By Dr. Mitch Shulman
When someone develops rheumatoid arthritis (RA), their immune system attacks the lining of the joints, the synovium, causing pain; swelling; and eventually, the deformity of those joints. The resulting inflammation can also damage the heart, eyes and many other organs.
Genetics plays a role. For example, women are at an increased risk. Furthermore, smoking and obesity make it worse. On the positive side, we have many more medications to choose from. Physiotherapy and work aids can also help.
Can your diet play a role? Warning: before making any radical changes please talk to your doctor or pharmacist. Diet and supplements can trigger unexpected side effects; can interact with medications that you might be taking; or, worsen underlying health conditions.
The best approach is to eat healthy, mainly fruits, vegetables and whole grains. Low-fat dairy products and lean sources of protein should make up about a third of the diet. Include cold-water fish (herring, mackerel, trout, salmon and tuna), which are relatively high in omega-3 fatty acids, which may help reduce inflammation. Similarly, some preliminary studies have found that fish oil supplements may reduce RA pain and stiffness but side effects can include nausea, belching and a fishy taste.
Increasing fibre (by eating more fruits, vegetables and whole grains) may also help reduce inflammation. Extra-virgin olive oil contains a compound called oleocanthal that blocks enzymes triggering inflammation. However, it would take 3½ tablespoons of olive oil (which is about 400 calories) to equal the anti-inflammatory properties of a single, regular-strength tablet of ibuprofen (trade names include Motrin, Advil among others).
So, rather than using it alone, perhaps it would make more calorie-sense to use it as an alternative to other oils and butter.
Research has shown that people with RA have low levels of selenium, a mineral found in whole-grain wheat products and shellfish such as oysters and crab, which may help control inflammation. However selenium supplements may also increase the risk of developing diabetes, so talk to your doctor first.
Vitamin D (found in eggs, fortified breads, cereals and low-fat milk) may lower the risk of RA especially in older women by helping regulate the immune system.
There are some interesting small studies that indicate that drinking mangosteen (which is not related to the mango by the way) may reduce inflammation but no studies showing any benefit in RA so the jury is still out. Certain plant oils may also help but there is a real risk of serious liver damage and interference with other meds.
There are foods that you may want to reduce or eliminate from your diet to see if that helps. Meat that has been grilled or fried at high temperatures can contain compounds associated with worsening inflammation. Similarly, consuming more omega-6 fatty acids (found in corn, sunflower, safflower and soybean oils, and many snack and fried foods) than omega-3s may raise your risk of joint inflammation.
Other interventions that may help: a scientific review by the respected Cochrane group suggested that low level laser therapy might help improve pain and morning stiffness with few side effects.
Yoga and Tai Chi are worth looking into. There are many different styles of yoga. Some are safer than others for RA patients. Performing tai chi has been found to improve balance and function, increase strength, and reduce stress and pain.
As with so many other diseases people turn to alternative treatments falsely assuming that they are safer or better. Unfortunately there is no strong scientific backing for most of them. The key to managing RA will depend on how your disease has evolved and the help of your entire medical team. In some cases you might want to consider being part of a clinical trial to get the most cutting edge treatment.
http://www.thesuburban.com/columnists/dr_mitch_shulman_public_health/rheumatoid-arthritis-what-can-you-do-to-make-it-better/article_f5d89cd4-e79e-5f70-b839-823dd7b581f3.html
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