What’s the best diet for arthritis sufferers? Part 2

In my last post, I sorted through some fact and fiction about  arthritis and diet – particularly foods that are frequently avoided.  All too often, though, when it comes to dietary solutions for various ills, people focus more on what they should cut out rather than what they should eat. While it’s true there are some substances  to banish, such as trans fats, and others to eat decrease significantly like added sugars, there are plenty of enlightened choices that can offer an assortment of benefits.

But first I’ll deal more with the initial question from Enlightened Eater  Facebook fan, Jennifer Burnham which included the topics of chondroitin/glucosamine, Vitamin E,  Vitamin D and omega-3s.

•    Chondroitin/glucosamine supplements

If you talk to a group of arthritis sufferers who have taken these supplements, you will get a mixed response as to their effect. Some swear by their benefits while others swear about the money they’ve wasted. It’s the same story when it comes to research findings. Some investigations show benefit while others do not.

One recent study looked at the long-term effects of glucosamine and chondroitin sulfate on the progression of structural changes in knee osteoarthritis. The six-year investigation examined the amount of cartilage lost (which is the cause of osteoarthritis as the loss of cartilage which covers bones leads to the wear and tear of joints) in subjects who were given these compounds for varying periods of time. Those who took the supplements for more than two years had significantly reduced cartilage loss compared to those who had taken the supplements for a shorter duration.

But a review of research on glucosamine and chondroitin sulfate published last month in the World Journal of Orthopedics  criticized  the quality of many of the studies on the compounds  and concluded that the evidence wasn’t convincing.

The verdict seems to still be out on this topic. But one thing to keep in mind: natural health products are not tested as to their contents so who knows if a supplement isn’t helpful, is it the combination that offers no benefit or is the particular brand of supplement chosen? Unfortunately we don’t have these answers.

•    Vitamin E

While some research has shown protective effects of vitamin E on osteoarthritis progression, going for vitamin E-rich foods rather than vitamin E supplements may be a wiser approach. Vitamin E supplements were once a nutritional star but their reputation suffered severely when studies showed they were linked to negative effects such as an increased risk of some cancers.

While we often think of vitamin E as one nutrient, it’s actually a group of different compounds (alpha, beta, gamma and delta-tocopherol and alpha, beta, gamma and delta-tocotrienol) and when you take a large amount of one kind of vitamin E, you can throw off the balance of the others.

Instead go for vitamin E-rich foods such as nuts and seeds, vegetable oils and fruits, vegetables and whole grains. These plant foods are packed with a host of antioxidants – powerful weaponry which may protect against arthritis and a long list of diseases.

•    Vitamin D, omega-3 fats and other anti-inflammatory foods

Coming up with a list of foods and nutrients that counter inflammation is indeed a challenging undertaking.  While it may seem to be straightforward, it is anything but. How potent one individual food may be in its anti-inflammatory action depends on a number of factors and up there near the top of the list is genetics. You may respond to certain well-known anti-inflammatory foods or even pro-inflammatory choices differently than the next person due to how that food affects your genes – a concept called gene expression. This area called nutrigenomics is coming into its own as scientist isolate different genes and their responses.

But researchers have been investigating global eating patterns and their impact on inflammation and disease and come up with the Dietary Inflammatory Index (DII).  After reviewing more than 6500 published research papers, they’ve categorized a long list of various whole foods and nutrients as to their both pro-inflammatory and anti-inflammatory potential. Check out the chart and go for those foods with a negative number while minimizing those with positive values.

Not surprisingly, the same plant foods which offer an array of antioxidants also supply significant anti-inflammatory action due to their various phytonutrients. Add in spices and herbs – with these anti-inflammatory ratings:  ginger (-0.588), pepper (-0.397), turmeric (-0.785), saffron
(-1.000), rosemary, oregano and thyme (-1.000) along with nutrients such as fibre (-0.663), vitamin D (-0.446), and omega-3 fats (-0.436).   Compare these figures to saturated fat (0.429) and trans fat (0.432).

Even if you’re using many of these anti-inflammatory ingredients, it’s key to look at how foods are prepared.  Advanced glycation end products (AGEs) are created when animal foods are cooked at high temperatures. AGEs are extremely inflammatory – even when seasoned with a lot of anti-inflammatory herbs and spices. (Read how to reduce your AGEs)

But don’t get hung up on the numbers or on only one food or another.   Instead look at the dietary  trend or pattern. The Mediterranean diet, the Dash diet or an eating style with plenty of whole plant foods, fish and healthy fats with only small amounts of fatty animal fare can all fit.

It’s time we stop demonizing one food while putting another on a nutritional pedestal. It’s the whole picture that counts.

Tags: , , , , , , ,

Categories: Research Roundup, Whole Foods, Your Questions Answered

Author:Rosie Schwartz

Rosie Schwartz is a Toronto-based consulting dietitian and writer.

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