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Rheumatoid Arthritis

RA is a connective tissue disease which develops an autoimmune inflammatory response affecting predominantly joints, triggered by environmental factors including lifestyle and diet, and is genetically predisposed.

It is one of a number of autoimmune diseases which can have a wide range of effects on organs and health, furthermore, it can strike at any age, typically beginning in young and middle age. Symptoms of painfully swollen and stiff joints in the hands and feet as well as damage to cartilage and other organ tissues can occur. Scientists aren’t sure what causes RA other than the body’s immune system attacks its own tissue and the numbers of those diagnosed with having autoimmune diseases is increasing and common place in the western world but non-existent in traditional lifestyles.

The immune system has two different lines of defense. The first line is to attack invaders like viruses and bacteria that it regards as an enemy regardless of whether it has seen it before. The second line is to to build up a defense by making antibodies to specific invaders that has seen before. Optimum balance determines immune status. This defense promotes tolerance and gives protection by keeping what are called T cells from being overactive which is often the case with autoimmune diseases.

There are four dietary approaches that can help regulatory T cells.

The gut is the first barrier designed to keep invaders and unnecessary things such as bacteria and toxins out and help transport beneficial nutrients in. When the gut lining is not in good condition, it allows substances to pass into the system such as food proteins, and bacterial toxins to cause an antibody response and inflammation. Gut health is very important for overall health and wellbeing as well as comfort and convenience. As with most of the bodies tissue, foods rich in collagen, vitamin C, zinc for healing, glucosamine and chondroitin with hyaluronic acid for making new cells, and glutamine and used to heal the gut lining. Probiotics help fight off bacteria that migrates into the human gut and digestive enzymes support better digestion to help breakdown food molecules that you may be sensitive or less able to tolerate. Bone broth, good fats such as coconut oil and butter, foods naturally enzymatic such as apple, pineapple, kiwi and papaya are high in food enzymes and fresh lemon or apple cider vinegar can help with the chemical breakdown of foods in the stomach. Aloe vera is a mucilage which puts a slimy lining on the gut lining and acts as a barrier to reduce sensitivity between the lining and foods as well as helping with better digestion.

Vegetarian, vegan, and gluten-free diets have shown many benefits to those with health problems, similarly they have been linked to symptomatic relief in RA patients (Muller 2001; Hafstrom 2001) (Zhernakova 2011). Based on the connection between foods renowned for causing an immune response or food intolerance, removing this inflammatory response may well help to relieve the inflammatory symptoms of RA. An IgG blood test could help RA patients to pinpoint potentially problematic foods and help identify a diet that best suits their immunological profile.

Flavonoids – Flavonoids such as lycopene (tomatoes), resveratrol, curcumin, and quercetin found in dietary supplements are well known for their anti-inflammatory activity have been found to have therapeutic effects in RA and osteoarthritis clinical trials.  They are found in colored fruits and vegetables while dietary supplements contain concentrated and purified flavonoids to either maintain joint health or to help to nutritionally manage the metabolic processes of osteoarthritis.

Sulforaphane-in cruciferous vegetables such as kale and broccoli have also shown promise in trials acting to block the enzyme that damages cartilage.

Vegan omega-3 essential fatty acids have long been associated with improving joint health and reducing inflammatory swelling. Combined with hyaluronic acid and astaxanthin both of which target pro-inflammatory agents in the body—arthritis patients reported a 55% pain reduction in under three months; 63% of participants were entirely pain-free post-treatment (Martinez-Calat – 2010).

Vitamins – Other important vitamins and supplements that influence cartilage and the immune response are Vitamins A, B3, B6, B12, C, D3 magnesium and enzymes.

Whether anecdotal or that the overall diet improves when high levels of refined wheat products are removed from the daily diet, gluten sensitivity/ Celiac disease is often claimed to contribute to inflammatory symptoms. Testing for celiac disease involves blood tests for IgG and IgA anti-gliadin antibodies and while you may test negative, you can still have a very real gluten sensitivity that worsens arthritic pain or causes symptoms similar to arthritis.

Research identifies a number of dietary and lifestyle recommendations:

Identify what makes flare ups worse such as food sensitivities and intolerances

Support the first line of defense which is gut health and the gut lining

Eat a varied diet high in vegetables, fruit, high quality protein, good fats such as butter, coconut oil, fish oil, olive oil and avoid processed seed oils

Increase intake of omega-3 fatty acids

Take collagen or bone broth regularly

Eat plenty of cruciferous vegetables such as broccoli, cabbage, kale, cauliflower, Brussel sprouts

Get some sun to boost vitamin D or take a regular supplement

Get plenty of antioxidants from berries, carrots, nuts and seeds,

Trial taking all wheat out of your diet for 3 months to gauge if inflammation is reduced

Trial a balanced gluten free vegan or vegetarian diet to see if this works for you

Get regular exercise

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Once considered a bit of a ‘wear and tear’ inflammatory disease of the joints as you age, evidence suggests otherwise. Multiple underlying causes and contributing factors include age, female gender and high BMI. Joints and particularly knees are affected where the protective cartilage cushion wears down leaving bones exposed to rub together. Medications are often the first form of treatment rather than looking at the root cause.

Research has focused on the high incidence of obesity and poor dietary choices as well as lack of exercise in OA patients. Obesity  increases the load and stress on many joints and data reveals that fat tissue is a major source of catabolic and pro-inflammatory mediators (i.e., cytokines, chemokines, and adipokines), which are implicated in the process of OA (Rai 2011). In addition, obese patients tend to experience insulin resistance and increased glucose load, which may also contribute to the chronic inflammation and cartilage deterioration of OA (Sowers 2010).

A greater understanding of the biochemical nature of cartilage and bone and its formation and breakdown has highlighted the role of nutrition and lifestyle, and the significance of a healthy diet to impact metabolic balance, aging and wellbeing. The big question as to what exactly does a “healthy diet” look like if we are to slow down the onset of age-related diseases is the key.

Much of the tissue injury and symptoms of pain and stiffness is due to chemicals produced naturally in our bodies and generated by metabolism of the omega-6 fatty acids from dietary intake of processed foods and seed oils (soy, sunflower, safflower, canola, corn, peanut oils). Tissue injury in the joint may also be due to the lack of intake of anti-inflammatory omega-3 oils (fish, algae, borage, flaxseed, walnuts) and micronutrients such as flavonoids which act naturally to manage inflammation and help to protect against oxidative and other damaging effects to cartilage in joints.

Studies indicate that supplementing daily with glucosamine sulphate may offer effective, long-term treatment for osteoarthritis by slowing the progression of disease, delaying degeneration of the joint and reducing pain. It is not quite so clear if it is of benefit in RA although it may provide some pain relief.

These sugar amine molecules have been specifically studied for their potential to treat symptoms and disease progression associated with osteoporosis, osteoarthritis and rheumatoid arthritis (RA).

Hyaluronic acid is a potential bright spot for helping lower the side effects of osteoarthritis. Its effectiveness is due to the many methods of actions it deploys, including lubrication, anti-inflammatory and chondroprotective effects. Treatment can be done both orally and through intra-articular injections. New products are continuously being developed that change the composition of the molecule as well as pairing it with other drugs to maximize the effect. Hyaluronic acid treatment shows a lot of potential that will hopefully be discovered through continued research.

Methylsulfonylmethane (MSM) has become a popular dietary supplement used for a variety of purposes, including its most common use as an anti-inflammatory agent. It has been well-investigated in human clinical trials and experiments with evidence of a variety of health-specific outcome measures are improved with MSM supplementation, including inflammation, joint/muscle pain, oxidative stress, and antioxidant capacity. This micronutrient is well tolerated for arthritis and a number of other conditions related to inflammation, physical function, and performance.

Another dietary consideration is the lack of dietary micro-nutrients in modern diets which have shown to help the body naturally manage inflammation and oxidation. Flavonoids and polyphenols are found in berries, grapes, nuts and seeds, non-starchy vegetables, spices such as curcumin and soy.

Research identifies a number of dietary recommendations:

  • lose weight, if overweight, preferably combined with exercise
  • increase intake of flavonoids to reduce oxidative damage
  • Supplement with glucosamine and chondroitin along with curcumin and essential fatty aid omega 3’s (EFA)
  • In addition, choose a supplement with additional hyaluronic acid and MSM for a more targeted treatment
  • reduce plasma cholesterol by dietary means
  • increase intake of long-chain n-3 fatty acids preferably by eating oily fish, flaxseed oil and walnuts or taking a vegan EFA supplement
  • aim for a safe level of sun exposure, eat rich vitamin-D dietary sources or take vitamin D supplements, 800IU/d or 10,000IU/wk
  • increase vitamin K intake by eating green leafy vegetables

If you feel it’s time to make dietary changes but don’t know where to begin, do not hesitate to contact us at