It may be inevitable that as we age, our joints start to wear out and become stiffer; enduring pain with arthritis should not also be considered inevitable. Current medical treatments for arthritis include the use of non-steroidal anti-inflammatory drugs and joint resurfacing / replacement surgery, which are certainly effective at treating the pain. The latter is often the option of last resort in severe cases and of course it does not address the causes. There is no ‘miracle cure’ for arthritis, but with the knowledge of which foods can support joint health, there is certainly potential to improve your symptoms, reduce pain and prevent further joint damage.
There are many different types of arthritis, of which osteoarthritis and rheumatoid arthritis are the most common. Arthritis involves inflammation in the joints and a breakdown of cartilage which is the protective tissue covering the bones. To help reduce the painful symptoms of arthritis we need to focus on nutrition for reducing inflammation in the body to healthy levels, protecting the cartilage, and providing adequate nutrients to the bones and surrounding ligaments.
Dietary tips for reducing inflammation in your joints
Inflammation is a normal biological process in the body, however with chronic inflammation in arthritis, this causes continuous damage to tissues.
The balance of fatty acids omega-3 eicosapentaenoic acid (EPA) and omega-6 arachidonic acid (AA) plays an important role in the production of anti-inflammatory or pro-inflammatory signalling molecules in the body, so maintaining a healthy ratio of these fatty acids is the first and most important step to take when regulating inflammation through dietary changes. A high ratio of AA:EPA is associated with a range of chronic inflammatory conditions, including arthritis (1,2).
EPA is found in high quantities in oily fish such as salmon, mackerel and herring, whilst AA is found in animal fat and is especially high in grain-fed animals. Other omega-6 fats, which can be converted to AA in the body, are sourced from vegetable oils such as sunflower and corn oil. To obtain a healthy ratio of AA:EPA, try to include oily fish 1-2 times a week, and choose lean cuts of meat, ideally grass fed. Also try to limit intake of omega-6 vegetable oils, which are found in many processed foods such as crisps and biscuits. To preserve the essential fatty acid EPA in fish when cooking, baking is preferable to frying, and fresh wild fish contain ideal fatty acid ratios.
A high strength EPA supplement providing 1000mg per day could also be considered for further reducing inflammation and severity of arthritis symptoms, which may be difficult to achieve from fish consumption alone.
Body mass index (BMI)
A high body weight can induce both inflammatory stressors and direct mechanical strain on joints. Pain as a result of high BMI can therefore manifest in both load-bearing joints, such as hips and knees, and non –load-bearing joints, such as fingers. Maintaining a healthy weight may therefore reduce long-term stress on joints (3).
It may be tempting to avoid exercise altogether when your joints are painful, however gentle physical activity such as swimming, cycling and lightweight training can actually be beneficial when performed at a level that does not over-stress the joints. Exercise not only aids in weight loss, but it also helps improve joint mobility by strengthening surrounding muscles, and can improve pain and physical function in mild / moderate arthritis (4). Keep your joints mobile with an active lifestyle and find an exercise regime suited to your form and severity of arthritis.
With the oxidative stress and inflammation associated with arthritis, a diet rich in antioxidants, including a variation of brightly coloured fruit and vegetables, may be of benefit. It has been suggested that a diet rich in antioxidants may reduce the inflammatory response in early inflammatory joint disease (5). Foods containing high levels of selenium, vitamin C and vitamin E (such as spinach, peppers, nuts, seeds, avocados and fish) are especially important to include.
How to protect your joint cartilage
Glucosamine plays a key role in building cartilage, tendons and synovial fluid in your joints. Supplementing with glucosamine may therefore particularly help to provide joints with the building blocks for maintaining healthy cartilage, which may otherwise be damaged in arthritic joints (6). Your body’s natural production of glucosamine is reduced with increasing age, therefore supplementation may be more relevant later on in life.
Important nutrients to include in your diet for healthy joints
There are several vitamins and minerals that are essential for joint health, including vitamin D, calcium, magnesium and zinc.
Vitamin D is required for joint and bone health, and deficiencies are very common in the UK as the main source is from skin exposure to the sun – difficult to obtain in the winter months. Small amounts of vitamin D are also found in oily fish, sun-dried shiitake mushrooms, dairy products, eggs and fortified products. If dietary levels and sun exposure cannot be met, a dietary supplement should also be considered. Vitamin D may also help to reduce risk of osteoporosis, (7) which is a high risk in individuals with arthritis.
Calcium and magnesium
Calcium is possibly the most discussed mineral for bone health, as it is required for bone structure; however, supplementing with calcium on its own has not been shown to improve bone density (8). Supplementary calcium on its own may not be sufficient, though when combined with magnesium, these two minerals work in synergy. Magnesium is required for the structural development of bone as it plays an active role in the transport of calcium across cell membranes; vitamin D also aids in calcium absorption.
It may be seen that calcium, magnesium and vitamin D are all, therefore, very important, working together for general bone health, especially for individuals at increased risk of osteoporosis. Rich food sources of calcium include dark green leafy vegetables, dairy, almonds and fish. Magnesium-rich foods include dark green leafy vegetables, nuts, seeds, beans and lentils.
Zinc supports tissue growth and repair, therefore is very important for joint integrity. Zinc is also beneficial for normal function of the immune system. Ensure that you include foods rich in zinc, such as seafood, meat, wheat germ, nuts and seeds.
Proper hydration is vital for arthritis as the flexible cartilage in your joints is naturally plumped up with water, helping it to act as a shock absorber. Consuming enough water is also needed for proper transport of nutrients in cells, which can significantly affect nutrients delivered to your joints.
1. Patterson E, Wall R, Fitzgerald GF, Ross RP, Stanton C. Health implications of high dietary omega-6 polyunsaturated fatty acids. J Nutr Metab, 2012, 539426.
2. Jordi de Batlle, Jaume Sauleda, Eva Balcells, Federico P. Gómez, Michelle Méndez, Esther Rodriguez, Esther Barreiro, Jaume J. Ferrer, Isabelle Romieu, Joaquim Gea, Josep M. Antó, Judith Garcia-Aymerich. Association between Ω3 and Ω6 fatty acid intakes and serum inflammatory markers in COPD. 2012, The journal of Nutritional Biochemistry, 2012, 23 (7): 817-821.
4. Golightly YM et al. A comprehensive review of the effectiveness of different exercise programs for patients with osteoarthritis. Phys Sportsmed, 2012, 40 (4): 52-65.
5. Pattison DJ, Lunt M, Welch A et al. Diet and disability in early inflammatory polyarthritis. Rheumatology, 2007, 46(S): i122.
7. Bischoff-Ferrari HA, Zhang Y, Kiel DP and Felson DT (2005) Positive association between serum 25-hydroxyvitamin D level and bone density in osteoarthritis. Arthritis and Rheumatism, 53: 821–826.