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.
Synotrex
Scientifically designed arthritis pain relief medication.Promotes healthy joint function, helps alleviate pain and swelling, and repair damaged joints.
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.
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.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.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.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
Fasting And Vegetarian Diets For Rheumatoid Arthritis
Fasting for a week can improve rheumatoid arthritis, but the arthritis quickly returns when you go back to a normal diet. We do not recommend fasting as a treatment for arthritis. If you do want to fast it should be done under specialist supervision.
However, less drastic changes may help. Vegetarian diets have been shown to be helpful in the long term to some people with rheumatoid arthritis. In addition, some studies have shown that people who eat large amounts of red meat seem to have a higher risk of developing inflammatory arthritis. A vegan diet (i.e. no meat, fish, or other animal products such as eggs, milk, cheese or other dairy-based foods) may also be helpful, but it is difficult to get enough of some important nutrients on a vegan diet. A possible explanation of the success of these diets is the change in polyunsaturated fatty acids being eaten. More information about fatty acids is given later in the section Omega-3 polyunsaturated fatty acids.
What about food allergies?
The subject of food allergy or intolerance and arthritis is very controversial. There are many books which recommend all sorts of elimination diets and claim miraculous results in arthritis. Some of these unproven diets would leave your body seriously short of important vitamins and minerals if you followed them for a long time. There are also tests which it is claimed can tell you whether you are allergic to food – but most of them are unreliable. The only way to be sure that you have a food allergy is an elimination diet followed by 'challenge' (see below). Non-steroidal anti-inflammatory drugs (NSAIDs), which are commonly used for arthritis, increase the permeability of the gut, causing it to become 'leaky', allowing larger molecules of food to pass through than would normally be the case, causing food sensitivity. So if you are able to reduce your NSAIDs, you may become less food-sensitive.
How do I know if I have a food allergy?
As mentioned above, there are many tests which it is claimed can detect food allergies. ELISA and RAST are blood tests which identify proteins called immunoglobulins in the blood. These methods have a scientific basis but are not entirely accurate. They only give a guide to foods which might be worth testing in an elimination diet (this type of diet is explained later in this section).
There are many other tests for food allergy, as described in the list below: some of these are quite expensive and all are unreliable. Unreliable methods of testing for food allergy include:
- applied kinesiology (AK), where a drop of the food is put under your tongue, and the strength of your arm tested
- dowsing or psionic medicine, which uses a pendulum and can be done remotely using a 'witness', like a lock of your hair sent by post
- vega testing and similar methods, where you hold an electrode and a sample of the food is put into a machine.
We do not recommend any of these unreliable methods.
Elimination diets
The only reliable method is an elimination diet where you exclude (leave out) a certain food from your diet, for a period of 3–4 weeks, followed by a 'challenge', where you reintroduce the food to see if it causes a reaction. If you think you have an intolerance to a food, try cutting it out of your diet for a month. Then start eating it again and see if it makes a difference. If you really are sensitive you will notice a flare-up of your arthritis within a few days.
However, an elimination diet can be quite difficult to follow. The power of suggestion can be very strong. Also, some foods are used in cooking or food preparation and you may eat them without knowing it. For instance 'modified starch' used in many processed foods may or may not come from wheat; casein and caseinates are milk products, although this is not obvious. They may affect you if you are milk-sensitive. It is important to be systematic, cutting out foods completely, then reintroducing them one at time. Care is needed when excluding foods from your diet as you may be excluding vital nutrients, for example if you cut out milk from your diet you might become deficient in calcium. If you think you have food sensitivities it may well be worth consulting a dietitian who can make sure you are excluding foods correctly and that your diet is providing enough nutrients.
Are there any foods or food supplements which really do help arthritis?
Omega-3 polyunsaturated fatty acids
One of the most exciting recent discoveries is that certain foods and food supplements really can help with arthritis. The effects are fairly specific to the type of arthritis you have, so you need to know which one it is in your case.
Omega-3 polyunsaturated fatty acids, particularly as found in oily fish and the oil produced from them, can be helpful for inflammatory arthritis. (As already stated, inflammatory arthritis includes rheumatoid arthritis, reactive arthritis, psoriatic arthritis and ankylosing spondylitis; it also includes gout but oily fish should generally be avoided if you have gout because of the high purine content.) More detailed information is given below.
What are fatty acids and what types are there?
When the fats and oils we eat are broken down by the digestive system they break down into fatty acids. The nature of the fat or oil depends on the type of fatty acid (or fatty acids) it is made of.
Some fatty acids can be made by the body from other compounds. But some cannot be made and the body must get them from food. These are called essential fatty acids (EFAs). Alpha-linoleic acid (ALA) and linoleic acid (LA) are essential fatty acids.
Polyunsaturated fatty acids are divided into two main groups: omega-3, found in high levels in oily fish and some plant seed oils and nuts, and omega-6, found mostly in plant seed oils such as sunflower oil. The body uses both these types of fatty acids to make chemicals called prostaglandins and leukotrienes; the right balance of these is important to control inflammation in the body.
What should I know about omega-3 (and omega-6) polyunsaturated fatty acids?
Research has shown that omega-3 (also called 'n-3') polyunsaturated fatty acids can help some people with inflammatory arthritis. Omega-6 (also called 'n-6') polyunsaturated fatty acids are not thought to be of benefit in arthritis and in fact they can increase inflammation by competing in the metabolism with omega-3 polyunsaturated fatty acids, causing a 'metabolic traffic jam'. In the UK, most people have diets which already contain more omega-6 than is needed, so it may be helpful to cut down on the amount of omega-6 in your diet (such as sunflower oil, corn oil, and products made from these such as sunflower margarines).
Omega-3 polyunsaturated fatty acids exist in 'long-chain' forms, such as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), and in 'short-chain' forms, such as alpha-linoleic acid (ALA). The long-chain forms are found naturally in oily fish, especially kippers, pilchards, sardines, mackerel and salmon (see Tables 4 and 5). The short-chain forms are found in rapeseed, hemp oil, flaxseed oil and walnuts (see Table 7). The omega-3 polyunsaturated fatty acids which are thought to be of most benefit in inflammatory arthritis are the long-chain forms EPA and DHA. So, if you have an inflammatory type of arthritis (other than gout) it is a good idea to eat oily fish twice a week. Also, most chemists and health food shops sell fish oil capsules which contain high concentrations of EPA and DHA. It is possible that, if you take the short-chain plant seed oil omega-3 essential fatty acids, they may be converted within the body into the long-chain forms which benefit arthritis, but it is not certain that they are as beneficial as the long-chain omega-3 fatty acids found in fish oil. Omega-3s also help protect against heart disease.
For inflammatory arthritis other than gout we recommend 3 grams of fish oil (fish body oil) daily. You can achieve this by eating oily fish, taking fish oil supplements, or a combination of the two.
In relation to osteoarthritis, studies have been carried out (including work funded by arc) to try to find whether fish oils can be helpful for this condition but the results so far have not been conclusive and more research is needed on this subject.
Caution with fish liver oils
It is important not to confuse fish oil with fish liver oil (cod liver oil and halibut liver oil are common examples). Fish liver oils contain omega-3 polyunsaturated fatty acids as well as vitamin D (which helps the body to absorb calcium) and vitamin A. But it is dangerous to take fish liver oils in the large doses recommended for arthritis because of the risk of overdosing with vitamin A. This is particularly important for pregnant women, or women who might become pregnant, because vitamin A can harm the unborn baby.
Pregnant women, or women who might become pregnant, should not take fish liver oils or vitamin A supplements at all. Other adults should not take, in total, more than 3000 micrograms (µg) of vitamin A per day. This is known as the Tolerable Upper Intake Level (UL) for vitamin A, which means that if you repeatedly take more than this you risk doing yourself harm. Be careful if you eat a lot of liver because this usually contains a lot of vitamin A. If you want to take fish liver oil capsules, look on the packaging to check the amount of vitamin A they contain. To summarise, vitamin A can be dangerous especially to women who are, or might become, pregnant. If you take fish liver oil, do not exceed the dose recommended on the label. If you want to increase your intake of omega-3 polyunsaturated fatty acids, you should do so by taking pure fish oil, not fish liver oil.
Table 4. Which are oily fish and which are not? |
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Table 5. Showing the omega-3 fatty acid content of some fish and other seafood |
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Table 6. Showing the omega-3 fatty acid content of some plant seed oils and nuts* |
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Are there any possible side-effects of polyunsaturated fatty acids?
In theory, polyunsaturated fatty acids can cause a problem by generating harmful substances called free radicals in the body. Free radicals can be eliminated by antioxidants. A number of vitamins and minerals are antioxidants. As mentioned earlier, the foods which are richest in antioxidants are fresh fruit and vegetables, especially brightly coloured varieties like cherries, blueberries, apples, oranges, avocado, peppers, spinach, tomatoes, sweet potatoes, beetroot and broccoli. Vitamin E is an effective antioxidant for omega-3 fatty acids, especially those found in fish oil. If you are taking a lot of fish oil (2 grams a day or more), you should eat plenty of fresh fruit and vegetables and include those with good levels of vitamin E. Good sources of vitamin E are: sunflower seeds, nuts, especially almonds, avocado, and spinach. Some breakfast cereals are fortified with vitamin E. Suitable combined preparations of antioxidant vitamins and minerals, which contain vitamin E, selenium and other antioxidants, can be found in chemists and health food shops.
Are there any foods or food supplements which might help arthritis?
Glucosamine sulphate and chondroitin for osteoarthritis
Osteoarthritis is the commonest form of arthritis. It is often regarded as a mechanical or 'wear and tear' form of arthritis and it particularly affects the weight-bearing joints of the legs and back, becoming more common with age (see arc booklet 'Osteoarthritis'). The main problem in osteoarthritis is changes to the cartilage, the smooth tough, elastic 'gristle' which covers the ends of the bones making up the joint. These changes affect the ability of the bones to glide over each other and absorbs shocks.
Many people try glucosamine sulphate and chondroitin tablets that they buy themselves from health food shops and chemists. These products currently are not licensed for use as drugs for osteoarthritis in the UK because there is insufficient research to date to show that they work. The reason behind their use is that joint cartilage normally contains glucosamine and chondroitin compounds and taking supplements of these natural ingredients may help improve the health of damaged osteoarthritic cartilage.
The research findings are conflicting; some recent studies have not shown a beneficial effect. Many people, however, report them to be effective and they appear to be safe, although they should not be taken by people who have an allergy to shellfish. If you want to try them it would be perfectly reasonable to try 1500 mg of glucosamine and 1200 mg of chondroitin (per day) for 3 months and if your joint pain is much improved you may wish to continue with them.
Vitamins and minerals for arthritis in general
Deficiency in some vitamins and minerals seems to be associated with arthritis progressing more quickly. As mentioned earlier, slight vitamin D deficiency is not uncommon, especially in winter. It can be obtained from
the diet (especially from oily fish) or vitamin supplements, such as fish liver oil, but as emphasised previously, it is important not to take too much fish liver oil. Poor vitamin C intake has been linked with arthritis but if you follow the '5 fruit and vegetables per day' advice, you should not have a problem with vitamin C, and we do not recommend supplements.
Mild selenium deficiency is quite common in the UK and may be associated with more rapid progression of arthritis. The richest natural source of selenium is Brazil nuts, but meat and fish also contain some. Selenium is nearly always included in antioxidant vitamin and mineral supplements which you can buy in chemists and health food shops.
Are there any diets or food supplements which are supposed to help but do not?
Some people feel that cutting out 'acidic fruit' such as oranges, lemons and grapefruit helps arthritis. Others believe that vegetables from the so-called nightshade family (solanaceous plants) are bad for arthritis: this is a large plant family which includes several important foods – potatoes, tomatoes, peppers (sweet and hot) and aubergines. There is no scientific evidence that leaving out either of these groups of fruits and vegetables helps arthritis, and such diets may have the undesired effect of reducing the beneficial antioxidants in the diet. Cider vinegar and honey is also sometimes recommended for arthritis. Again there is no scientific evidence that it is helpful.
MSM (methylsulphonylmethane) is a sulphur-containing substance which has been recommended for various health problems, including arthritis. There are no clinical trials in humans which demonstrate that it is effective.
CMO (cetylmyristoleate) is a waxy substance made from beef fat, which it is claimed can help arthritis. Again, there is very little scientific evidence that it does so.
Can diet help if I am taking drugs?
Yes. A good diet still helps even if you are taking strong drugs for your arthritis or rheumatism. In fact, if you are, there is even more reason to eat a good diet as it can help to protect the body against some of the side-effects of drugs. For example steroids, such as prednisolone, can cause osteoporosis, particularly if you stay on them for a long time. Plenty of calcium in your diet will help to reduce the risk.
In addition, some of the changes we recommend in this booklet can help to reduce the amount of drugs you need – losing weight, taking a healthy diet, perhaps excluding some foods, and increasing your omega-3 polyunsaturated fatty acid intake, either though foods or supplements or both.
What are the main points to remember about my diet?
arc and other organizations are continuing to support research into the links between what you eat and your arthritis. From the research evidence so far, we recommend that you should:
- try to lose weight, if you are overweight, by changing your eating habits and increasing exercise if possible – not by crash diets
- eat less sugar and fat, especially saturated fat, and try to use olive oil in your diet
- eat more fruit and vegetables, especially brightly coloured varieties
- take plenty of calcium- and iron-rich foods
- try replacing meat with oily fish twice per week (unless you have gout)
- If you have inflammatory arthritis which is not gout consider further increasing your intake of oily fish and/or fish oil supplements produced from oily fish as described in the text.
If you think you are allergic or intolerant to a food, exclude it from your diet for one month, then reintroduce it, to see if it makes a difference. If this food is a major part of your diet, or if you think you might be sensitive to several foods, it is advisable to seek professional help from a dietitian before starting an elimination diet.
Glossary
Anaemia – a shortage of haemoglobin (oxygen-carrying pigment) in the blood resulting in a decrease in the ability of the blood to carry oxygen.
Antioxidants – substances which can neutralize free radicals (more accurately oxygen free radicals). The body produces its own antioxidants but it is thought that antioxidants in the diet (such as vitamin C) help destroy excess free radicals which may cause tissue damage or disease.
ELISA – enzyme-linked immunosorbent assay.
Free radicals – atoms or molecules which have one or more unpaired electrons. This means that they react very readily with other molecules and can damage cells or tissues. Free radicals are produced naturally in the body as a result of the metabolism, but disease, environmental pollutants, radiation, and stress can create extra free radicals leading to an imbalance. Free radicals are neutralized by antioxidants.
Immunoglobulins – a class of blood proteins which are responsible for immunity to specific infections.
Leukotrienes – have a role in allergic or inflammatory reactions.
Minerals – substances such as calcium, iron, silicon and fluoride. Other minerals are the trace elements such as zinc, selenium, manganese, molybdenum, chromium, cobalt, iodine, vanadium and nickel.
NSAIDs – non-steroidal anti-inflammatory drugs. A large family of drugs, prescribed for different kinds of arthritis which reduce inflammation and control pain, swelling and stiffness.
Prostaglandins – chemicals derived from fatty acids, some of which control inflammation.
Purines – nitrogen-containing compounds, found mostly in nucleic acids – DNA and RNA. The body breaks purines down to uric acid.
RAST – Radioallergosorbent test
RDA – recommended dietary allowance
Further reading
'Food Allergies and Food Intolerance: The Complete Guide to their Indentification and Treatment' by Professor Jonathan Brostoff and Linda Gamlin, published by Inner Traditions Bear & Company, Vermont USA, 2000. ISBN 0892818751, price around £12, 480 pages.
'Nutrition and Arthritis' by Dr Margaret Rayman and Alison Callaghan, published by Blackwell Publishing, 2006. ISBN 1405124180, price £39.99, 280 pages.
Please note: this is a textbook intended primarily for dietitians and medical professionals and, as you will see, this is reflected in the price. If you wish to consult this book, you may be able to find a reference copy in your local library.
These books are available from libraries, bookshops and via the internet. (They are not available from arc.)
Reference
Used as a source of information for Tables 5 and 6:
'McCance and Widdowson's The Composition of Foods, Sixth summary edition.' Published by The Royal Society of Chemistry, Cambridge and The Food Standards Agency, London, 2002. ISBN 0854044280.
'Fatty Acids: Seventh Supplement to the Fifth Edition of McCance and Widdowson's The Composition of Foods.' Published by the Royal Society of Chemistry, Cambridge and the Ministry of Agriculture, Fisheries and Food, London, 1998. ISBN 0854048197.
Useful addresses
The Arthritis Research Campaign
PO Box 177
Chesterfield
Derbyshire S41 7TQ
www.arc.org.uk
As well as funding research, we produce a range of free information booklets and leaflets. Please contact the address above for a list of titles.
Arthritis Care
18 Stephenson Way
London NW1 2HD
Phone: 020 7380 6500
Helpline (freephone): 0808 800 4050
www.arthritiscare.org.uk
Offers self-help support, a helpline service, and a range of leaflets on arthritis.
The British Dietetic Association
5th Floor, Charles House
148/9 Great Charles Street
Queensway, Birmingham B3 3HT
www.bda.uk.com
The professional association for dietitians. The BDA’s website has a number of useful links to other diet-related sites.
Food Standards Agency
PO Box 369
Hayes, Middlesex UB3 1UT
Phone: 0845 606 0667
www.foodstandards.gov.uk
www.eatwell.gov.uk
Offers a wide range of information on its websites and publishes a number of free booklets and leaflets, such as 'Healthy Eating Fats', 'Healthy Eating Sugars' and the 'Eat Well Guide'.
NHS Direct Online
www.nhsdirect.nhs.uk
The website has useful information on healthy eating under the section 'Common Health Questions'.
nras (National Rheumatoid Arthritis Society)
Unit B4 Westacott Business Centre
Westacott Way, Littlewick Green
Maidenhead SL6 3RT
Phone: 01628 823524
Helpline: 0845 458 3969
www.rheumatoid.org.uk
A national charity which focuses specifically on rheumatoid arthritis.
The Vegetarian Society
Parkdale, Dunham Road
Altrincham, Cheshire WA14 4QG
Phone: 0161 925 2000
www.vegsoc.org
Information on drugs
Separate arc leaflets are available on many of the drugs used for arthritis and related conditions. We would recommend that you read the relevant leaflets for more detailed information about your medication.
back to page 1: Diet and Arthritis
About the Author
© Arthritis Research Campaign 2006. All rights reserved. A team of people contributed to this publication. The original text was written by an expert in the subject. It was assessed at draft stage by doctors, allied health professionals, an education specialist and people with arthritis. A non-medical editor rewrote the text to make it easy to understand and an arc medical editor is responsible for the content overall.This publication has been made possible because of voluntary donations given to the Arthritis Research Campaign. Printed copies can be ordered on this web site or by writing to arc Trading Ltd, James Nicolson Link, Clifton Moor, York YO30 4XX, United Kingdom.
