Authors: Carol Svec
SPICES: GINGER AND TURMERIC
Most people don’t realize that spices are for more than, well, spicing things up. They’re an important source of essential nutrients. Like fruits and vegetables, spices come from plant sources, and they can have powerful effects on health. Certain spices seem to have anti-inflammatory effects, and therefore should be considered for arthritis treatment. Among the most promising are ginger and turmeric.
Ginger has been shown to lessen the pain of knee osteoarthritis when taken in highly purified, standardized supplement form. Ginger contains chemicals that work similarly to some anti-inflammatory medications, so its effects on arthritis pain are not surprising. However, ginger can also act as a blood thinner, so anyone taking a blood-thinning medication should limit their ginger use. Better yet, collaborate with your physician to monitor and possibly adjust your medication while adding foods and beverages seasoned with ginger.
GOUT
Imagine needle-sharp shards of glass inserted between the bones of your joints, grating and grinding with every move. That not-so-happy image is the pain of gout, one of the more common forms of arthritis. Of course it’s not actually glass in the joints. In some people with a genetic susceptibility—men more often than women—the body converts excess uric acid into crystals which can accumulate in joints.
In most cases, the extreme pain of gout starts in the big toe. I’ve known clients who have had so much swelling and agony that they can’t wear shoes. At the very least, the discomfort is enough to make walking difficult (and according to one of my clients “ruin an otherwise great vacation”). Gout can also settle into other joints of the feet, ankles, knees, fingers, wrists, and elbows.
Most cases of gout are controllable. Treatment involves medication, and avoiding anything that raises levels of uric acid. Because uric acid is a byproduct of the metabolism of purine, a substance naturally found in body tissues, you’ll never get rid of it entirely. However, if you have gout, or have been told you’re at high risk, there are several ways to keep uric acid levels as low as possible:
- Maintain a healthy weight.
Extra body tissue means extra uric acid production from normal processes of breakdown and turnover.- Avoid purine-rich meats and seafood.
The more purine-rich meats and seafood you eat, the more uric acid you’ll produce, and the greater your risk of gout. Studies have shown that eating lots of these high-purine foods increases the risk of gout by about 50 percent. I’ve seen this in my practice. Some of my clients who never before had a gout attack found themselves suffering after following a super high-protein diet because many meats can contribute to uric acid load. (High-purine vegetables don’t seem to increase risk of gout, but if you’re suffering with an attack, I recommend eating them only in moderation to be safe.) High-purine foods to avoid: Anchovies, herring, mackerel, scallops, sardines, sweetbreads, liver, kidney, red meat, poultry, wild game, lentils, dried beans and peas, asparagus, cauliflower, spinach, mushrooms.- Eat more reduced-fat dairy foods.
People who eat two or three servings daily of reduced-fat dairy foods—especially milk and yogurt—can cut their risk of gout by about half, compared with those who eat few dairy foods. Add reduced-fat or fat-free milk or yogurt to your diet.- Reduce alcohol intake—especially beer.
Alcoholic beverages interfere with the body’s ability to clear uric acid, increasing risk of gout. In 2004, Harvard researchers reported that beer was the greatest offender—men who drank two or more beers per day had more than twice the risk of gout compared with men who didn’t drink beer. Spirits also caused an increase in gout, but to a lesser degree. Wine did not seem to increase risk of gout, but I still recommend limiting your consumption.- Drink plenty of water.
I recommend that my clients with gout drink at least eight glasses of water daily to help flush uric acid out of the body.- Use aspirin sparingly.
Salicylates—the active ingredients in aspirin—can raise uric acid levels.- Get a check up.
About 75 percent of people diagnosed with gout also have the metabolic syndrome, a serious condition that increases the risk of heart disease. If you receive a diagnosis of gout, insist on testing for the metabolic syndrome. (More information about the metabolic syndrome is on Chapter 7.)
Turmeric, sometimes called curcumin, is a mustard-yellow spice from Asia. It is the main ingredient in yellow curry powder. Scientific studies have shown that turmeric may help arthritis by suppressing inflammatory body chemicals. Because of its effects on enzymes related to inflammation, turmeric may have the same mode of action as Celebrex and similar medications. Note: turmeric is also used as a dye, so use caution when handling it—it can discolor clothing and some surfaces. Dig in and enjoy my curry chicken recipe on Chapter 8!
BONUS POINTS
- See a doctor about symptoms.
Don’t be complaisant about joint pain, stiffness, swelling, or weakness, and don’t assume that joint pain is a normal part of growing older. Early treatment of OA, RA, or other arthritis can help slow the disease progression and provide a lot of pain relief.- Work to reduce cholesterol.
Although no one knows what triggers RA, an interesting European study may provide at least one clue. Researchers analyzed 10-year-old blood samples of people who later developed RA, and compared them to blood of a random sample of individuals. They discovered that people who developed RA had higher than normal levels of low-density lipoprotein (LDL) cholesterol, triglycerides, and apolipoprotein B; and lower than normal levels of high-density lipoprotein (HDL) cholesterol. The theory is that these blood results indicate the start of atherosclerosis…and atherosclerosis means more inflammation in the body. (See C-Reactive Protein on Chapter 7 for more information about how heart disease is related to inflammation.) Could it be that a higher level of inflammation could turn into inflammatory joint disease? More research is needed, but it certainly gives added reason to treat your cholesterol problem as early as possible.- Drink plenty of water.
Cartilage is 65 to 80 percent water, so staying hydrated is important for the health and lubrication of joints. It isn’t necessary to count the number of glasses of water you drink in a day—the latest research suggests that if you drink a glass of water whenever you feel thirsty, you’ll probably do fine. My biggest recommendation is that you choose water, herbal tea, or green tea instead of sugary drinks or soft drinks.- Exercise.
Many people stop exercising at the first twinge of pain in a joint, but this can be a big mistake. Exercise can help you lose or maintain weight, which reduces the overall stress impact on joints. Strong muscles can absorb shock from daily movements, keep joints stable, and protect against additional joint injury. Stretching and yoga can improve flexibility and range of motion. Exercise of all sorts can also help you sleep better, although you should not exercise vigorously late in the day if insomnia is a problem. Talk with your doctor about the best kind of exercise for you, because the best choices will depend on your particular medical situation and pain levels. Swimming and water aerobics are usually good for everyone because they allow free movement without added stress on the joints. No matter which exercise you choose, don’t overdo it when you are just starting out, and don’t do anything that threatens your balance. By all means stop if the pain worsens.- Try acupuncture.
Among people with osteoarthritis, studies suggest that traditional Chinese acupuncture can help reduce pain and improve function. People who had about one treatment per week felt better after just four weeks, and they felt better and better, week after week. It is important to choose a qualified, skilled acupuncturist who knows how to treat osteoarthritis. I prefer that my clients go to an acupuncturist who also has a traditional medical degree to be sure that they are receiving the best combination of Western medicine and Eastern acupuncture. (Ask your rheumatologist or primary care physician for a referral. You can also find certified acupuncturists at the website for the National Certification Commission for Acupuncture and Oriental Medicine at www.NCCAOM.org.) Also, watch out for those who are more concerned with business than with health care—the most reputable will treat you only when you have pain, and will not pressure you to come in for a set number of treatments.- Stop smoking.
There are so many good reasons to stop smoking, but now we can add healthy joints to the list. Smoking delivers toxins throughout the body, causing inflammation and increasing the risks of rheumatoid arthritis and osteoarthritis. In one study, smokers were more than twice as likely to develop RA than people who didn’t smoke. Smokers who also had a genetic susceptibility for RA were more than seven times more likely to develop the disease than the average person. The effects of smoking on osteoarthritis are less clear, but researchers from a multi-center study reported in 2005 that smokers had a greater risk of osteoarthritis of the knee, possibly because smoking interferes with the body’s ability to repair its own cartilage. If you quit smoking, you’ll immediately reduce your inflammation load, and you’ll improve blood flow to all parts of your body, including your aching joints.- De-stress.
Some experts believe that autoimmune disorders, including rheumatoid arthritis, can flare up in response to stress. Plus, people who feel stressed are more sensitive to pain. Stress reduction can be as important to your health as medication, so make it a priority. Carve out time in your schedule to relax and, if necessary, downsize your to-do list by asking others to help out. Chances are friends and family will offer to help when they learn of your condition—take them up on it. Check with your local hospital to see if it offers classes in stress reduction techniques, such as guided imagery, meditation, and progressive relaxation.- Control your pain.
When it comes to the pain of arthritis, don’t try to be hero. You have nothing to gain by toughing it out. If you hurt, see your doctor. If your doctor prescribes medication, take it. If you still hurt, make another appointment. People in constant pain may stop doing the things they love and before long their quality of life takes a real turn for the worse. Some arthritis patients become depressed; small wonder, if they’re in constant pain! If you don’t have the pain under control, and your current doctor seems to have exhausted the options, research pain specialists in your area through organizations such as the American Academy of Pain Management (www.AAPainManage.org).
SUPPLEMENTS
If you have arthritis and want to consider supplements
in addition to
the food fixes, I recommend:
FOR BOTH OSTEOARTHRITIS AND RHEUMATOID
ARTHRITIS
- Multivitamin.
If you would like to consider a multivitamin to supplement your healthy (I hope!) diet, I recommend brands that provide 100% DV of vitamin D (in the form of D
3
, or cholecalciferol, the most potent form of vitamin D), vitamin C, selenium, and vitamin A (with at least 50% coming from beta carotene and/or mixed carotenoids, and no more than 2,000 IU coming from retinol). Definitely
do not choose mega-dose varieties
, because some vitamins may make certain cases of arthritis worse.- Omega-3 fatty acids from fish oil.
Eat foods rich in omega-3s, but for serious arthritis relief, you’ll want to try fish oil supplements. Rheumatoid arthritis studies have tested the effectiveness of various dosages, from 1.2 grams to 3.2 grams. I recommend you start with a daily dose of 2 grams. If there’s no relief after 4 weeks, speak with your physician about increasing to 3 grams. Store the supplements in the fridge to prevent rancidity. To prevent fishy burps, buy enteric-coated varieties, take with food, and split doses throughout day. Because fish oil acts as a blood thinner, it should not be taken by people who have hemophilia, or who are already taking blood thinning medications or aspirin (always consult your physician). People with diabetes should talk with their doctors before trying fish oil supplements because they may affect blood sugar.
FOR OSTEOARTHRITIS
- Glucosamine plus chondroitin.
These nutrients are naturally found in and around cartilage cells, and are thought to strengthen and stimulate growth of cartilage. They have been rumored to be helpful for osteoarthritis pain for years, but until 2006 there was no research to back up those claims. The large-scale Glucosamine Arthritis Intervention Trial (GAIT) showed that arthritis sufferers with moderate-to-severe pain had significantly reduced pain after taking a combination of glucosamine plus chondroitin compared with those who took either supplement singly or a placebo. Arthritis sufferers with mild pain did not benefit from taking the glucosamine/chondroitin combo. The amounts generally recommended are 1,500 milligrams glucosamine and 1,200 milligrams chondroitin sulfate daily. These supplements are available anywhere you buy vitamins, and are sold individually or in pre-packaged combinations. This treatment is slow-acting—you may not feel any difference for 4 weeks. In Europe, where glucosamine and chondroitin are more commonly recommended by doctors, they are used in addition to other medical treatments and medications. So if you want to try glucosamine plus chondroitin, talk with your doctor to see how it might fit in with your current treatment.
Important note
: Glucosamine is extracted from shellfish shells (chitin), so if you have an allergy to shellfish, seek your doctor’s advice. If you develop a rash or other symptoms of allergy, discontinue taking it immediately. Plus, these supplements may thin the blood. If you are already taking blood thinners, or if you have a clotting disorder, consult your doctor.- SAMe.
Some studies have shown that SAMe (S-adenosylmethionine) may be as effective as nonsteroidal anti-inflammatory medications. One study conducted by researchers from the University of California, Irvine, compared the effects of SAMe with the anti-inflammatory medication celecoxib (Celebrex) in 56 people with osteoarthritis. After one month, people who took celecoxib had greater pain relief, but after two months, celecoxib and SAMe reduced pain to the same degree. Joint function also improved. So although SAMe took longer, it ended up working just as well as a prescription pain reliever. Recommended dose of SAMe for arthritis is 1,200 milligrams per day. Even though SAMe is generally thought to be safe, it can have side effects, including insomnia, rash, allergy, and gastrointestinal problems. To be safe, talk with your doctor before starting treatment with SAMe.