Painful joints afflict around 13 million people
in the UK, according to the Arthritis Research Council. In fact, so
common is the condition, that many people think joint problems are
inevitable.
Arthritis is neither an inherited condition nor inevitable with
age. In fact, joint health is more to do with our diet (nurture)
than our genes (nature). Arthritis is an inflammatory condition
linked to toxic free radicals and although conventional treatments,
such as non-steroidal anti-inflammatory drugs (NSAIDs), bring
symptomatic relief, they do not reverse arthritic pathology and are
common causes of stomach irritation and bleeding. For healthy
joints we need to eat the right foods and to exercise regularly to
conserve mobility1.
DIET
Shown below are the five elements of a healthy diet. Two of
these are particularly important to reduce the body’s
inflammatory tendency and prevent age-related joint problems:
- Antioxidants (from fruit and vegetables) to neutralise free
radicals. Fruit and vegetables provide us with vitamin C plus a
whole armoury of other antioxidants, such as the carotenoids and
flavonoids, which work together as a network to tackle toxic free
radicals.
- Balance of the omega 6:3 ratio of essential fatty acids. The
importance of the omega 3 fatty acids in heart, brain and joint
health cannot be overstated, so I will be brief. If the intake of
the seed oils, rich in omega 6 fatty acids is high compared with
that of omega 3, then inflammation often results. Oils rich in
omega 6 fatty acids include sunflower, corn (maize), grape seed and
safflower. Choose instead oils that are rich in monounsaturated
fats, such as olive oil, rapeseed, avocado, almond, and most nut
oils. These are low in omega 6 essential fatty acids and are
therefore recommended to replace the omega 6-rich oils.
The five elements of a
healthy diet:
- 5 portions of fruit and vegetables per day.
- 3 portions of whole-grain products per day.
- 3 portions of dairy products per day.
- A balance of essential oils; two-three portions of oily fish
per week, olive oil and olive oil products instead of sunflower oil
and products derived from it.
- Plenty of fluid.
SUPPLEMENTS:
OMEGA 3 AND ANTIOXIDANTS
Even if you regularly eat oily fish, taking a supplement of
omega 3 fish oil is recommended if you are concerned about joint
health. Vegetarians can take flaxseed oil, from which the body
synthesises EPA (one of two omega 3 fatty acids required by it) and
they can now get DHA supplements (the other omega 3 fatty acid
required) which is extracted from algae. People with arthritis or
joint problems who do not eat enough fruit and vegetables should
also take extra vitamin C.
GLUCOSAMINE
These days, it is rare to find any practitioner – orthodox
or holistic – who does not recommend glucosamine to a patient
with arthritis, because the evidence for its effectiveness is
overwhelming2. Glucosamine is a metabolite, made in the
body, but as we get older, less is produced and as a result, joint
health suffers. As scientific evidence from recent clinical trials
also supports supplementary chondroitin for joint health, there is
an added benefit from taking a supplement of glucosamine plus
chondroitin.
HERBAL STRATEGIES
Bromelain comes from the stem of the pineapple plant and
contains enzymes with anti-inflammatory effects, which are absorbed
into the bloodstream.
A few years ago, along with colleagues at the University of
Reading, I conducted a clinical trial to investigate the effects of
bromelain on acute knee pain3. We recruited 80 subjects
who had had knee pain for less than three months. We divided them
randomly into two groups to take either one or two tablets of
bromelain per day for one month. At the end of that time there was
improvement in knee health in both groups, but a stronger effect
among those taking two tablets a day. In my opinion, bromelain
should be considered as the first-line treatment for acute (sudden)
joint pain. It also appears to be very useful for speeding up the
healing of muscle damage (tears etc). Turmeric is a strong
anti-inflammatory agent and is often included in
practitioners’ prescriptions. Ginger may have a role in joint
health. Again, it is an anti-inflammatory agent, but, in addition,
it improves the circulation – an important consideration in
holistic, multi-faceted therapy. Devil’s Claw. This is
another anti-inflammatory agent with good research support and it
is also a muscle relaxant. It is for this reason that it is often
used for back pain, where arthritis can lead to muscle spasm.
(Herbal practitioners often use Devil’s Claw in prescriptions
for both osteo and rheumatoid arthritis, irrespective of location
in the body). While a herbal practitioner would use a mixture of
antiinflammatory herbs for treating arthritis4, in many
cases, preparations of single herbs taken as tablets can be helpful
for minor joint problems.
A MULTI-FACETED APPROACH TO REGAINING JOINT
HEALTH
From my experience of dealing with patients with osteoarthritis,
I can say this – natural medicine works. However, the greater
the pathology (ie the worse the condition), the greater the
‘intervention’ needs to be. Arthritis, with sufficient
pathology to show up on X-ray, is unlikely to respond to a single
supplement. On the contrary, a combination of a change in diet,
nutrient supplementation and herbal support is needed. In fact, it
never ceases to amaze me what can be achieved through diet and
supplementation. A patient came to see me before Christmas with
severe debilitating pain in his left hip. An X-ray taken at his
local hospital had shown osteoarthritis and he was to be reviewed
in five months’ time for hip replacement. He assiduously
followed a dietary regime plus multi-nutrient and herbal
supplementation and by June reported full hip mobility with only
residual pain and indefinite postponement of his hip operation.
1 Reader’s Digest. (2005) Foods
that harm, foods that heal. ISBN 0-276-42673-8.
2 Richy F et al. (2003). Arch Intern Med 163,1514.
3 Walker AF et al. (2002). Phytomedicine. 2002,
9:681.
4 Mills S, Bone K (2000). Principles and Practice of
Phytotherapy: Modern Herbal Medicine. ISBN
0-443-06016-9.
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