Eating à la Italia for Joint Wellness

The Mediterranean diet may “suppress disease activity in patients who have modestly active rheumatoid arthritis.”

She Said

My friend Pamela enters the café and I see she’s walking with a cane. She uses it occasionally, but often she goes without it. “Every day I don’t wake up so stiff that I’m scared to move is a miracle,” she says.

Now 48, Pamela has suffered with rheumatoid arthritis since diagnosis at the age of 12 of juvenile idiopathic arthritis (JIA). Juvenile varieties of arthritis may continue into adulthood, but sometimes go into remission, with symptoms disappearing, never to return. Treatment usually consists of medication(s), including cortisone joint injections to reduce swelling, and physiotherapy.

Over the last eight years, Pamela has used complementary and alternative treatments and now lives medication-free, with the exception of occasional analgesics and nonsteroidal anti-inflammatories for flare-ups that may accompany severe colds.

He Said

There are several types of arthritis, of which the two most common are osteoarthritis (OA)–degeneration of joint bone and cartilage–and rheumatoid arthritis (RA), an autoimmune disorder that causes swelling and inflammation of the joints.

Research on alternative therapies is burgeoning due to the success of treatments and supplements. Among these are vitamins and antioxidants, including vitamins C, D, and E, as well as fish oils. Chondroitin sulfate, especially in combination with glucosamine, appears to improve the symptoms of OA, and may even help keep further degeneration from occurring. However, a scan of the literature on glucosamine makes it clear that the research jury is still out on its efficacy as an arthritis remedy.

She Said

Pamela is a cheery woman. She’s large and breathes heavily as she sits, but she assures me that the last three years of her life have been the happiest and most active. “The juvenile arthritis kept me in a lot of pain, and I became an example of the dangers of a sedentary life,” she admits. “Now I walk, do my stretches faithfully, and take my fish oil supplements and shark cartilage. My treat is yogourt–I eat it every single day because of the helpful bacteria.”

Pamela has gone from unemployable and bedridden to working part-time and participating in Pilates at her local community centre.

He Said

Supplemental and physical therapies for osteo- and rheumatoid arthritis are necessarily different but can complement each other. As an autoimmune disorder, RA seems more responsive to immune stimulants, whereas OA responds to physical therapies, supplements, and in extreme cases, joint replacement surgery (arthroplasty). However, improving nutrition is one approach used for both types of the disease that has shown excellent results.

Reducing consumption of sugar, processed foods, nightshade vegetables such as tomatoes, potatoes, eggplant, and peppers (due to the high alkaloid content), and fatty foods appears to ameliorate both conditions.

A 2003 study on the Mediterranean diet concluded that this diet “suppresses disease activity in patients who have stable and modestly active rheumatoid arthritis.” The Mediterranean diet focuses on fruits, vegetables, and legumes, favouring fish over meat. Happily, the diet can include a moderate amount of wine and use of extra-virgin olive oil. Although research is inconclusive on the effects of nightshades on arthritis, the Mediterranean diet can be modified to exclude those vegetables.

She Said

Pamela’s goal is to help kids who’ve been diagnosed with JIA understand that they don’t have to exacerbate their condition with a sedentary lifestyle and what she calls “the popular North American diet,” which focuses on high-fat, high-sugar, and overprocessed foods.

Eliminating white flour, white sugar, and trans fats is a good place to start. For those afflicted with the myriad forms of arthritis, meat-and-potatoes meals are best replaced with grilled salmon and steamed broccoli spears drizzled with olive oil. Thankfully, there are worse dietary constraints!

Web Resources

Arthritis

• arthritis.ca

Mediterranean Diet and RA

• ard.bmj.com/cgi/reprint/62/3/208

Vitamins for OA

• annals.org/cgi/reprint/133/8/635.pdf

Glucosamine and Osteoarthritis

• publib.upol.cz/~obd/fulltext/Biomed/2005/1/51.pdf
• rheumatology.oxfordjournals.org/cgi/reprint/41/3/279

Lactobacillus for Arthritis

• jn.nutrition.org/cgi/reprint/134/8/1964

Fatty Acids and Mediterranean diet for RA

• pubmedcentral.nih.gov/articlerender.fcgi?artid=1289295

Current Conventional Medical Treatment for JIA

• pediatrics.aappublications.org/cgi/reprint/109/1/109

The Controversy Over Cox-2 Drugs for Treating Juvenile RA

• kron.com/Global/story.asp?S=5752490

Childhood arthritis

• arthritis.ca/types of arthritis/childhood/default.asp?s=1