Wednesday, July 25, 2012

Arthritis and diet

In the comments on a recent blog post, a friend asked me to address what I've learned about exercise and diet as it relates to arthritis.  I was diagnosed with rheumatoid arthritis a few years ago.  At that time, I was very sad.  I felt that my body was betraying me.  In an autoimmune disease like RA, your immune system, which is supposed to fight illness, instead attacks some part of your body.  In RA, it is the synovium that lines your joints.  The result is pain and inflammation and eventually, the disease can result in the loss of cartilage between bones, joint and bone erosion, malformation of joints, loss of range of motion, and disability.  It doesn't always progress that way. Early treatment can prevent or slow the progression and it sometimes goes into remission.  If you want to learn more about RA, there's plenty of information online, here and elsewhere.

For me, the main joints involved are in my hands, though I've had some pain in my hips and feet at times.  When the disease flares, simple things like pulling up zippers, opening jars, even holding a pencil are painful.  I had a flare back in May and my hands and feet hurt constantly.  They were swollen and stiff.  That has passed now and I am relatively pain free, except for one thumb and one finger joint.  Really not bad.

But back to the point of this post - what about diet and exercise?  They are key!  I am certainly NOT an expert, but I know that what you eat and whether or not you exercise DO make a difference.

So, let's look at diet first.  There are plenty of conflicting opinions out there and lots of information that is confusing.   Eat whole grains/don't eat wheat; eat a variety of veggies/avoid tomatoes, potatoes, and peppers; avoid meat/eat meat.  What to do???

I'm not sure I have the best answer for myself yet.  I haven't kept extensive food diaries or done any elimination diets.  All I can do is tell you what I am doing now and give you a bit of the rationale behind it.  I can share some of the RA diet literature with you and give you a few examples.  You will have to do your own research and see what works best for you.  Though there are some general healthy eating tips for people with arthritis, there is no "one size fits all" answer.

Before I get to specifics, however, I want to share a couple of "overarching" thoughts about food.

-Christians are reminded to eat to the glory of God.  (1 Corinthians 10:31).  Something in our eating and drinking can and should remind us and others of the goodness and grace of God.

-Food is much more than just fuel for our bodies.  If we think of it only as calories and nutrients, we miss so much.  It is a gift to be enjoyed and shared, given and received.  It is both ordinary and celebratory.  This is articulated so well by Robert Farrar Capon in The Supper of the Lamb, which I read last year and which I highly recommend!

Now to the specifics of what I do, with a few links to RA diet literature:

1.  Eat a variety of foods.  One of the easiest ways to do this is to think about color.  Eat lots of different colors of foods and you'll probably be OK (skittles don't count!).  I think this is one of Michael Pollan's food rules, from his book of the same name, which is a very common sense guide to eating decisions.  Think red like beets, green like spinach, kale, and broccoli, yellow like mangoes, orange like carrots and butternut squash etc.  A plate full of colorful food is likely a healthy plate of food.

2.  Eat as much fresh and raw as you can.  Think fresh fruits and veggies, big salads with a variety of greens, veggies, fresh berries, and almonds or walnuts.  A little olive oil and balsamic vinegar with some chopped garden herbs from dressing.  Skip the storebought salad dressings with artificial ingredients.  Or how about a dinner of roasted beets and butternut squash, watermelon, cantalope, and honeydew, and sliced homegrown tomatoes.

3.  Be careful with fats and make sure you get your omega 3's.  I take cod liver oil (old fashioned, I know) and flaxseed oil.  I use olive oil and coconut oil and I eat butter.  That's about it.  No margarine or shortening, vegetable oil and sesame oil on occasion.  I limit how much fat I eat.  I avoid processed foods and fried foods.  However, I DO like french fries and onions rings.  So I consider them as treats, celebratory foods, to be eaten on rare occasions, not as daily or even weekly diet items.

4,  Go easy on the sugar.  Less is better.  Avoid soda, sweet drinks, and candy as much as possible.  Learn to appreciate the natural sweetness in raw fruits and veggies.  If you do eat sweets or desserts, don't do it everyday.  I'm not a candy nazi here.  I do like a bit of dark chocolate from time to time (which we ALL know is good for us) and I have a weakness for a Coke every once in a while (Yikes! That sounds rather blasphemous, doesn't it).  But here's the thing.  I think there is a food group that the FDA has never put on any food pyramid.  It's the Happiness Food Group.  The foods in this group are the ones that may not be the most healthy for you, but they bring happy memories, remind you of someone special, or just make you smile.  I maintain that the happiness obtained from eating them on occasion far outweighs the deleterious effects and counteracts all that worrying we do about food.  But the Happiness  Food Group is at the very tip top of the pyramid.  If you eat too much from this group, it becomes ordinary and doesn't evoke those happy feelings any more.  (I am well aware that this is totally unscientific, however if laughter makes you get well faster, doesn't happy food help boost your health, too???  Has anyone done a study on this?)

5.  I am not gluten free.  I've never had any symptoms of gluten sensitivity, nevertheless, I have begun reducing how much wheat I eat, on the recommendation of my daughter who has done more reading on this subject than I have, and another friend, who experienced relief from a variety of symptoms when she reduced her wheat intake.  Reducing gluten may reduce inflammation.  We'll see.  Instead of bread, I eat brown rice.  For breakfast, instead of bread products, I eat oatmeal.

6.  Drink plenty of water.  I have to work at this, except when I'm exercising a lot.  I do drink a cup of coffee or tea in the morning.  I do use half and half and a little sugar.  It's a weakness, I know.  But it makes me happy.  The research is inconclusive on the affects of coffee on RA, but most studies suggest that coffee in moderation may have beneficial effects.  I also drink herbal teas.  We used to drink more juice, but I've drastically reduced the amount of juice we drink.  Too much sugar.  It's better to just eat a piece of fruit.

7.  Go easy on the meat.  We used to be completely vegetarian.  Then we added fish and seafood.  A few years later, we added chicken now and then.  These days, we occasionally (though pretty rarely) eat beef.  Our protein sources are most often beans, tofu, salmon, and tilapia.  We do eat eggs sometimes.  I like them hard boiled for breakfast.  It is not hard to get enough protein.

8.  I don't drink much milk, but I do eat yogurt and kefir.  Cultured foods provide probiotics to your system.  Some researchers say that RA is triggered by a deficiency of healthy bacteria in the gut and that probiotics can help reduce symptoms.  The research is not conclusive, eating yogurt has been linked to longevity for, well, a long time.

Folks, as I finish writing this, I am well aware that none of this is earth shattering information.  Neither is it based on the most recent dietary information.  I know very little about the Paleo diet, which seems to be the latest thing in combating RA and other autoimmune disorders.  There are SO many books out there and I should do more reading. Honestly though, right now I'd rather spend time training for the triathlon and eating fresh, raw, colorful, tasty, happy food than reading diet books.  Maybe there will be time for that in the winter!

Thanks for reading.  I'd enjoy hearing your suggestions and dietary wisdom.


Susan said...

From what I've learned about eating to combat migraine disease, I'd say you're on the right path. You've always eaten a healthy diet as long as I've know you. The big thing for me has been to eliminate unhealthy carbs, which means bread, pasta, rice, etc because they might not bother my migraine, but they do have a negative effect on my diabetes. And as far as the Paleo diet goes, I think anything that eliminates other healthy foods and focuses on eating mainly from one food group, here it is meat, is unhealthy in the long term.

If we eat foods as close to the way GOd made them as possible I think we'd all be healthier!

Erin said...

A friend of mine switched her family (she and her husband and kids 6, 4 and 2) to the Paleo diet around Christmastime and they have all seem a huge difference in their health. Her kids were having almost constant loose stool, various stomach ills, etc. Her insomnia has gotten better, they all just feel better in general.

I appreciate the changes she's seen in her family but don't think completely cutting out grains is necessary and dairy is necessary or helpful. I think Susan's comment of "eating foods as close to the way God made them" is right on target. However, that doesn't mean just cutting out processed foods. Modern highly bred wheat is not anywhere near to the ancient wheats God created in appearance, nutritional quality or genetic structure. Skim or 1% milk from grain-fed cows which has nonfat dried milk (a process which makes the proteins toxic) added back into it is nowhere near the way God make milk, either. The great majority of soy out there is genetically modified, as are other crops.

This is why we have moved more and more towards the WAPF/Nourishing Traditions way of eating. There's more fat and less sugar in our diet, more eggs, meats and veggies and fewer grains. I try to only include wheat in our diet as much as rice or quinoa and no more. This means once or twice a week at the most. I think we are relying more heavily on oats as a result which I'm not thrilled about but do feel is better than modern wheat. The days that we do eat wheat, my restless leg syndrome is HORRIBLE. The days we don't, it's almost non-existent. That's the most noticeable difference so far for me. Perhaps if we went completely off gluten for a month (which is how long it supposedly takes to get out of your system) I'd see more differences.

The grains we do eat are soaked ahead of time to reduce phytic acid. I also soak all our nuts and legumes. Certain veggies such as spinach, broccoli, cabbage, etc. are eaten raw very infrequently, if at all, since they contain goitrogenous compounds (and spinach I believe contains oxalic acid, the poisonous substance in rhubarb leaves). These compounds are destroyed through light cooking.

It's so hard for me to find a balance between doing the best I can and becoming obsessive about it (hmm, optimizer much?!). It is such a journey.

Elizabeth Foss said...

You continue to inspire and bless me. Thanks for this post! I appreciate the food advice, but the Biblical wisdom sprinkled throughout is the real inspiration.