Chapter 2
Food, supplements and medication

‘People are more easily convinced of the power of magic, than convinced of the healing power of nutrition.’

The above statement – one I often use to open seminars – is, sadly, very true. Yet you can halt the pain of arthritis by changing the way you eat. In most cases, the difference will be so great it will change your life forever. All that is required for this transformation is the knowledge of which foods to avoid and which to enjoy, and a commitment to staying on the diet long enough to experience its benefits. Once you have experienced the improvement it brings about you will be very reluctant to return to your old ways. The path to success is not easy, however. You will be giving up foods and drinks that are part of most people’s daily lives – for example, coffee, alcohol, bacon, bread and sugary sweets. These changes will be easier if you understand why they are necessary. Use this book as your guide, and you will soon find that you feel better, look better and no longer crave the foods that trigger the pain that once overshadowed your life.

Several years ago a group of women attending a community meeting about nutrition were asked for a show of hands as to how many agreed with the statement: eliminating a single food from the diet can change a person’s health. Less than a third agreed. During the discussion that followed, some people were slightly amused by the question: after all, they ate a ‘healthy’ diet, how could that do them harm? When asked to describe a ‘healthy diet’, it was generally agreed that a healthy diet consisted of foods they ‘had always eaten’. In fact, none of us eats ‘what we have always eaten’. Differences in food production and processing – along with changing cultural influences – have subtly reshaped both the content and nutritional value of the food we eat. A healthy diet entails eating a high proportion of fresh fruits and vegetables, pulses, grains and nuts, and a modest amount of meat.

Many consumers are confused by all the dietary advice provided in the media these days. What should we listen to: old advice that we have followed for years; or new opinions still untested by time? Listen to both, and then ask yourself which makes good sense. If promises made for a wonder food sound too good to be true, they probably are. If someone tells you that a special diet will help control an illness, ask why and how it works. That is why you should take time to read all the information in this book, rather than just trying the recipes. You need to become familiar with your enemy in order to beat it.

Do eggs dangerously increase levels of blood cholesterol? The answer to this question is an example of how conflicting information about the health value of a food arises. Until the medical community became convinced that high levels of blood cholesterol were a significant risk factor in coronary artery disease, eggs were looked upon as a safe and healthy food, ideal for all the family – including infants and the infirm. Then came the theory that the cholesterol contained in foods, such as egg yolk, increases the level of blood cholesterol. As a result, people were advised to reduce their intake of eggs to as few as two per week. Recently, scientific research has established that the cholesterol contained in eggs has very little effect on blood cholesterol: saturated fats, such as those found in red meat, are the culprits. Eggs contain a far lower percentage of saturated fat than a portion of cheese of equal weight and, when enjoyed in moderation, they are an easy-to-eat food, high in the protein and vitamins our bodies need. Produced by free-range hens fed on grain and free of infection, eggs are a welcomed part of breakfast, lunch or dinner. You will see in Parts Three and Four that eggs are very much a part of the Eat to Beat Arthritis Diet.

Basic nutrition

Food is the essential link between your body and the rest of the living world. For optimum health, there is no substitute for a diet based on leafy vegetables, root vegetables, fruits, nuts, seeds, grains and various forms of meat. Eat food in a form as close to its natural state as possible: fresh, raw or lightly cooked, unsalted and without artificial flavours, colours and preservatives. That way, you will be giving your body the nutrients it requires.

Plants contain natural compounds that have healing properties. Ginger, for example, is not only a good source of B-vitamins, magnesium and zinc, but also contains a substance that helps control nausea. Chilli peppers contain a substance that fights pain. (More examples are found here.) So to get the most from your diet, include a wide range of foods from plants, and vary what you eat.

A balanced diet contains a healthy combination of carbohydrates, proteins and fats. It may surprise you to know that international experts recommend a diet containing about 50 per cent carbohydrate, 30 per cent fat and 20 per cent protein. The healthiest carbohydrates come from grains, root vegetables and fruits. Sources of protein should be as low-fat as possible. Red meat (muscle) and full-fat milk products are high in saturated fats, which should be limited to no more than 10 per cent of the total calories consumed. Organ meats such as liver and kidney are relatively low in saturated fats, as are tofu and other plant-protein products.

It is widely believed that fats are bad for us, and that all fats should form a minimal part of a healthy diet. This is not true. Our bodies need fat, and deficiencies in certain fats lead to illness. Fats are a compact source of stored energy. They also aid the absorption of vitamins A, D and E from the gut, and form important parts of cell membranes, hormones and messenger molecules in the body. For good health, enjoy oils obtained from plants, and oily fish. These provide healing substances that people suffering from arthritis need to help fight pain. More is said about this when the omega-3 fatty acids, like those found in fish oil, are discussed. (See here and here.)

If you are a vegetarian, ensure you eat at least one meal a day that combines grain and one or more pulses; for example, rice and beans. All the amino acids (protein building blocks) needed by the human body are found in plants, but not in the combination required by the human body. The amino acids we must obtain from our diet are called essential amino acids, and must be supplied in the same meal. More in-depth information can be found here.

Vegetarians may not benefit from this diet as much as people who eat meat because they will not benefit from the healing properties of liver.

Foods that harm

Things we eat may cause harm in several ways:

float image 1 Some may contain a toxic substance that, eaten in excess, can create metabolic problems in your body.

float image 1 Some may trigger an allergic reaction.

float image 1 Some may cause food sensitivity.

float image 1 Some may aggravate inflammation.

Here are some examples:

Arthritis sufferers, and people concerned about the health of their bones, should be aware that rhubarb contains oxalic acid, which inhibits the body’s ability to absorb calcium and iron from other foods. (The acid is concentrated in the leaves, which are poisonous and should never be eaten.) Rhubarb aggravates gout and rheumatoid arthritis, and may even cause an attack if eaten in excess. It may also increase the risk of kidney stones in some patients. If you cook rhubarb, do not use aluminium pans, as the acid juice dissolves aluminium from the surface, leaving it in the food for you to eat. Aluminium may be harmful to the body. Rhubarb is not the only plant containing oxalic acid. Smaller amounts are found in spinach, sorrel and chocolate.

Certain foods can trigger an allergic reaction – some people are allergic to nuts, for example. Seafood, especially lobster and prawns, may also cause problems.

This is a good opportunity to talk about the difference between an allergic reaction and food sensitivity (also known as food intolerance). These two conditions are frequently confused.

An allergic reaction is a serious matter that has immediate consequences. It is caused when the body’s immune system has built up antibodies to one or more substances in a particular food. Symptoms include hives (urticaria), severe breathing difficulty, rash, swelling of the tongue and throat, and – in extreme cases – shock and death. Tingling of the lips and mouth after eating a particular food is a sign that an allergy to a particular food may be developing. If you experience such a response to a specific food, obviously it is prudent to avoid it.

Food sensitivity, or intolerance, is far less dramatic, but can cause serious symptoms that may vary from person to person. Migraine headaches, nausea, indigestion, eczema, stomach upset and hyperactivity have all been linked with food sensitivity. Symptoms do not appear with the speed seen in allergic reactions, and it is frequently difficult to identify the exact cause of the problem. In order to identify which food is causing the symptoms, an elimination diet is usually necessary.

For a few days the sufferer is placed on a diet based on foods known to cause little, if any, intolerance. This gives the body time to rid itself of substances that may be causing the problem. Following this rest period, other foods are introduced one at a time. Most will cause no recurrence of symptoms, and thereafter can be safely added to the diet. As more foods are introduced, almost inevitably one new item will cause symptoms to reappear. When this occurs, the culprit (or one of them) has been identified and the person on the exclusion diet will know to avoid that food in the future.

The Eat to Beat Arthritis Diet includes an elimination diet that should help you identify your sensitivity to foods that can trigger, or increase, the painful inflammation of arthritis.

Certain foods known to cause sensitivity are eliminated from the Eat to Beat Arthritis Diet. These are:

ALL PRODUCTS MADE WITH WHEAT AND OTHER GRAINS CONTAINING THE PROTEIN GLUTEN (RYE, BARLEY AND OATS)

More is said about this later (see here). For the moment, however, you need only be aware that gluten is often the cause of health problems ranging from migraine headaches to coeliac disease – a debilitating condition characterized by diarrhoea, bloating, and even anaemia. Coeliac disease can cause serious problems in some people, and even mimic the symptoms of certain forms of cancer.

Cutting out gluten will improve your general health and nutritional status. It will also help control the inflammation that causes much of the pain of arthritis.

ALL FOOD AND DRINK CONTAINING CAFFEINE

Some experts believe that caffeine increases the swelling and pain of inflammation. Many people find that removing this one source of trouble from their diet dramatically improves their life.

ALL PROCESSED FOODS, INCLUDING SALTED AND PRESERVED MEATS

Removing processed foods from your diet may seem daunting, but the rewards are great. You will be eliminating major sources of additives and unnatural chemicals from your body. You will be choosing not to eat foods that have been milled, stewed, or baked to the point that all the precious nutrients they once contained have been removed. And you will be leaving room in your diet for foods that are full of natural flavour and nutrition.

If you have gouty arthritis, the problem of diet becomes more complicated because liver and all other forms of offal should be avoided.

Foods that heal

How can something as basic as food heal? How can it be true that simply by changing the content of your dinner plate you can beat illness and heal damaged tissues?

Nothing in your body is static. Every moment of every day billions of cells are in constant change. They form, fill with molecules that conduct the chemical processes of life, and eventually die. It is said that over the course of seven years every molecule in the body is replaced. What we eat, and therefore supply to the body to reconstruct itself, determines its health and strength in the future.

When illness or injury damages the body, eating foods rich in the nutrients needed to replace and rebuild tissues promotes healing. When arthritis is present the nutrients most needed are protein; the B-vitamins, plus folic acid and biotin; vitamins C, E, B12, and D; the minerals selenium, manganese, iron, calcium and zinc; and certain specific fats known as omega-3 fatty acids.

The foods rich in these nutrients that form the basis of the Eat to Beat Arthritis Diet are:

float image 1 Liver: polyunsaturated fats, vitamin A, vitamin B2 (riboflavin), vitamin B3 (niacin), vitamin B5 (pantothenic acid), vitamin B12 (cobalamin), folic acid, biotin, selenium, copper

float image 1 Kidney: vitamin A, vitamin B2 (riboflavin), selenium, copper

float image 1 Milk and dairy products: calcium, zinc

float image 1 Black treacle (molasses): calcium, magnesium, zinc, iron

float image 1 Brewers’ yeast: vitamin B1 (thiamin), vitamin B5 (pantothenic acid), vitamin B12 (cobalamin), folic acid, biotin, copper, magnesium, zinc

float image 1 Oily fish: omega-3 essential fatty acids, vitamin A,

float image 1 Vegetable oils: vitamin E, omega-3 essential fatty acids

float image 1 Nuts and seeds: vitamin E, manganese, magnesium, copper (omega-3 fatty acids are found in walnuts)

float image 1 Fresh fruit and vegetables: vitamin C, manganese

(More about healing foods can be found here and here.)

People with gout should enjoy celery and cherries several times a week. Both are thought to contain compounds that help the body eliminate uric acid. Celery also contains an anti-inflammatory substance.

Most of these nutrients play numerous roles in human metabolism. It is unnecessary to know all the details, but the following list identifies the specific role that makes them appropriate for arthritis sufferers:

float image 1 Vitamin A is needed for normal function of the immune system, and the control of inflammation.

float image 1 B-vitamins help maintain a healthy nervous system and fight depression.

float image 1 Vitamin C is needed to build collagen required for healthy tissues, including tendons and joints; it is also a strong antioxidant and fights damage by free radicals.

float image 1 Folic acid is needed for the normal absorption of other nutrients from the gut.

float image 1 Vitamin D plays a vital role in normal formation of bone.

float image 1 Vitamin E helps fight the oxidation of essential fatty acids in the body, thus reducing the symptoms of inflammation.

float image 1 Selenium is a strong antioxidant and helps protect against free-radical damage.

float image 1 Magnesium is an important component of bone.

float image 1 Manganese is vital for the normal formation of tissues in joints and bone.

float image 1 Zinc is essential for a normal immune system.

float image 1 Copper is needed for normal connective tissue and bones; it also helps protect against damage caused by free radicals and acts as an anti-inflammatory agent.

float image 1 Omega-3 fatty acids (as found in fish oil, hemp oil and walnuts) help control the inflammation, swelling and pain of arthritis.

The Eat to Beat Arthritis Diet recommends including frequent servings of offal such as liver, sweetbreads, heart and tripe. These are low-fat sources of protein that supply all the amino acids needed for healthy tissue. Sweetbreads contain useful amounts of important minerals, but not in quantities as large as those found in liver and kidney. Tripe and heart are good sources of low-fat protein, but contain smaller amounts of healing nutrients.

The BSE crisis in Europe forced the removal of many fine products from the market, and sweetbreads are among them. Very few stores now stock them, but a few organic meat producers have earned the right to sell these delicious morsels again. They are expensive, but when cooked correctly are delicious delicacies.

People with osteoarthritis will benefit significantly from eating foods rich in vitamin B12. The best source of these nutrients are the healthy bacteria in your own gut, but food sources are also available: liver and other animal proteins are a rich source, and play an important role in the Eat to Beat Arthritis Diet. If you are a vegetarian, vitamin B12 will be difficult for you to obtain from your diet. Plant sources include mushrooms and parsley. Certain fermented foods, such as tempeh and fermented black beans, contain a high bacterial count that insures they are a good source of vitamin B12.

PLANTS WITH HEALING POTENTIAL FOR ARTHRITIS SUFFERERS

float image 1 All fruits, except citrus, cranberries and plums.

float image 1 All green vegetables, except rhubarb and spinach.

float image 1 Broccoli, cauliflower, kale and cabbage are excellent sources of substances that fight cancer. (People with thyroid problems should limit their intake of these foods.)

float image 1 All root vegetables, with the exception of true potatoes. Sweet potatoes and yams are excellent for you, and full of texture and taste, as are Jerusalem artichokes and parsnips.

float image 1 Onions, garlic, leeks and shallots.

float image 1 Sprouted grains, beans and seeds. Mung beans and alfalfa are good. Sprouted brown rice is nice in a salad or stir-fries.

float image 1 Spices, especially turmeric and cinnamon.

float image 1 Seaweed, especially kelp, kombu and nori.

float image 1 All pulses (legumes), including aduki beans, black beans, soya beans, lentils, peas, chickpeas (garbanzo beans) and kidney beans. (People with gout should limit their intake of these foods.)

float image 1 Gluten-free grains: maize, millet, wild rice, brown rice, quinoa, buckwheat (kasha), amaranth. Avoid all products made with wheat, rye, barley or oats.

Dietary supplements and medications

The past ten years have seen a considerable increase in the number of medications available to treat all forms of arthritis. (The more frequently used of these are discussed here.) Although many people find these a primary avenue of relief from arthritis, they all carry some risk of side effects. The NSAIDS (non-steroidal anti-inflammatory drugs) can irritate the lining of the stomach and in some cases can cause ulcers when used over a long period. Commonly used NSAIDS include aspirin and ibuprofen. Treating arthritic symptoms by altering your dietary habits carries none of these risks.

The following dietary supplements have been shown to have special healing properties that counter the effects of both rheumatoid and osteoarthritis:

Vitamin E is one of the most powerful natural antioxidants identified to date. It works best when combined with vitamin C and the mineral selenium, both of which are well known for their antioxidant properties. Scientific studies have shown that people with rheumatoid arthritis have lower blood levels of antioxidants than others, and there is growing interest in what this means for the treatment of the disease. In a controlled study of osteoarthritis patients with knee and hip joint problems, 400mg of vitamin E was shown to be as effective in controlling symptoms as 50mg of Diclofenac, a medication classified as an NSAID. The effects of the NSAID were faster, but it produced more side effects than vitamin E. As pain relief over time was comparable, vitamin E was thought to be the treatment of choice.

Another study showed that rheumatoid arthritis patients treated with vitamin E had less pain and improved symptoms when treated over a three-month period. Vitamin E can be taken in large quantities with little risk of side effects.

Fish oil supplements are an important source of omega-3 essential fatty acids, and part of the Eat to Beat Arthritis Diet. You can read more about this subject here. If you are a vegetarian, or cannot tolerate fish oil, try flaxseed oil instead. This is another rich source of omega-3 fatty acids, although they are in their original plant form, and have not been through the metabolic processes that produce the DHA and EPA fatty acids known to be deposited in the flesh of oily fish. These specific fatty acids are necessary for the body’s production of small hormone-like molecules with strong anti-inflammatory properties, known as prostaglandins. Many people suffering from inflammatory illnesses experience dramatic effects when they supplement their diets with a fish or flaxseed oil supplement. For maximum benefit:

float image 1 Do not mix fish oil and other fatty acid supplements. Take omega-6 supplements (evening primrose oil or borage oil) at a different time of day.

float image 1 Make sure you take a vitamin E supplement, as this protects the omega-acids.

float image 1 Keep any opened bottles of supplements in the refrigerator or other cool place.

Note: there is a difference between fish oil and fish liver oil. Liver oils contain substantial quantities of vitamin A, which is stored in your liver and can be toxic if taken in large amounts. If you are setting out on this diet, it is recommended that you use fish oil supplements.

Flaxseed oil is the richest known source of omega-3 fatty acids, and also contains substantial amounts of omega-6 fatty acids. It also contains plant chemicals known as lignins, which are plant estrogens that help control the body’s estrogen level. Lignins are also believed to have other biological effects, including anti-viral and anti-bacterial activities.

Glucosamine and chondroitin are naturally occurring substances in the body that act as a building block in many tissues. Of the two, better curative effects have been demonstrated by glucosamine than by chondroitin, so it is suggested that this is the supplement of choice. Sometimes called the ‘basement membrane builder’, glucosamine is an essential substance in manufacturing and maintaining the ligaments, tendons, cartilage and synovial fluid found in joints. More detailed information on glucosamine and how it is thought to work can be found on page here.