Arthritis: What You Need To Know

As we get older, one of the things that can start to happen is that we experience aches and pains. If your aches and pains are a regular feature of your life, it’s definitely worth asking your doctor or physio for advice. Sometimes that regular twinge you are getting is something more serious, but don’t let the possibility of ‘something more serious’ prevent you from getting it checked out. If it’s nothing but creaking joints, that’s great. If it’s something else, well we can work on that too.

You may have guessed that the ‘something else’ I am thinking about is arthritis. I want to share some of my top tips for using food to help alleviate some of the symptoms of arthritis.

Types of Arthritis

There are 2 types of arthritis: osteoarthritis and rheumatoid arthritis.

Osteoarthritis occurs when cartilage between bones and joints wears down, allowing bones to rub together rather than giving them the protection and cushion they need. Cartilage is made up of collagen and other substances that make connective tissue both flexible and strong. Cartilage covers the ends of bones where they meet the joints — and deterioration over time can affect the shape and functionality of the joints, making it painful and difficult to carry out everyday tasks.

Under the age of 45, it’s more common in men, and over the age of 45, it’s more common in women. By the time they get to 50, 80% of people will have symptoms associated with this type of arthritis, which starts as a stiffness in the hips, back, knees or other joints. The joints then become increasingly swollen and inflexible.

Rheumatoid Arthritis is a chronic autoimmune disease that affects someone’s joints and causes ongoing pain, swelling, stiffness and limitations in terms of movements. For most people, their rheumatoid arthritis symptoms tend to flare up at times and become worse when inflammation levels rise, but then become better for a while, only to return once again. It can be triggered by genetics, or a bacterial or viral component, and also environmental or lifestyle factors. About 80% of sufferers are women. The body – for whatever the reason – develops antibodies against its own tissue, and it attacks the cartilage and connective tissue. Over time, joints become inflamed and enlarged.

There are a number of factors that are important in managing arthritis:

  • How good your digestion and detoxification are
  • Blood sugar balance
  • Inflammation
  • Levels of essential fats
  • Allergies

Underlying Causes

The key to improving the symptoms of arthritis is to work on the underlying causes rather than just treating the symptoms.

Digestion

The scene for inflammation – even if that inflammation is elsewhere in the body, e.g. the joints – is often set in the digestive tract. If the gut environment is disturbed (a disruption in the normal balance of bacteria), this can lead to bacterial infection, parasites, intestinal permeability (aka ‘leaky gut’), allergies and intolerances.

What then happens partially digested food proteins get into the bloodstream, along with other toxins and microbes, putting greater pressure on the body’s detoxification processes. Once the liver starts to become over-taxed, any dietary or environmental toxins may cause further inflammation.

A programme that works on creating a good gut environment is ideal. Probiotics and prebiotics can be very helpful.

Blood Sugar Balance

There is a big link between inflammation and how well your body responds to insulin, the hormone produced in the pancreas to help control blood sugar levels. If your body has a reduced sensitivity to insulin, for example due to long-term poor dietary/lifestyle habits or you are diabetic, this can lead to high levels of sugar and/or insulin in the blood. Too much of either is toxic and can trigger inflammatory reactions.

Learning to balance your blood sugar levels plays a key role in managing the symptoms of arthritis. This is achieved through eating adequate amounts of protein at every meal and snack, increasing the amount of non-starchy vegetables, and considering the quality and the quantity of the starchy carbohydrates you eat.

All of my work with clients looks at balancing blood sugar, which focusses on eating real foods (not weird things you can only buy at health food shops), keeps you feeling full, and helps you manage your cravings.

Inflammation

In pretty much every circumstance, joint problems are linked to inflammation and sometimes also to problems with the immune system (autoimmunity).

The body produces chemical agents in the body to either switch on or reduce inflammation.

Prostaglandins are one of the main chemicals in this process, and these are the easiest to manipulate with diet. There are 3 different types. Types 1 and 3 are anti-inflammatory and type 2 is pro-inflammatory (causes inflammation and promotes pain).

Omega-6 fats can convert into either type 1 or type 2 prostaglandins. Eating a diet high in omega-6 polyunsaturated animal fats (found in processed food, ready-made meals, meat and dairy produce – particularly non-organic) has the body producing more of these less desirable type 2 prostaglandins. Reducing animal proteins and dairy products can bring symptomatic relief.

Omega-3 fats on the other hand, can only go down the route towards the anti-inflammatory type 3 prostaglandin. Omega-3 polyunsaturated fats are found in foods like walnuts, flaxseeds, hemp, chia seeds, and oily fish. Monounsaturated fats, e.g. avocados and olive oil, are also anti-inflammatory but work differently and are not involved in these specific pathways.

High levels of sugar and insulin can also direct the conversion of omega-6 fats down the type 2 pro-inflammatory pathway.

There’s another group of chemicals called ‘free radicals’. These are highly reactive oxygen molecules that “steal” electrons (a negatively charged particle that orbits the nucleus in an atom of matter) from neighbouring molecules to stabilise themselves.  You might have heard of free radicals in skincare commercials. They are linked to accelerated ageing, cancer and other diseases. What helps keep these unstable molecules in check are antioxidants (again, something often talked about in skincare).

Antioxidants are found in large amounts in brightly coloured fruit and vegetables. The different colours tend to indicate the type of antioxidants produced – all are good. What we know about antioxidants is that they have a synergistic effect – eating a variety of different ones (by eating a large range of different coloured fruit and veg) has a greater effect that eating the same volume of the same type of fruit or veg.

Bottom line? Eat a LOT of vegetables and a moderate portion of low sugar fruits like berries (which have some of the highest antioxidant levels of all fruit).

If you have rheumatoid arthritis, talk to me about whether a more restrictive diet would work for you. This further cuts out all grains, nightshade foods (like potatoes, peppers, tomatoes, and aubergines) and other foods thought to play a role in causing an inflammatory environment.

Levels of Essential Fats

Omega 3 fatty acids (found in oily fish, seeds like flax, pumpkin and chia, and walnuts) are important to include daily because of their anti-inflammatory properties, which are well-documented.

Allergies

Many people with inflammatory conditions have allergies or intolerances, some of which may be due to leaky gut, where food proteins are able to get through the gut lining, triggering an inflammatory immune response. Common offenders are dairy products, yeast, wheat and gluten, other grains, eggs, beef, chilli, coffee and peanuts. If you experience arthritis – or in fact any other inflammatory condition, there may be mileage in having a food intolerance test. Ask me for details.

Food Action Plan

Remove Gluten and Dairy products

Reduce Animal protein

Increase non-starchy vegetables of all kinds (eat a rainbow of colours),vegetable protein such as pulses, oily fish, nuts, seeds, olive oil

Increase specific foods: celery, chilli, garlic, ginger, pineapple, red peppers, shiitake mushrooms, sweet potato, turmeric

Supplements– there are also numerous supplements which have been researched and can help reduce inflammation, including fish oil, curcumin, proteolytic enzymes, Boswellia. Ask me for details as it’s best to take them under supervision.

Stay Active

Low-impact exercise which doesn’t overly stress sensitive joints, including cycling, walking, water aerobics and yoga is beneficial for strengthening the muscles around the affected joint. this provides added support and reduces strain. Exercise has been shown to help lower inflammation and can even help prevent unnecessary replacement surgeries.

Sugar Substitutes

One of the things I am asked about most as a Nutritional Therapist and Health Coach is sugar substitutes. “What can I use instead of sugar ?” I am asked, so here’s the here’s the good, the bad and the ugly low down on some of  those sugar replacements you might think are healthy (and some that definitely aren’t).

Honey

Honey has a lot going for it in some regards. It contains amino acids, electrolytes and antioxidants, and antimicrobial compounds that can support your health. To get these extra benefits, you’ll want to choose a raw (unprocessed) local honey. It may also help relieve allergy symptoms, specifically hay fever, because the bees feast on the local pollen, and taking raw local honey can help you develop natural immunity over time. But, whichever way you cut it, honey is sugar. It may be natural, but sugar it is, and it behaves that way in your body, spiking blood sugar exactly as actual sugar would.

Medjool Dates

Dates are a popular feature of many paleo or natural sugar-free bars, because they are naturally very sweet. They have the highest nutritional benefit of all-natural sweeteners because they also contain minerals like selenium, copper, potassium and magnesium, as well as providing fibre to slow the speed at which the sugars hit your bloodstream. Studies show that they don’t spike your blood sugar levels that much and they’ve been proven to decrease cholesterol and boost bone health, and can help relieve constipation. Stick to 1 or 2 a day so there is no guilt associated with these caramel-like gems.

Maple syrup

It contains antioxidants (24 in fact), which are helpful in the fight against cell-damaging free radicals and inflammation. While studies show maple syrup does not spike your blood sugar levels as much, it is still wise to use sparingly. You’ll want grade A (lighter in flavour) or B (nutritionally better as it’s richer in antioxidants than grade A and with a more intense flavour). Avoid maple flavoured syrups as these are not the same.

Coconut sugar

Coconut sugar has become very trendy of late and brings a lovely caramel flavour to your food. It contains small amounts of iron, zinc, calcium, potassium, and antioxidants, and a fibre known as inulin which  may help reduce the absorption of glucose. It is perfect for baking with and has a lesser impact on your blood sugar levels than regular sugar, but it is still sugar, so use sparingly.

Palmyra Jaggery

You may not even have heard of this, but it’s the crystalized nectar collected from the flower of the Palmyra palm and has a deep, warm caramel flavour. You use it exactly as you would sugar, and often you can reduce the amount needed by up to a half. It’s packed with B vitamins and has a much lower GL than table sugar.

Brown Rice Syrup

This has found its way into ‘healthy’ recipes. It’s made from fermented, cooked rice. It’s not a particularly good option as a sweetener as it’s highly processed, contains very little in the way of nutrition benefits and the effect on blood sugar is almost identical to standard sugar.

Agave Syrup

Agave syrup comes from a cactus, and the syrup is made from the pulp of the leaf. It’s very highly processed and is mainly fructose, which needs to be processed by the liver, causing more stress for an already over-worked organ. Fructose is actually worse for you than glucose. Agave syrup (or nectar) is very similar to the (deservedly) much-demonised high fructose corn syrup, that has contributed greatly to the obesity epidemic in the US. My advice? Do not use it!

Stevia

This is another natural sweetener. There a number of different types of stevia, and ideally you want full, green leaf stevia that is unadulterated with other sweeteners. There are many brands out there that you should avoid because they’re so highly processed, and they also add in other chemicals. Pure stevia will not unbalance your blood sugar levels, thus avoiding an energy rollercoaster. But, a little bit goes a long way, so use sparingly.

Xylitol

Often found in the UK under the brand names Total Sweet or Xyla, xylitol is a sugar alcohol. It’s a little sweeter than sugar, has fewer calories and (the important part) 75% less carbohydrate, so the impact of blood sugar levels is lower than it would be if you were to eat the same amount compared to real sugar. It’s the same stuff used in sugar free chewing gum, thanks to its antibacterial properties. The downside is it is very highly processed, and some people can be sensitive to large amounts and may find their stools a little loose, or they get bloated, if they eat too much. Note as well that it is toxic for dogs.

Artificial sweeteners (like aspartame and saccharin)

People usually resort to artificial sweeteners in a bid to cut calories. This is bad news for a number of reasons, but I’ll mention the two biggies here: Research into some of them shows a correlation with cancer (weak, perhaps, and refuted by the food industry, but personally I’m not taking any chances). Secondly, nutrition science conclusively proves that weight gain/loss has little to do with calories in and out but what happens hormonally inside the body – how much insulin your body makes (insulin being the fat storage hormone that also sabotages fat burning). Recent research shows that these artificial sweeteners can increase blood sugar (and consequently insulin) levels more than normal sugar. So really, what is the point? Thirdly, research shows that ironically, they actually increase hunger. My advice is to stop now.

BUT…

The very best scenario of all is that you wean yourself off sweeteners of any kind as this helps you appreciate and embrace natural sweetness from real food. If you continue to eat sweet things, your taste buds will always want sweet things. That’s because sugar has been shown to have an effect on the brain similar to that of addictive drugs like nicotine, cocaine, heroin, and alcohol. In fact, quickly removing it from your diet can cause withdrawal symptoms, including fatigue, depression, headaches and muscle aches. No wonder it isn’t easy to quit.

If your diet has traditionally been quite high in the white stuff, the first few weeks can be a little tricky as your body (and brain and taste buds) starts to adjust – but bear with it.

 

 

 

The Vitamin D Epidemic

By London Nutritionist Sylvia Hensher

How Vitamin D Deficient Is The UK?

A recent survey in the UK showed that more than half of the adult population in the UK has insufficient levels of vitamin D. In the winter and spring about 1 in 6 people has a severe deficiency. It is estimated that about 9 in 10 adults of South Asian origin may be vitamin D-deficient. Most affected people either don’t have any symptoms, or have vague aches and pains, and are unaware of the problem.

Why Do Your Vitamin D Levels Matter?

In addition to the well-known osteoporosis connection, deficiency of this fat-soluble vitamin can be linked to a wide range of health problems, from cancer and cardiovascular disease to cognitive impairment and problems with auto-immunity such as multiple sclerosis and type 1 diabetes. Huge increased research interest in this field is constantly bringing to light new evidence which underscores the enormous importance of vitamin D to human health.

Sources of Vitamin D

What many people don’t realise is that very few foods naturally contain vitamin D. Fortified milk, egg yolks and oily fish are the best sources, but we can’t rely on food to provide with optimal amounts of vitamin D on a daily basis. In fact, the major source (80 – 100%) of vitamin D is actually sunshine. Ultraviolet B (UVB) sunlight rays convert cholesterol in the skin into vitamin D.

That’s right, although cholesterol is often a much maligned substance, our bodies literally could not survive without it! The sunlight has to fall directly on to bare skin (through a window is not enough). To add to the complexity of this issue, age, skin colour, geographic latitude, seasonal variations in sunlight availability and sunscreen use can impact on your body’s ability to produce all the vitamin D it needs. For example, darker skins need more sun to get the same amount of vitamin D as a fair-skinned person and because of geographic location, people in the United Kingdom cannot synthesise vitamin D from November to the end of March.

Why the Vitamin D Epidemic? Continue reading “The Vitamin D Epidemic”

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Curcumin, Pain And Inflammation In Osteoarthritis

By London Nutritionist Sylvia Hensher

What Is Osteoarthritis?

In osteoarthritis, the cartilage that cushions your joints deteriorates and the synovial fluid that keeps your joints lubricated and cushioned is typically reduced as well. It is the most common form of arthritis among the elderly. It’s normally associated with “wear and tear” on your joints, but can also be caused by repetitive stress or acute trauma. The pain is a result of your bones starting to come into contact with each other as cartilage and synovial fluid is reduced.

It causes joint stiffness, pain, inflammation and swelling that can become debilitating. Many patients turn to non-steroidal anti-inflammatories (NSAIDs) and analgesics for pain relief but the regular, chronic use of these types of medications is associated with side effects such as cardiovascular problems, gastrointestinal harm and kidney and/or liver damage. If you are taking an NSAID, you are at approximately three times greater risk for developing serious gastrointestinal side effects than those who aren’t.

What Is Curcumin?

Curcumin is the pigment that gives the curry spice turmeric its yellow-orange color and is the active ingredient in the herb turmeric. Both the ancient Chinese and Indian systems of medicine have recognized curcumin’s beneficial properties for thousands of years, and now modern research is showing it may be one of nature’s most powerful potential healers.

Curcumin is known for its potent anti-inflammatory properties. The compound has been shown to influence more than 700 genes, and it can inhibit both the activity and the synthesis of enzymes such as cyclooxygenase-2 (COX2) and 5-lipooxygenase (5-LOX) that have been implicated in inflammation.

How Can Curcumin Help Osteoarthritis Patients? Continue reading “Curcumin, Pain And Inflammation In Osteoarthritis”

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