What Is Arthritis (Joint Inflammation)? 5 Foods People with Arthritis Should Avoid

Arthritis is a group of diseases characterized by inflammation in the joints. Arthritis causes joint pain, swelling and stiffness. Pain, particularly when it persists for a long time and is sometimes very severe, is the main complaint of people with arthritis. Pain may decrease with painkillers. However, diet is also claimed to play an effective role in worsening or relieving arthritis symptoms. In particular, removing inflammatory foods such as saturated fat and sugar, as well as foods high in purines, from the diet is thought to help relieve symptoms.

The most common type of arthritis is osteoarthritis. Other types of arthritis include;

• Rheumatoid arthritis (RA) 
• Psoriatic arthritis 
• Juvenile idiopathic arthritis 
• Gout
• Lupus
• Ankylosing spondylitis.

Can diet reduce arthritis symptoms?

Proper nutrition in arthritis

• Helps reduce inflammation levels in the body
• Supports weight control
• Supports tissue health and healing

Under normal circumstances, inflammation helps the body defend itself against bacteria and heal wounds. When inflammation lasts longer than necessary, chronic symptoms may develop.

The foods consumed affect inflammation levels. Some foods have inflammatory effects, while others have anti-inflammatory effects. According to the Artrit Foundation, a nonprofit organization working to meet the needs of people living with arthritis in the United States;

• Anti-inflammatory foods can reduce arthritis pain and slow disease progression.

Weight control can be very beneficial for people with arthritis. This is because fat cells increase inflammation and immune cells called cytokines. Therefore, people with arthritis can help reduce pain by controlling their weight.

Foods to avoid in arthritis

1. Fats that increase the inflammatory response

Some types of fat can increase inflammation in the body. These fats therefore need to be limited in the diet.

• Omega 6 Fatty Acids: Corn, safflower, sunflower and vegetable oils. Although they are not harmful when consumed in moderate amounts, excessive consumption can worsen symptoms.
• Saturated Fats: Animal foods such as butter, milk and dairy products and red meat, as well as date palm oil, coconut oil and palm oil, contain saturated fat. Avoiding saturated fat as much as possible is beneficial. However, consuming it will not be harmful if it is limited to less than 10% of total daily calorie intake. For example, someone whose daily energy requirement is 2000 calories should not consume more than 200 calories, or 20 grams, of saturated fat per day.
• Coconut oil: Despite its high saturated fat content, it is thought not to have an inflammatory effect and may even help reduce inflammation. However, more studies are needed because this has not been fully proven.
• Trans Fats: Trans fats (for example, margarine), obtained by converting liquid oils to solid form, are known as the most harmful group of fats for health. Trans fats lower “HDL” cholesterol, known as good cholesterol, while raising “LDL” cholesterol, known as bad cholesterol. Completely removing trans fats from the diet can be beneficial. The recommended daily trans fat limit is around 1% of daily calories.

2. Sugar

Excessive sugar consumption increases inflammation as well as the risk of obesity and other chronic diseases. A study published this year in “Nutrients” concluded that people who regularly consume drinks high in sugar have a greater risk of developing rheumatoid arthritis.

The World Health Organization (WHO) recommends keeping daily simple sugar intake below 10% of daily calorie requirements, and below 5% to improve health further.

• Simple Sugar: All monosaccharides and disaccharides added to foods by manufacturers, cooks or consumers are simple sugars. Simple sugars also occur naturally in honey, syrups and fruit juices. The sugars in fruit, vegetables or milk are not simple sugars.

Packaged products bought from stores can contain high amounts of sugar. It is therefore useful to read nutrition labels to check the sugar content of products such as breakfast cereals, soft drinks and sauces.

3. Advanced glycation end products (AGE)

AGEs are inflammatory compounds that can accumulate in tissues. A study published in “Patient Education” in 2017 concluded that people with rheumatoid arthritis have increased AGE levels in their bodies. Therefore, lowering AGE levels in the body is thought to reduce inflammation.

Sugar and fat consumption increase AGE levels in the body. Cooking food at high temperatures and food processing methods also raise AGE levels in the body.

4. The Nightshade Family

The nightshade family is a group of vegetables containing a compound called solanine. There is no evidence that these vegetables worsen arthritis symptoms. However, removing them from the diet is thought to help relieve symptoms.

Vegetables in the nightshade family include;

• Tomatoes
• Peppers
• Red pepper flakes
• Eggplants
• Potatoes

The Artrit Foundation recommends that people who notice increased pain after eating nightshade vegetables stop eating them for a few weeks and then reintroduce them into their diet one at a time.

5. Purine-rich foods

Purine is a compound found in foods and drinks that are part of a normal diet. The body metabolizes purines and produces a waste product called uric acid.

For gout, doctors generally recommend a purine-restricted diet alongside medication. This is because uric acid can accumulate in the bloodstream and increase gout attacks.

The “Centers for Disease Control and Prevention (CDC),” an organization working to ensure public health and public safety in the United States, defines purine-rich foods as;

• Red meat 
• Organ meats such as liver
• Beer and other alcoholic drinks 
• Processed meat products such as sucuk, sausages and salami
• Seafood such as mussels.

Vegetables such as mushrooms, spinach, cauliflower and asparagus, as well as dried legumes, are also high in purines. However, they are thought not to increase gout attacks as much as alcohol and animal foods do.

Recommended foods for arthritis

Anti-inflammatory fats

• Unsaturated Fats: Olive oil, avocado oil, hazelnuts and hazelnut oil contain a compound called “oleocanthal” that has anti-inflammatory effects.
• Omega-3 Fatty Acids: Oily fish such as salmon, sardines and herring contain omega-3 fatty acids. Vegetarians and vegans can increase their omega-3 intake by consuming walnuts or walnut oil. Fish oil capsules taken under medical supervision can also increase omega-3 intake. Research suggests that taking 600mg-1000mg of fish oil daily may relieve joint stiffness, swelling and pain.

Vegetables and Fruit

Vegetables and fruit, whose health benefits are too numerous to list, can reduce symptoms in people with arthritis.

Vegetables and fruit that the Artrit Foundation recommends for arthritis include;

• Onions, garlic and leeks: These vegetables contain quercetin, an anti-inflammatory compound.
• Sweet potatoes, squash and carrots: Orange and red vegetables contain carotenoids, which are antioxidants.
• Green leafy vegetables: Vegetables such as cabbage, broccoli, chard and spinach are high in antioxidants. They also contain calcium, which is essential for bone health.
• Citrus fruit, kiwi and strawberries: These fruits are rich in vitamin C, an antioxidant vitamin. Vitamin C is thought to help protect bones and cartilage.

What is an anti-inflammatory diet?

An anti-inflammatory eating pattern can help improve health and reduce symptoms in people with arthritis. The Mediterranean diet is the most extensively researched dietary pattern among diets with anti-inflammatory effects.

- Related Topic: Health Benefits and Metabolic Effects of the Mediterranean Diet: How Did It Become the World's Best Diet?

The Mediterranean diet mainly recommends vegetables, fruit, whole grains, dried legumes, fish, lean white meat, olive oil and nuts. It also advocates moderate consumption of milk and dairy products and limiting sugar, alcohol and red meat consumption.

The Arthritis Foundation states that the Mediterranean diet can reduce inflammation and pain and protect against fracture risk in people with osteoarthritis. People following the Mediterranean diet, one of the easiest dietary patterns to adopt and sustain, can also control their weight.

A large study published in Arthritis Research and Theraphy in 2018, involving 1721 patients with rheumatoid arthritis and a control group of 3667 people;

• concluded that people who followed the Mediterranean diet had a lower risk of developing rheumatoid arthritis.

Another study published in The Open Rheumatology in 2018 argues that the high antioxidant content of the Mediterranean diet;

• can reduce pain in patients with rheumatoid arthritis.

Other suggestions that may help people with arthritis;

• Light exercise: Low-intensity exercise such as walking, swimming and cycling helps people stay active without damaging their joints.
• Cooking Methods: Techniques used during cooking can increase or reduce nutrient losses. Steaming instead of boiling, or sautéing with a small amount of oil or grilling instead of deep-frying, can help prevent nutrient losses and provide a healthier way to consume food.
• Sunbathing: Some foods contain small amounts of vitamin D. However, consuming these foods will not be enough to meet requirements. Therefore, sunbathing for 15-20 minutes a day is necessary for adequate vitamin D intake. Vitamin D obtained from sunlight improves bone health by increasing calcium absorption.

Summary / Comment

People with arthritis need to remove or limit foods such as sugar, trans fat and saturated fat that increase inflammation in the body. Limiting purine-rich foods can also be beneficial because they may contribute to worsening symptoms. Vegetables, fruit, unsaturated fats and omega-3 fatty acids have anti-inflammatory effects in the body. Reviewing these recommendations brings us back to the Mediterranean diet, as in the prevention and treatment of many diseases. Many studies argue that the Mediterranean diet improves health and helps reduce inflammation. We can therefore recommend following the Mediterranean diet to improve general health, reduce arthritis risk and help relieve arthritis symptoms.