacteria, some free radicals participate in unwanted side reactions that can damage important cellular components, and cause cell injury and death. Excessive free radicals are thought to play a role in cancer, stoke, heart attack, diabetes, and inflammatory disorders such as arthritis.
To counter the effects of free radicals, dietary antioxidants play a key role in minimising cell damage and repairing damaged cells. Vitamins A, C, and E, glutathione, selenium, bioflavonoids (quercetin and anthocyanidins), tocopherols, and polyphenols are all antioxidants. Insufficient levels of antioxidants can lead to oxidative stress, when cells are damaged and can’t function adequately, and eventually chronic inflammation.
Quescetin is found in onions, kale, leeks, cherry tomatoes, broccoli, blueberries, black currants, elderberries, cocoa powder, apricots and apples. While anthocyanidins are found in blackberries, black currants, blueberries, eggplant, elderberries, raspberries, cherries, boysenberries, grapes, strawberries and plums.
Glutathione is the primary antioxidant produced within the body, and keeps the dietary antioxidants (vitamins A, C, and E) in their active forms.
The Omega-3 fatty acids (ALA, DHA, EPA) are polyunsaturated fatty acids that are essential to normal growth and play an important role in reducing inflammation. The body can’t produce this substance, so we can only derive omega-3 fatty acids from what we eat and drink. However, mammals can use ALA to derive EPA, and to a lesser extent DHA.
Omega-3 and omega-6 fatty acids compete for the same metabolic enzymes. This means that while eating omega-3-rich foods reduces inflammation, eating too much omega-6 can negate the benefits. The metabolites of omega-6 are more inflammatory than those from omega-3. Elevated omega-6 intake is associated with an increase in all inflammatory diseases. Decreasing the omega-6/omega-3 ratio protects against chronic, degenerative disesases.
A typical Western diet provides an omega-6/omega-3 ratio of 10:1 to 25:1. Most nutritional experts agree that the omega-6/omega-3 ratio should range from 1:1 to 5:1. (Mel to check). As a general rule avoid highly processed, highly refined, and highly oxidised oils used in processed foods, such as corn oil, canola oil, soy oil, hydrogenated fats, margarine, and shortening.
Ratios for various vegetable oils are:
Flaxseed oil 1:3 – an important source of omega-3
Cold pressed, extra virgin olive oil 3:1
Canola oil 4:1
Corn oil 46:1
Peanut, grape seed, safflower, sesame, coconut, and sunflower oils contain no omega-3 fatty acids.
Omega-3 fatty acid is found in:
Seafood – salmon, herring, mackerel, sturgeon, green lipped mussels, halibut, flounker, hoki, oysters
Nuts and seeds – sunflower seeds, walnuts, flaxseed, pecan nuts, hazel nuts, chia seeds, sesame seeds, pumpkin seeds, almonds
Vegetables – spinach, broccoli, alfalfa sprouts, rocket, capers, pumpkin, cauliflower kale, parsley, watercress
Fruits – kiwi fruit, walnuts, avocado, grape leaves, strawberry
Herbs – basil, oregano, tarragon, mint, spinach, mint
Oils – extra virgin olive oil, flaxseed oil, avocado oil,
Pro-inflammatory effects of omegy-6 fatty acids. Modifying the ratio of omega-3 to omega-6 fatty acids to include more of the former and less of the latter may reduce pain and stiffness.
A toxin called advanced glycation end product AGE can damage proteins and incite the release of inflammatory messengers called cytokines, which speed up oxidative damage to cells and can lead to inflammatory conditions such as arthritis and other degenerative diseases.
AGEs are abundant in Western diets, because these days so much of the food we eat is reheated, pasteurised, dried, smoked, fried, or grilled. AGEs form during glycation, the chemical reaction when a carbohydrate binds to a protein without the help of an enzyme. Glycation makes cells less pliable and more prone damage and premature aging. Glycation takes place within the body after the ingestion of sugar-rich foods and during food preparation, when foods are processed, heated, and fried. Researchers believe that the daily AGE intake for many people eating a typical Western diet is at least three times higher than what the body can handle.
Not all sugars cause cell-damaging glycation. Glucose is the main sugar humans metabolise for energy. The two sugars that have a high likelihood of forming AGEs are fructose and galactose.
Fructose is a fruit sugar derived from sugar cane, sugar beet, and maize. Food manufacturers add fructose to foods and drinks to sweeten and enhance the flavour and to improve browning in baked goods. Lactose is found in milk and milk products and galactose forms when the body breaks down lactose into glucose and galactose. Dairy products, sugar beets, and gums also contain galactose.
Therefore, the amount of oxidative and perioxidative stress experienced by a person in good health is proportional to the amount of sugar-rich and processed foods he or she eats. To reduce exposure to AGEs, reduce your intake of sugar-rich foods and poach, stew, bake, steam, or bake at a low temperature instead of frying, boiling, grilling, or baking at a high temperature.
Because dairy products contain lactose and galactose, foods such as milk, cheese, and yoghurt may contribute to arthritis pain. For some people lactose can irritate the tissues around joints.
A gluten-free vegan diet, which contains no animal products or gluten at all, has reduced the level of pain and joint stiffness in some sufferers of arthritis. A raw, vegan diet is rich in antioxidants and fibre, high in omega-3 fatty acids and contains no saturated fat (omega-6 fatty acid). When people switch to a vegan diet they often lose weight as a result, which reduces the stress on damaged joints.