If it’s true that “you are what you eat,” then what is the link between diet and arthritis? For people seeking to live well with arthritis, this is not just an idle question. You may have heard reports about diets for arthritis that have stated by eating certain foods your arthritis will feel better. This is a seductive idea. But is it true that there’s a connection between nutrition and arthritis?

It is important to understand that available data does not indicate that a specific diet for arthritis reduces arthritis symptoms. Dr. David Fisher, MD, an orthopaedic surgeon specializing in hip and knee replacement, says that there is no significant, proven correlation between specific foods and reducing arthritis symptoms except in terms of maintaining ideal bodyweight. Dr. Fisher is a member of Orthopedics Indianapolis, an orthopaedic group practice in Indiana.

A healthy diet is important for everyone, of course. Arthritis patients, however, sometimes look beyond this notion of healthy eating and look to nutrition for a cure. The link between nutrition and arthritis is complex. There is limited evidence that diet can influence some forms of arthritis, but to fully understand this, the type of arthritis and the kind of diet must be considered.

According to the American College of Rheumatology (ACR), arthritis patients spend nearly $1 billion annually on unproven remedies. Prominent among these unproven, questionable or controversial remedies are diets for arthritis. It is easy for arthritis patients to believe that there is a link between diet and arthritis. If this were true, changing their diet would enable patients to get better control over their disease. Research does not support the importance of diet in treatments for most arthritis patients; diet and nutritional therapy for arthritis should still be considered largely investigational, according to the ACR.

The ACR says preliminary observations of patients whose arthritis was aggravated by certain foods do have some scientific validity. However, researchers believe that these patients represent a very small percentage of arthritis sufferers. Additional studies are needed to better define and identify these patients, their prevalence, the impact of foods on their disease, and the implications for other arthritis sufferers.

A number of substances, including copper, zinc, vitamin B, fish oils, plant seed oils and others have also reportedly helped arthritis patients. The evidence to support most of these claims is weak. Several studies have now examined the effects of fish and other oil ingestion on symptoms of rheumatoid arthritis. Patients had very modest decreases in certain symptoms. So far the clinical benefits of fish oil haven’t been proven, according to Richard S. Panush, MD, author of an official American College of Rheumatology position statement on the subject of diet and arthritis.

Some arthritis patients appear to have low levels of vitamins and minerals. Patients with rheumatoid arthritis many times show deficiencies in a wide variety of vitamins including vitamin C, vitamin D, vitamin E, calcium, and folic acid. Some theories suggest that by increasing your intake of antioxidants like vitamin E, it can decrease the damage to joint lining thus reducing pain. But, more studies are needed to determine the effectiveness of antioxidants. Adding calcium and vitamin D is often recommended to decrease the risk of osteoporosis.

Dr. Panush in his American College of Rheumatology statement outlines his two conclusions about nutrition and arthritis.

A. “A type of allergic immune-system reaction to foods may occur in the joints of some patients. It is believed that the number of patients affected in this manner is small. Although no specific food has been implicated as a cause of arthritis, it is known that foods can alter the function of the immune system. Asthma, rashes, and hives are examples of immune-system reactions. In regard to arthritis, caffeine, dairy products, certain vegetables, sugar, additives and preservatives, chocolate, red meats, and salt are often viewed as offenders. However, the American College of Rheumatology urges continued research in this area.”

B. “Diets of certain nutritional content may alter inflammation and modestly improve certain symptoms in some patients with rheumatoid arthritis. Studies are still needed to better define which patients may benefit, and by how much.”

There are some basic guidelines you should follow when it comes to diet and arthritis. Here are some of the key points from the book Nutrition Your Health: Dietary Guidelines for Americans (1995):

• Eat different types of foods including grain products, fruits, and vegetables.
• Eat a food low in cholesterol and saturated fat.
• Balance food consumption with exercise.
• Maintain a healthy weight.
• Choose a diet moderate in sugars.
• Drink alcohol in moderation.

According to Dr. Richard Konsens of the Jewett Orthopaedic Clinic in Orlando, FL, a well balanced diet can help arthritis patients in numerous ways. One example is with some of the most common anti-inflammatory medications. Some of the side effects of these medicines can involve diarrhea, indigestion, and ulcers. A diet low in sodium, fat, and alcohol can help patients better tolerate these medications.

As noted earlier, excess bodyweight influences arthritis by putting extra strain on already burdened joints. Clinical experience shows that people who are 20 percent or more over normal body weight have more problems with their arthritis. The extra load placed on the weightbearing joints (specifically the knees, legs, feet, and spine) can increase the pain in those joints. The increased pain, resulting sedentary lifestyle, and further weight gain can become a vicious cycle. Osteoarthritis patients commonly deal with this problem of battling weight gain. Rheumatoid arthritis patients who are on corticosteroid therapy (i.e. prednisone) are warned about increased appetite, fluid retention and weight gain as side effects of the therapy.

According to Dr. Fisher, the Indianapolis orthopaedic surgeon, “Maintaining an ideal bodyweight does your joints a favor.”

A healthy diet:

• Counterbalances nutritional side-effects of medications.
• Provides the nutrients you need for good overall health.
• Provides nourishment to strengthen muscles that support joints.
• Helps maintain ideal bodyweight to reduce joint stress.
• Produces the positive feeling that comes from knowing you are doing your best.

Nutrition cannot cure arthritis, but it can make a difference in your arthritis management program. “Nutrition in patients with arthritis should be viewed as an important part of the overall treatment plan. Just like diabetes, arthritis is a chronic condition, that can be successfully managed with the appropriate diet, medication and activity,” according to Dr. Konsens.

It is always important to work with your physician to determine the appropriate diet for arthritis for you.