Dietary advice

Diet and arthritis

Principles

There are many diets advocated as being beneficial for arthritis patients, and unfortunately, most are founded on anecdotes and misinformation. There is no population group immune from arthritis, despite variation in diet patterns. Vegetarians suffer the same degree of arthritis as meat eaters, and there is no evidence that such a diet is beneficial, despite claims to the contrary. Perhaps the only disease where there is a definite impact of diet, is gout, where there is a need to reduce, concentrated meats, red meat, and gravies, amongst others, as well as alcohol. This applies especially in the acute and subacute stages of the disease. The second general rule, is good healthy overall nutrition. This means - weight control for the obese and avoidance of malnutrition in patients with ongoing inflammation and weight loss.

There is a tendency for most nutritionists to reduce red meat in general, with reduction in cholesterol and free fatty acids. The Animal fats are theoretically responsible for greater production of prostaglandins that are responsible for mediation of inflammation. Fish and fish oils result in a greater production of anti-inflammatory mediators, and therefore it may be a general recommendation for patients to reduce red meat and increase fish in the diet.

However, my own personal recommendation is to advise patients to listen to their own bodies. Most people note no association between diet and joint symptoms. However, some patients note a definite increase in symptoms the day after eating a particular food. My advice to these people is to "listen" to their body and leave out that particular food.

Such patients do not have difficulty in noting this situation. It will occur EVERY time they eat the particular food that bothers them.

Supplements:

In the case of osteoporosis, adequate calcium is required and should be taken as a carbonate supplement, and should be taken at night.
Methotrexate and sulphasalazine should be supplemented with folic acid.
There is no definite evidence that trace elements, antioxidants, vitamins, noni juice or other nutritional supplements do anything positive for arthritis.
MSM, procydin, green lipped muscle, african potato plant, also have no basis for effectiveness on clinical trial criteria.

Dr D Gotlieb
Rheumatologist
Cape Town
drdoc on-line

 Copyright protected