Nutrition • 27 May 2020
Osteoarthritis: Foods to Help You Find Relief
Osteoarthritis: Foods to Help You Find Relief
By Kim Storm, MD, RD
Susan Samueli Integrative Health Institute
UCI Susan and Henry Samueli College of Health Sciences
Osteoarthritis (OA) is a debilitating chronic disease that affects 1 in 5 adults in the United States (Clinton, 2015). This painful condition is caused by degeneration of cartilage and bones in joints. Cartilage protects bony surfaces in joints and as cartilage thins, bone may be exposed or damaged which can lead to joint tenderness, stiffness and pain. Many people with OA lose mobility and as a result suffer from muscle loss . Current strategies for treating OA involve rehabilitative exercises, pharmaceutical drugs, and in some cases, joint replacement surgery (Clinton, 2015).
Unfortunately, even with these therapies, as many as 27 million people in the United States still suffer from chronic pain related to OA (Clinton, 2015). Chronic pain has consequences beyond physical discomfort. It is frequently accompanied by dependence on pain medication, relational issues, loss of productivity, and financial burdens (Hilton, 2017). The unrelenting discomfort associated with OA has led to an increased interest in alternative treatments.
Recent evidence suggests that diet may influence the occurrence, persistence and severity of chronic pain (Brain, 2019) (Rondanelli, 2018)(Tick, 2015). It’s well documented that proper nutrition is essential for bone and cartilage health (Karpouzos, 2017). However, until recently, it’s been unclear what specific diet recommendations to make for those suffering from OA.
Consider a whole foods plant-based diet to maintain a healthy bodyweight.
People who are overweight or obese are more likely to develop OA (Kadam, 2004). Furthermore, the severity of OA related pain is directly associated to the degree of overweight/obesity as measured by body mass index (Lee, 2012). Also, it’s been shown that pain actually diminishes with weight loss after following a calorie-restricted diet (Riecke, 2010).
These conditions often occur as a result of poor nutrition so dietary behavior change is an important way to manage OA (Elma, 2020). Unfortunately, many popularly promoted diets are not based in science and can inadvertently do a disservice to those genuinely trying to improve their health.
There is mounting evidence that following a whole-foods plant-based (WFPB) diet is an inexpensive, practical, and sustainable way to achieve a healthy weight while simultaneously improving OA symptoms (Elma, 2020)(Clinton, 2015). The WFPB diet is a far cry from the standard American diet and is centered on fruits, vegetables, legumes, grains, nuts, and seeds. Consumption of processed foods high in sugar, fat, and salt and animal products like meat, dairy, and eggs is minimal.
While many diets focus on prescribed calories, the beauty of the WFPB diet is that it is effective for weight loss without a hyper focus on calorie deprivation. While eating freely, without restricting intake, people who adopt the WFPB lose weight and report significant improvement in OA related pain in as little as 2 weeks after changing the diet (Hilton, 2017) (Clinton, 2015).
Favor healthy fats.
Chronic inflammation is suggested as one of the mechanisms underlying chronic OA pain (Stürmer, 2004). The inflammatory response is influenced by the types of fats in the diet. It’s best to get a majority of dietary fat from whole plant based foods (i.e. avocados, olives, nuts, seeds, coconut, and cocoa)(Clinton, 2015).
Limit foods high in saturated animal fat like meat, butter, and cheese as well as refined omega-6 polyunsaturated fats like corn oil and soybean oil that are commonly found in processed foods. These fats are prone to oxidation and can lead to excess inflammation. Instead favor foods like walnuts, chia seeds, flax seeds, and hemp seeds.
People with OA have an increased risk of heart disease and should avoid all foods that contain pro-inflammatory “partially or fully hydrogenated oil” (trans-fat) like cookies, crackers, tortillas, margarine, muffins, cakes, or candy.
Support your gut microbiome by eating fiber and probiotic rich foods daily.
Plant-based diets are high in dietary fiber and play an important role in maintaining the abundance and diversity of the gut microbiome (Tomova, 2019). The bacteria that comprise the gut microbiome help manage pain by maintaining a healthy inflammatory response within the central nervous system (a relationship called the “gut-CNS axis”) and throughout the body (Pimentel, 2012). Disruption to the gut-CNS axis is associated with increased severity of chronic pain (Hakansson, 2011).
Factors that contribute to unhealthy gut flora include: prolonged antibiotic use, diets high in sugar, refined oils, and processed grains, low fiber intake from lack of fruits and vegetables, chronic stress, and limited sleep (Tomova, 2019).
To maintain a healthy gut microbiome, consume plenty of probiotic-rich fermented foods and plant foods high in fiber. Probiotic rich foods include yogurt, kefir, sauerkraut, kimchi, kombucha, or dill pickles. All fruits and vegetables contain prebiotics, the fibers that feed the probiotic bacteria and help shift the gut microbiome to better reduce inflammation (Tomova, 2019). Eat a variety of fruits and vegetables because they contain different types of fiber and each type of bacteria enjoys a unique type of fiber. While all plant foods offer prebiotics, leeks (great with scrambled eggs), artichokes (try adding canned artichoke hearts to soups/pasta), jicama (peel and slice for a crunchy refreshing snack), and onions and garlic are especially potent.
Overall dietary patterns are more influential than any one single food.
There is mounting evidence that diet can play an important role in minimizing OA pain. However, it is important to note that there is little evidence for the use of isolated nutrients for improving OA symptoms. Rather, it appears that foods act synergistically to promote or prevent disease. For managing OA pain, overall dietary and lifestyle patterns are more influential than any one single food and the WFPB diet is an excellent option for those seeking relief from chronic pain.