Synotrex
Scientifically designed arthritis pain relief medication.Promotes healthy joint function, helps alleviate pain and swelling, and repair damaged joints.
Liquid Glucosamine
Instead of buying three separate products you can get the most popular arthritis and joint pain natural supplements in one formula with outstanding potency. Each one-ounce serving provides you with an incredible 1600 mg of glucosamine, 1200 mg of chondroitin and 1000 mg of OptiMSM brand of MSM.Syn-flex®
Liquid Glucosamine is very beneficial in easing the pain of arthritis and effectively assists in rehabilitating damaged cartilage. Syn-flex provides a pharmaceutical quality glucosamine with eleven other synergistic ingredients in liquid form. This allows for maximum absorption and bioavailability.Smooth orange flavor.
Osteo Support
120% of the recommended daily allowance of calcium. Contains ostivone which has been shown to increase the effectiveness of calcium supplements. Four tablets provide 1200 milligrams of highly bioavailable calcium.Ostivone
Ipriflavone has been the subject of 60 clinical trials worldwide and has shown remarkable efficacy in maintaining healthy bone density. The compound improves the balance between bone building and bone breakdown.Calcium/Magnesium
This high potency calcium product combines three different kinds of calcium, Vitamin D, Magnesium, and Boron into 1 capsule. Since bodies are different and handle calcium types differently, calcium citrate, calcium carbonate, and chelated calcium are all included. Provides a 2:1 calcium to magnesium ratio.RealHeal Massage Oil
RealHeal is a blend of especially chosen aromatherapy oils well known for their healing, restorative and pain killing properties. Used for relieve of arthritic and rheumatic conditions.Grape Seed Extract
High-tech antioxidant far more powerful than vitamins C, E and beta-carotene. Other grape seed extracts often use potentially dangerous chemicals which can leave residues and strip away many of the nutrients.Super Antioxidant
One of the most progressive antioxidant formulas. Contains potent compounds that neutralize both water-soluble and lipid-soluble free radicals. Cellular breakdown from increased oxidant activity is a primary contributor to the aging process. Antioxidant Boost Liquid
Helps neutralize free radicals that can lead to illness and disease. Liquid form means you get superior absorption for greatest effectiveness. Includes Grape Seed Extract with potent OPC's. Powerful liquid combination of outstanding ingredients.Desert Burn ZA 750™
Certified Authentic South African Hoodia Gordonii - Desert Burn ZA 750™.Your hunger will be gone for at least 6 hours.
The greatest natural appetite suppressant of all time.
Desert Juice™
Number One Authentic Liquid Hoodia Supplement in the World. Desert Juice™ is made from 100% Hoodia Gordonii Succulent Powder which is imported directly from South Africa and processed into liquid form. Hoodia Liquid is perfect for putting into juice, water or your favorite beverage. Great for those who don't like swallowing capsules.500mg Hoodia Per Serving. Each Bottle contains 59 Servings.
Hoodia Java™ Coffee
African Plant that Helps Fight Fat.Hoodia Java™ is made from 100% Hoodia Gordonii Succulent Powder plus Dark Roast Coffee, imported directly from South Africa.
1 gram hoodia per cup, 25 cups per bag.
Hoodia Desert Tea™
Hoodia Gordonii & Rooibos Tea.1200mg hoodia per cup, 20 tea bags per pack.
Appetite suppressant.
Diet and Arthritis
by © Arthritis Research Campaign 2006
Introduction
There is a great deal of advice about diet and nutritional supplements for arthritis and rheumatism in magazines, books, and on the internet. Much of it is confusing. Claims are made for many food supplements and diets, suggesting that they help with arthritis. Some of the advice, particularly on the internet, is given by companies who produce food supplements, and who have an obvious interest in you buying their products! Some people end up taking expensive food supplements or following elaborate and inconvenient diets which do not help, or may even be harmful. Often the same results can be achieved by simpler, cheaper methods. For example, it is generally better to get the vitamins you need from food, rather than take supplements. On balance, altering your diet will not have as great an impact on your arthritis as the more standard drug treatment and in particular you should not stop your medical treatment without discussion with your doctor.
This booklet explains how the food you eat might affect your arthritis. It then gives advice on the most sensible diet to follow and answers the most common questions which people ask about food and arthritis. Terms which are in italics when they are first used are explained in the glossary at the back of the booklet.
Can changing my diet really help my arthritis?
Yes. The right diet can certainly help some people with arthritis and rheumatism. For example, if you are overweight and suffer from arthritis, one of the most important things you can do to help yourself is to change the amount and type of food you eat. Recent research has also discovered several new links between arthritis and diet.
It is also important to consider whether your regular diet is giving you all the important basic nutrients including minerals such as calcium and iron. If it does not, then your general health will suffer and this may have an effect on your arthritis – see the next section.
How can I change my diet (and lifestyle) to help my arthritis?
There are four golden rules you should follow to help your arthritis:
- eat a balanced and varied diet to maximize your intake of vitamins, minerals, antioxidants and other nutrients you need which will help to keep your weight within the recommended range (see Figures 1, 2 and 3)
- change the type of fats and oils you eat and include oily fish
- eat a more Mediterranean style diet with plenty of fruit and vegetables
- take regular exercise.
Taken together, these measures are likely to be beneficial whatever type of arthritis you have. Current evidence suggests that oily fish is likely to be beneficial if you have an inflammatory type of arthritis (such as rheumatoid arthritis, reactive arthritis, psoriatic arthritis, or ankylosing spondylitis). Oily fish helps protect against heart disease and is good for your health in general, but the strongest evidence that it can help arthritis relates to inflammatory arthritis. Advice relating to specific types of arthritis is given later in the booklet, so it is important to know what type of arthritis you have. All the points above are dealt with in more detail after we have explained why watching your weight is so important.
Why is my weight so important?
The most important single link between your diet and arthritis is certainly your weight. Being overweight puts an extra burden on the weight-bearing joints (back, hips, knees, ankles and feet) when they are already damaged or under strain. Because of the way joints work, the pressure in your knee joints is 5–6 times your body weight when you walk. Even a small weight loss can make a big difference to your joints. If you are overweight and have arthritis in any of your weight-bearing joints losing weight will help you more than any food supplements. Too much body fat may also increase inflammation in the body, making your joints more painful. Some evidence for this can be seen in the fact that achieving a healthier weight can improve the results of blood tests for inflammation such as CRP (C-reactive protein) and ESR (erythrocyte sedimentation rate).
How can I lose weight and eat a healthy diet?
Slimming has become big business. There are many slimming treatments and so-called miracle diets, and this can be confusing. Unfortunately there is no miracle cure for arthritis. Crash and fad diets are usually unbalanced and are not recommended. Most people find they put weight back on when they return to normal eating. The only way to lose weight permanently is to make permanent changes to the way you eat or the amount of exercise you do.
To work normally, your body needs food to supply energy and a variety of vitamins and minerals. If your diet contains more energy than you burn up, your body will convert the extra energy to fat and you will put on weight. On the other hand, if your food contains less energy than you are using, you will lose weight. It may be that you are unable to take as much exercise as before because of your arthritis. This means that you need less energy and should eat less high calorie foods while maintaining your intake of essential nutrients. The chart in Figure 3 shows whether you are a normal weight for your height. Please note that, in this chart, the 'OK' range is shown in two shades and spans, for example, 8 stones to just under 11 stones for a person who is 5'6" tall. Another method of defining whether you are a healthy weight for your height, overweight or underweight is the Body Mass Index (BMI) (see Table 1 for a description).
Table 1. How to find your Body Mass Index |
| First, multiply your height in metres by itself – this will give you a figure (A). Then divide your weight in kilograms by the figure A. The result is your BMI. An ideal BMI for most people is 20–25. This corresponds to the 'OK' weight range shown in Figure 3. |
The energy in food is measured in kilocalories (kcal), often just called calories. If you eat fewer calories, it is important not to lose out on vitamins and minerals. This is why it is important to eat foods that are high in vitamins and minerals but low in calories, such as fruit and vegetables.
It is healthy to eat starchy foods like bread, potatoes, rice, and pasta. They have no more calories than protein. Wholemeal versions of these starchy foods are better as they are more filling because they are high in fibre, and often supply more vitamins and minerals – for example, wholemeal bread, brown rice, wholegrain breakfast cereals.
Cut down on fat
Fat has twice as many calories as the same weight of starch or protein. Most people eat far more fat than they need for health. Eating 30 g (about 1 oz) less fat each day saves 270 calories. So cutting calories does not require massive sacrifices. Making minor changes to the food you eat can be enough.
The fats in food are of three kinds: saturates, mono-unsaturates, and polyunsaturates. Saturated fats are mostly of animal origin and are found particularly in full-fat dairy products and processed foods including foods like cakes, pastry and biscuits. Chips are sometimes fried in animal fat and therefore can be a source of saturated fat. Lean meat does not contain much saturated fat, and for most people who eat a typical 'traditional' British diet, dairy products (milk, butter, cheese, yogurt etc.) make up the biggest source of saturated fat. Asian food can also be quite high in saturated fats, for example meals cooked using ghee (clarified butter). Some vegetable oils, such as palm oil and coconut oil, contain a lot of saturates. Saturated fats are the most important kind of fat to reduce since they can increase the pain and inflammation in the body. Softer fats and oils from corn or sunflower sources are high in what are called omega-6 polyunsaturates and these can also increase general inflammation in the body. Mono-unsaturates, as found in olive and rapeseed oil, are 'neutral' fats in this respect and do not worsen inflammation, but remember they contain just as many calories, so limiting them is still important to lose weight.
To eat less fat, follow these guidelines:
- look out for and avoid 'invisible' fats in foods like biscuits, cakes, chocolate, pastry and savoury snacks – check the labels
- trim fat off meat
- choose lean cuts of meat
- choose fish and poultry more often
- use low-fat milk (skimmed or semi-skimmed)
- use low or reduced fat dairy products (e.g. yogurt, low-fat cheese)
- use low-fat, olive-oil-based or soya margarines
- grill instead of frying
- if you do have the occasional 'fry-up', use olive oil and use only a very small amount
- fill up on wholegrain bread, cereals, fruit and vegetables
- look for snacks which are naturally low in fat such as plain popcorn or fruit or try roasted beans, such as 'soya nuts'.
Cut down on sugar
Sugar contains only calories and has no other food value (so-called 'empty' calories) so it can be cut down without any loss of nourishment. Eating 30 g (about 1 oz) less sugar each day saves 120 calories.
Try not to add sugar to drinks and cereals. Although artificial sweeteners contain very few calories, it is better to get used to food being less sweet by not adding them to drinks. Dried fruit like raisins can be used to sweeten cereals and puddings; unlike sugar and artificial sweeteners, they also provide vitamins and minerals.
Eat more fruit and vegetables
The World Health Organization recommends that we eat at least five portions of fruit and vegetables every day (see Table 2). This is to make sure that the body receives the important nutrients, particularly vitamins, minerals and antioxidants which it needs to maintain good health and to protect it during the stress of disease. Antioxidants can help protect joints, and help reduce inflammation by 'mopping up' some of the body chemicals which cause inflammation, and may even help prevent arthritis. Recent research has shown that people who eat plenty of fresh fruit and vegetables, particularly those containing vitamin C, seem to have a lower risk of developing inflammatory arthritis. Choose fruit and vegetables of various different colours especially the brightly coloured varieties as these tend to be rich in antioxidants. Examples include apples, oranges, cherries, blueberries, peppers, spinach, tomatoes, avocado, sweet potato, beetroot and broccoli.
You can also get more fibre from eating plenty of fruit and vegetables. Remember that you also get fibre from wholegrain versions of bread, cereals, pasta and rice. In addition, as suggested above, fruit, vegetables and wholegrains are relatively filling and help if you are trying to lose weight.
What counts as one portion of fruit or vegetables?
The table below gives examples.
Table 2. What counts as one portion of fruit or vegetables? |
| ½ grapefruit ½ pepper ½ avocado 1 medium apple 1 medium orange 1 medium banana 1 medium tomato 1 medium onion 2 medium plums 2 small tangerines 2 tinned pineapple rings 2 tinned peach halves 2 2-inch mango slices 2 broccoli florets 3 sticks of celery 3 heaped tablespoons of carrots (raw or cooked) 3 heaped tablespoons of fruit salad 3 heaped tablespoons of frozen peas 5 fresh asparagus spears 6 baby sweetcorn 7 fresh strawberries 8 cauliflower florets 14 button mushrooms 1 heaped tablespoon of sultanas or other dried fruit A handful of grapes 150 ml of fruit juice (counts only once however much you drink) |
You should try to eat at least 5 portions of fruit or vegetables a day
Take regular exercise
Exercise is very important. Not only does it use up calories which would otherwise end up as fat, but it also increases your strength and suppleness. Exercise is good for your general health, especially the heart and circulation. Of course, arthritis can make exercise difficult and painful, and the wrong kind of exercise can make it worse. But exercise does not have to mean running a marathon! A daily walk for half an hour with the dog, for example, or a walk to the local shops or park is exercise and it will help. Many people find particular types of exercise suit them: swimming is a good exercise because being in water takes the weight off the joints. Others prefer keep-fit classes, yoga or cycling. The most important thing is that you enjoy it and so do it regularly.
Should I take extra calcium, vitamin D, or iron?
Calcium and vitamin D
Calcium is an important basic nutrient. Not having enough calcium in the diet can make you more likely to get osteoporosis (brittle bones). Women after the menopause are particularly liable to osteoporosis. Many people with arthritis also have a risk of developing this condition. (See arc booklet 'Osteoporosis'.) Lack of calcium in the diet can also increase your risk of developing osteomalacia (see arc booklet 'Osteomalacia'). The richest sources of calcium are milk, cheese and yogurt and, as shown below, certain types of fish which are eaten with the bones. If you are watching your weight it is worth knowing that skimmed or semi-skimmed milk actually contains more calcium than full-fat milk. We recommend a daily intake of calcium of 1000 milligrams (mg) or 1500 mg if you are over 60. A pint of milk a day, together with a reasonable amount of other foods which contain calcium, should be sufficient (see Table 3). Vitamin D is needed for the body to absorb calcium and there is some evidence that arthritis (both osteoarthritis and inflammatory types), progresses faster in people who are low in it. Vitamin D is produced by the body when sunlight falls on the skin, so slight deficiency is quite common in winter, and it can be obtained from the diet (especially from oily fish) or vitamin supplements (see arc booklet 'Osteomalacia' for more information on vitamin D and vitamin D deficiency). For people over 60 it may be helpful to take a supplement containing 10–20 micrograms (µg) of vitamin D.
If, for whatever reason, you do not take many dairy products, soya milk is now available in most supermarkets. It can be used in exactly the same way as cow's milk. Some soya milk is fortified with calcium, so try to use this type. Other 'milks', made from rice or oats, are now available; some of these are also fortified with calcium. If you are not taking dairy products or a suitable quantity of other calcium-fortified 'milk' or other calcium-fortified products, you may need a calcium supplement. Discuss this with a dietitian or your doctor.
Table 3. Approximate calcium content of some common foods |
|||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
Iron
Iron is important to prevent anaemia. Many people with arthritis are anaemic. The anaemia can be due to different causes. NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen and diclofenac help the pain and stiffness of arthritis but may cause bleeding and stomach ulcers in some people, leading to anaemia.
The other main cause of anaemia in arthritis is anaemia of chronic disease, which often occurs with rheumatoid arthritis and similar conditions, and does not improve with iron supplements. If you are anaemic your doctor can tell you if more iron is likely to help.
The best source of iron in food is red meat. However, as many people are now cutting down on red meat for various reasons (and this may also be wise in relation to inflammatory arthritis – see later), it is important to have iron from other sources. Iron from fish is easily absorbed and oily fish are a good source. For example, sardines contain as much iron as beef. Iron is better absorbed if there is also vitamin C in the meal so have a good portion of vegetables or salad or fresh fruit with your meal. On the other hand, tea reduces the amount of iron which your body can absorb so it is a good idea not to drink tea with your meal. If you are vegetarian, please note that dairy products like milk and cheese are a very poor source of iron, but pulses like haricot beans and lentils and dark green vegetables (such as kale, spinach and watercress) are quite good sources. Good sources of iron like these should be included daily in a vegetarian diet.
Should certain foods be avoided?
- Some foods tend to produce substances in the body which may aggravate arthritis. This is the case, for instance, with gout, although in this case the effects of losing weight and reducing the amount of alcohol you drink are more significant than the effect of cutting out specific foods.
- Fasting can have a temporary effect on rheumatoid arthritis. However, it is not recommended unless done under specialist supervision.
- Some people are allergic or intolerant to certain foods. This is highly individual, and varies from person to person. Finding out whether you really are sensitive to a particular food can be quite a difficult process.
Should I alter my diet if I have gout?
Gout is a particular type of arthritis caused by a high level of urate in the body (more information is given in the arc booklet 'Gout'). The urate can crystallize in the joints causing severe pain and inflammation. Urate is produced from purines, which are chemicals that result from the natural death of cells. Most purines in the body are produced by this turnover of cells. The build-up (accumulation) of urate is mostly due to the body not metabolising it efficiently enough – often an inherited tendency.
The accumulation of urate is made worse by alcohol and certain medical drugs such as diuretics (water tablets) used to treat heart disease or high blood pressure. Stopping or changing any drugs which may be causing the gout, or treatment with specific drugs designed for gout, tend to be the main approaches used. Certain foods are rich in purines, and reducing these may help if you have gout. The effect of reducing the purine intake may not be particularly great, because the main problem is usually not the amount of purine coming from diet, but the body's metabolism of it. Details of ways in which you can change your diet to help yourself if you have gout are given below.
The most effective dietary treatment for gout is losing weight if you are overweight. This can significantly reduce urate levels in your body, but it must be done gradually because extreme weight loss or starvation diets (fasting) can actually raise urate levels, because they increase cell breakdown in the body.
The second most useful dietary change if you have gout is to cut down on alcohol. Excessive alcohol consumption has been known to be associated with gout for centuries. If you have gout it is advisable to keep your alcohol intake below the safe maximum levels recommended by the government. Currently this is 3–4 units a day for men and 2–3 units a day for women. A unit is 1/2 pint (0.3 litre) of ordinary strength beer, lager or cider (3.5% alcohol by volume or abv), a single pub measure of 25 ml of spirits (40% abv) or a very small glass of wine (12% abv) – no more than 85 ml, which is much smaller than the standard wine glass used!
To reduce the risk of urate crystallizing in the joints it is important to drink plenty of water – if possible as much as 3.5 litres (6 pints) a day. You can include some other fluids in this total, particularly low-fat dairy products. According to recent scientific evidence, drinking a glass of skimmed milk every day may be helpful. But remember that beer or other alcoholic drinks are likely to make gout worse. If you are trying to lose weight bear in mind that many soft drinks contain large amounts of sugar and should be avoided.
As mentioned earlier, cutting down on foods which are high in purines may be helpful if you have gout. This is best done by eating one less portion of meat or fish per day; this could be replaced by other sources of protein, such as beans and pulses, or low-fat dairy products. Note that urate levels are not affected by so-called 'acidic food' like oranges or grapefruit, so you can eat these safely.
Next page: Fasting And Vegetarian Diets For Rheumatoid Arthritis
