by Ocean Robbins: Arthritis is a common condition characterized by stiff and painful joints. Does diet play a role in arthritis severity? What are the best (and worst) foods to alleviate symptoms?

In our society, getting older is associated with aching joints. “Oh, my arthritis is killing me,” is almost a punch line. We treat it like a natural and often unavoidable consequence of aging as if the passage of time were the root cause. But what if we’re wrong? What if how we live, and specifically what we eat, can determine if and when we get arthritis, and how bad it will be? In this article, we’ll look at common types of arthritis, and the link between these diseases and what’s at the end of our forks.

What is Arthritis?

Arthritis is a degenerative condition characterized by inflammation of the joints. In fact, the word “arthritis” comes from the Greek words for joint (“arthron”) and inflammation (“itis”). It’s a common disease that can cause chronic pain, and decreased mobility and dexterity in sufferers. There are an estimated 91 million adults in the United States, and hundreds of millions more worldwide, living with some form of arthritis.

People who work in manual-labor-intensive jobs, like farmworkers, are at a higher risk for the condition, a risk that increases with every year on the job. Growing older is also a risk factor, although arthritis can strike at any age. Other known factors are obesity, heart disease, and type 2 diabetes – all of which are profoundly impacted by your diet and lifestyle choices.

Common Forms of Arthritis

There’s no single disease called arthritis; it’s actually an umbrella term that can refer to over 100 distinct conditions. The most common forms of arthritis include:

• Osteoarthritis: Characterized by pain, decreased range of motion, aches when moving, and the feeling of stiffness, this is the most common type of arthritis. People with osteoarthritis often feel wear and tear of the joints caused by use, overuse, injury, or infection. Areas most often affected include the knees, hips, feet, and spine.
• Rheumatoid arthritis: Often shortened to “RA”, rheumatoid arthritis is an autoimmune disorder. This means that it’s a condition in which the body mistakenly attacks itself. By attacking joint linings, RA causes joint pain and swelling, in addition to nodules in the knuckles, heels, or elbows. RA can have consequences beyond the joints, including the eyes, lungs, and the cardiovascular system.
• Psoriatic arthritis: This is also an autoimmune disorder. It’s similar to RA, but also involves the skin. Psoriatic arthritis causes pain, swelling, redness in the joints (especially the hands), nail changes, fatigue, eye problems, skin rashes, and swelling and tenderness in the fingers and feet.
• Gout: This causes sudden, severe attacks of pain, swelling, redness and tenderness in the joints, often in the joint at the base of the big toe. Gout occurs when urate crystals accumulate in your joints, causing inflammation and intense pain called a gout attack. Urate crystals can form when you have high levels of uric acid — a normal end product of metabolism — in your blood.
• Lupus: This is an autoimmune disease that can affect your joints and many organs in your body. It’s caused when your immune system, instead of attacking viruses and other invaders, causes inflammation and pain throughout your body – often especially in your joints, organs, and brain. It typically appears between ages 15-44, and disproportionately women and especially African-American women of childbearing age.

Arthritis Foods: How Your Diet Can Help or Hurt

The medical profession treats arthritis like it treats most other diseases… with drugs. Anti-inflammatories, pain relievers, and corticosteroids are among the most commonly prescribed drugs for arthritis management. This approach can provide relief from symptoms, at least for a while, but it doesn’t address the root causes of disease. No form of arthritis is caused by a “prescription drug deficiency.” And while there are many factors that contribute to the development, progression, and severity of arthritis, one of the most powerful – and fortunately within our control – is diet.

There are two dietary approaches to the management of arthritis: foods to get rid of, and foods to add. Certain foods appear to spark inflammation in the joints and are thus commonly referred to as trigger foods. Removing these foods from the diet can reduce pain and inflammation associated with arthritis.

Worst Foods for Arthritis

Some of the foods most likely to increase arthritis symptoms include:

Soda

Surveys among people with RA have found that sugary drinks like soda are one of the most reported foods for worsening symptoms. A 2014 observational study published in the American Journal of Clinical Nutrition examined the association between drinking sugary soda and risk of RA among women. The authors found that those women who drank at least one soda per day had a 63% increased risk of developing RA compared to those women who drank no soda or less than one can of soda per month. This was independent of other dietary and lifestyle factors, and the same correlation was not seen with diet soda intake.

Alcohol

While some older studies have suggested that there may be a link between moderate alcohol consumption and less severe arthritis symptoms, a 2019 study suggests that this is inaccurate. Instead, the 16,762 person study found that those with more severe disease progression were more likely to stop drinking alcohol altogether, giving the false appearance that it’s beneficial. In other words, the alcohol didn’t reduce arthritis; instead, the arthritis reduced alcohol consumption. Furthermore, alcohol is associated with hyperuricemia — high levels of uric acid in the blood — which may be associated with gout. It’s also known that alcohol doesn’t mix well with certain medications often used to alleviate arthritis symptoms; can disrupt sleep, promote weight gain and put further stress on aching joints; and damage mental health.

High-sugar Desserts

Similar to the effects of drinking sugary soda, eating high-sugar desserts may also worsen arthritis as evidenced by reports of this experience among people with the disease. What’s more, researchers have been examining Advanced Glycation Endproducts (AGEs), compounds formed as a result of high sugar intake that may play a role in the development of metabolic diseases and inflammation. AGEs can accumulate from inflammation and be present in people with RA, especially those with a long history of the disease, and may be an early warning sign of heart disease among people with RA.

Meat and Dairy

Meat and dairy products contain certain compounds that may play a role in worsening arthritis. A 2017 study published in Arthritis Care & Researchassessed diet patterns and disease progression among 2,092 people with osteoarthritis in the knee for up to 4 years. The authors found that high intakes of total and saturated fat may be linked to worse osteoarthritis progression, while unsaturated fats may slow it. Another study found that people who ate over 75 grams of protein per day — especially when it included red meat — had three times the risk of inflammatory arthritis than people who ate fewer than 62 grams. Purine compounds, which can raise uric acid levels and contribute to gout, are highly concentrated in bacon, veal, turkey, certain fish, venison, and organ meats. Lastly, a 2018 study by the University of Central Florida found that a strain of bacteria in beef and milk, called Mycobacterium avium subspecies paratuberculosis (MAP), may trigger RA in people genetically at risk for the disease.

Gluten

There may be a link between Celiac disease and the development of RA, which many researchers think could be related to gut bacteria and intestinal health. In fact, gluten is an immunological trigger in both Celiac disease and RA, and many people with RA who follow a vegan, gluten-free diet report related benefits. Interestingly, research also suggests that people with Celiac disease may be at a higher risk for RA.

What’s the bottom line? In addition to all the other reasons, following a whole foods, minimally processed, plant-strong diet may reduce your risk, alleviate symptoms, and even slow the progression of arthritis. And of course, this goes hand-in-hand with avoiding processed, high-sugar foods, and animal-derived products associated with inflammation and reportedly worsened arthritic symptoms.

Nightshades and Arthritis

One of the most common things people think of as a “trigger food” is nightshade vegetables, such as tomatoes, peppers, eggplants, and potatoes. These vegetables contain solanine, which some people believe will aggravate arthritis pain and inflammation. And indeed, there are some anecdotal reports of arthritis symptoms improving on a no-nightshade diet. But the Arthritis Foundation reports that there have been no scientific studies that have demonstrated that nightshade vegetables actually cause inflammation or make arthritis symptoms worse.

If you are facing arthritis symptoms, then you might want to try omitting nightshades from your diet for a couple of weeks and slowly reintroducing them, to see if they have any impact on your pain level. Nightshade vegetables are rich in nutrients and provide many health benefits, so it’s best to experiment to find out whether removing them does you any good, rather than simply removing them without knowing whether that will produce any positive results.

Best Foods for Arthritis

So if you’re eliminating or cutting down on soda, alcohol, added sugar, animal products, and gluten, what should you replace them with? The simple answer is, with foods that fight inflammation. In other words, minimally processed plant foods. Studies have shown that plant-based diets can reduce symptoms or even eliminate arthritis completely in some people. For instance, a 2015 studypublished in the journal Arthritis found that just six weeks of a whole foods, plant-based diet significantly reduced self-reported osteoarthritis symptoms among participants aged 19-70, compared to a control group.

Some of the best foods for alleviating inflammation and reducing arthritis symptoms include:

Blueberries and Other Berries

A 2018 study published in Food & Function examined current evidence, including research from clinical studies, regarding the effectiveness of berries in reducing arthritis pain and inflammation. The authors concluded that blueberries, raspberries, and strawberries offered some of the best protection for arthritis, largely attributed to anti-inflammatory fruit polyphenols like quercetin, anthocyanins, and citrus flavonoids. Another 2018 study published in Arthritis Care & Research evaluated survey responses from 217 participants regarding their diet and arthritis symptoms. The authors found that blueberries were one of the foods most often reported to improve symptoms.

Spinach

The same Arthritis Care & Research study mentioned above found that in addition to blueberries, consuming spinach was also very often attributed to an improvement in arthritis symptoms by survey participants. Test tube research suggests that spinach has anti-osteoarthritic effects that appear to target cartilage cells. For a long time, gout sufferers were told to avoid spinach, as its high levels of purines might trigger an attack. However, a 2012 study found that while animal foods rich in purines were associated with five times the risk of attack, plant-based purine-rich foods did not increase gout incidence or severity.

Foods High in Omega-3 Fats

Some of the richest sources of plant-based omega-3 fats are flax seeds (freshly ground for best nutritional value), chia seeds, hemp seeds, certain forms of algae, and walnuts. This type of fat has been shown to reduce swelling, tenderness, and morning stiffness of joints among people with rheumatoid arthritis. A 2016 study found so much improvement among arthritis symptoms among people who took a daily omega-3 supplement that many were able to reduce their need for pain medications. Algal oil, derived from algae, is a vegan source of the omega-3 fats EPA and ALA, and has been found to be equally well-absorbed and tolerated as cooked salmon but without all the mercury and other contaminants found in fish products.

Citrus Fruits

Polyphenols like hesperidin and naringenin, found in citrus fruits such as oranges, lemons, and limes, have been found to help reduce the inflammation that can worsen arthritis symptoms. A 2016 study published in Clinical Rheumatology assessed the impact of dietary choices on the risk of developing RA among a Chinese population. The authors found that RA patients tended to have a low intake of citrus fruits, indicating that there might be a correlation between citrus fruit intake and susceptibility to arthritis.

Garlic

Garlic is a pungent food in the allium family. It’s known to be one of the best natural medicines for alleviating arthritis, largely due to its anti-inflammatory organosulfur compounds.