What is the role of diet in managing osteoarthritis?
Osteoarthritis does not currently have a cure. However, a diet rich in anti-inflammatory foods that support strong bones, a good lipid balance, and a healthy gut microbiome can help manage osteoarthritis. Additionally, cholesterol and lipids in the diet can affect the development and progression of osteoarthritis.Diet for osteoarthritis should have 4 main goals.1. Reducing inflammation.Inflammation plays a key role in the pathogenesis of osteoarthritis. Increased inflammation is associated with increased pain and disease progression. Inflammation in osteoarthritis is caused by many different types of stimuli. These include cytokines, lipids that act like hormones such as prostaglandins, and other bioactive lipids. Inflammation in osteoarthritis is also increased by conditions such as obesity, injury, excessive use of a joint, and aging in general. A diet that reduces inflammation can help relieve some of the symptoms of osteoarthritis.2. Providing enough calcium and Vitamin DBone health generally benefits from sufficient calcium and vitamin D in the diet. Published studies show that while vitamin D supplementation did not slow the progression of osteoarthritis, it did relieve osteoarthritis-related pain in women with low vitamin D levels.3. Correcting the lipid balanceA class of nutrients called lipids have many important roles in the body. They are important components of cellular membranes that play crucial roles in cellular signaling processes and determining what goes in a cell and what stays out. They help maintain a state of metabolic balance and regulate immune cells. They are precursors of inflammatory cytokines, molecules that cause inflammation and cellular destruction. They are also condensed as fats to store energy.Abnormal lipid accumulation in chondrocytes may be responsible for the development and progression of osteoarthritis. This is irrespective of the person’s BMI.Local lipid content in the joints can impact how many bone-forming/repairing cells are made. Bone cells are derived from mesenchymal stem cells (MSCs). MSCs can differentiate to form adipose cells that store fats and osteoblasts that form bone. The more adipose cells are generated, the fewer osteoblasts are produced, and vice versa. Different metabolic factors such as cholesterol can tip the balance of MSCs to produce more adipose cells at the cost of osteoblasts. Some of these factors are released from adipose cells themselves suggesting the more cholesterol and adipose cells there are in the joint, the more is the production of adipose cells instead of bone-forming cells.Low-fat diets and high-fat diets can have different impacts on the bone microenvironment. When eating a low-fat diet, MSCs differentiate into more bone cells. When eating a high-fat diet, MSCs differentiate into more adipose cells.MSCs also make cartilage cells. A low-fat diet containing healthy fats such as omega-3 fatty acids can be beneficial in both osteoporosis and osteoarthritis.4. Maintaining healthy gut microbiotaStudies from the past 5 years show a connection between gut health and osteoarthritis. Patients who were diagnosed with osteoarthritis also had a quantifiable imbalance of gut microbes. Another study showed that a higher relative abundance of some Streptococcus species was associated with greater pain and inflammation in knee osteoarthritis. A diet that supports healthy gut microbiota can benefit those with osteoarthritis.Recommended foods
TurmericThis wonder root has long been associated with reduced inflammation. A member of the ginger family, this orange spice adds a mild flavor to both sweet and savory foods. Recently, Dr. Kristopher Paultre from the Department of Family Medicine at the University of Miami Sports Medicine Institute published a review of 10 studies exploring the use of turmeric in treating knee osteoarthritis. In all 10 studies, using turmeric decreased pain and improved function.Turmeric may be used directly as a supplement. It can also be incorporated into daily life as homemade turmeric lattes and soups. However, it is often best to use fresh turmeric. Dry and powdered turmeric can sometimes be contaminated with a toxic yellow dye called yellow lead chromate.
GingerAnother nutritious root, ginger significantly reduced the pain of knee osteoarthritis patients. The spicy herb pairs well with turmeric and can be enjoyed in lattes and soups.
Fatty fishOily fish such as salmon, mackerel, and herring reduce inflammation and improve the body’s lipid balance. In overweight or obese older adults, fish oil supplementation also reduces osteoarthritis-specific pain.
Fruits and green vegetablesEating lots of fruits and green vegetables can reduce the risk of developing osteoarthritis in older adults. Cruciferous vegetables such as broccoli, cabbage, and cauliflower can have a protective effect on cartilage. Fibrous fruit and vegetables are also great prebiotics that help the gut microbes thrive.
Probiotic foodsData from preclinical and clinical studies indicate that probiotics can relieve pain from osteoarthritis. The decrease in pain is mediated through many signaling pathways that originate from the bacteria in the gut.Probiotic bacteria beneficial in osteoarthritis include:Lactobacillus acidophilus – found in yogurt, miso, and tempehLactobacillus casei – found in ripening cheddar and Sicilian green olivesLactobacillus rhamnosus – found in fermented foods such as kimchi, sauerkraut, and misoStreptococcus thermophiles – found in yogurt and hard Italian cheesesClostridium butyricum – soil bacteria found in some vegetables, soured milk, and kefir.When eating yogurt as a probiotic, it is important to choose the unsweetened versions as the excess sugar can prevent the growth of probiotic bacteria.
Foods to avoidIndividuals with osteoarthritis can benefit from avoiding foods that disrupt the gut microbiota or increase inflammation. This includes foods with a high content of refined sugars, saturated fats, and trans fats.Some vegetables, such as those of the nightshade family (potato, tomato, peppers), can adversely affect the gut microbiota and are also not recommended in an anti-inflammatory diet for arthritis.
The information provided in our blog posts is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.
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