Arthritis and diet

Arthritis is a general term for more than 150 different conditions. A more accurate name for this group is musculoskeletal conditions, because they affect the muscles, bones and joints. There is no special diet or “miracle food” that can cure arthritis, but everyone can benefit from eating a healthy, well-balanced diet to support general good health.

Some conditions may improve with changes to your diet. For example:

• People with inflammatory conditions such as rheumatoid arthritis may benefit from eating more omega-3 fats, found in oily fish such as sardines and salmon.
• People with gout (a type of arthritis) may benefit from avoiding foods high in purines, such as offal, shellfish and beer, and from drinking plenty of water.

Eat a wide range of healthy foods#

Your body works best when you eat a varied diet. Most people feel better when their meals are balanced and varied enough to provide all the vitamins, minerals, antioxidants and other nutrients the body needs.

A Mediterranean-style diet is a good model. It includes fish, pulses, nuts, olive oil and plenty of fruit and vegetables. Eating well and drinking enough fluid can also give you better energy levels, help you maintain a healthy weight and improve your overall sense of wellbeing, which may ease your symptoms.

Always talk to your doctor or dietitian before making big changes to your diet. Without advice, you may restrict your food unnecessarily or take too much of certain products, such as mineral supplements, that have no effect on your condition.

Some supplements may also interact with your medication#

Ask your doctor before taking any supplement to make sure the type and dose are right for you.

Weight and arthritis#

If you are overweight, the extra load on your joints may make symptoms worse, especially in weight-bearing joints such as the hips, knees, feet or spine. There is also a clear link between carrying excess weight and a higher risk of developing osteoarthritis.

Losing excess weight usually requires being active, which can be challenging when pain or stiffness is present. Your doctor, dietitian or other health professional can give you information and advice on managing this safely.

Omega-3 fats and inflammation#

Foods that contain omega-3 fats can help reduce the inflammation linked with some forms of arthritis, such as rheumatoid arthritis. These effects are modest compared with medication, but they have no side effects and may bring other benefits, such as a lower risk of heart disease.

Sources of omega-3 fats include:

• Oily fish such as salmon and sardines
• Linseeds (flaxseed) and linseed oil
• Canola (rapeseed) oil
• Walnuts
• Foods fortified with omega-3, such as some margarines and eggs

Some fish oil supplements are also available. Do not confuse fish oils with fish liver oils, such as cod liver oil or halibut liver oil. Fish liver oils also contain vitamin A, and large amounts of vitamin A can cause serious side effects. Ask your doctor before taking any supplement so that you take the correct dose.

Gout and diet#

Gout occurs when uric acid, a normal waste product, builds up in the bloodstream and forms crystals in a joint, such as the big toe, causing inflammation and pain. Lowering uric acid levels through small dietary changes may help reduce the chance of future attacks.

Helpful changes include:

• Restricting or avoiding alcohol, and avoiding binge drinking
• Restricting or avoiding offal meats, such as liver, kidneys and brains
• Restricting or avoiding shellfish, such as prawns and scallops
• Restricting or avoiding some seafood, including sardines, herrings, mackerel and anchovies
• Restricting or avoiding products that contain yeast
• Drinking plenty of water
• Eating plenty of fresh fruit and vegetables
• Avoiding fasting or crash dieting, and not overeating on a regular basis

Your doctor or dietitian can help you make these changes safely. Be aware that diet alone is not enough to address the underlying cause of gout, which is too much uric acid in the blood. You also need to keep taking any medication your doctor has prescribed.

Glucosamine and chondroitin#

For many years, glucosamine and chondroitin were among the most commonly used supplements for osteoarthritis. Past evidence was conflicting, and current research concludes that they are not effective for treating osteoarthritis of the hip or knee.

Glucosamine and chondroitin may also interact with other medication, including warfarin, and should only be taken after talking with your doctor.

Other foods and arthritis#

People with gout may find that avoiding certain foods, alongside their gout medication, helps prevent an attack. However, there is no strong scientific evidence that other forms of arthritis can be improved by avoiding particular foods.

There is no conclusive evidence that foods such as acidic foods (lemons, oranges and tomatoes), “nightshade” foods (tomatoes, potatoes, peppers and eggplants) or dairy trigger or worsen arthritis symptoms. These foods all contain important nutrients, and avoiding them may cause other health problems.

Some people who are intolerant to certain foods feel better overall when they leave those foods out, but it is unclear how this affects arthritis symptoms. If you are thinking of cutting out foods, speak with a dietitian first so you do not lose important nutrients.

Tips for managing your diet if you have arthritis#

• Eat a well-balanced diet to get all the vitamins, minerals, antioxidants and other nutrients you need, including a variety of fruit, vegetables, protein foods, dairy, nuts, pulses and cereals.
• Include plenty of omega-3 fats, such as oily fish, linseeds, canola oil, walnuts or omega-3 fortified foods.
• Include enough dietary calcium to reduce the risk of osteoporosis in later life.
• Drink plenty of water.
• Keep your weight within your target range, as excess weight increases stress on joints, especially weight-bearing joints such as the knees and hips.
• Keep a food diary. If you think a food aggravates your condition, record your food and symptoms. After about a month you may have an idea of which food could be involved, and you can discuss this with your doctor or dietitian.
• Do not cut out whole food groups, such as all dairy products, without talking to your doctor, as you may miss important vitamins and minerals.
• Remember that arthritis symptoms, especially the inflammatory types, can change for no clear reason. Do not assume any improvement is due to diet, and be guided by your health professional.
• Seek advice. There is a lot of conflicting information online and in the media, so talk with your doctor or a dietitian if you need guidance.

Key points#

• There is also a clear link between being overweight and an increased risk of developing osteoarthritis.
• Large amounts of vitamin A can cause serious side effects.
• Glucosamine and chondroitin have been among the most commonly used supplements for osteoarthritis.
• People with gout may find that avoiding certain foods, in combination with gout medication, may prevent a gout attack.
• These foods all contain important nutrients and avoiding them may cause other health problems.

Where to get help#