Dr. Sarah Brewer September 20, 2018

Here’s some food for thought: the meals you eat contribute to your joint health. With that in mind, what can you eat to stay flexible?

What you eat is as important for keeping fit and healthy as exercise, so your diet is the first port of call if you start to get joint aches and pains. Whether you’re just trying to maintain healthy joints or simply to take pressure off your aching bones, here are some tips to keep you in top shape.

You are what you eat

If you eat a lot of processed foods, your joints are likely to suffer; an unhealthy lifestyle can promote inflammation which increases stiffness and decreases flexibility, making it harder to move around on a day-to-day basis. Here are some foods that may help you regain your flexibility and lessen inflammation.

Mediterranean diet

The Mediterranean diet is the subject of many studies about health benefits, many of which have shown the diet has positive effects on health.1, 2 The Mediterranean way of eating helps to reduce inflammation throughout the body, reducing the risk not only of coronary heart disease and diabetes, but also slowing the progression of arthritis.3, 4 The Arthritis Foundation has praised the Mediterranean diet as the 'Ultimate Arthritis diet' as studies have found it helps to lower blood pressure, protect against chronic conditions, curb inflammation and leads to weight loss which also benefits your joints.

The Mediterranean diet involves eating locally grown fruits and vegetables, healthy unsaturated fats such as those found in olive oil and nuts, whole grains and some fish, complemented by a modest amount of red wine. The diet is also relatively low in dairy, sugar and red meat. Find out more about the Mediterranean diet and how you can try it at home.

Fruit and vegetables

The Arthritis Foundation recommends nine portions of fruit and vegetables daily as part of the 'Arthritis Diet' or the Mediterranean diet as they’re full of antioxidants which help to suppress inflammation.

Citrus fruits are rich in vitamin C which helps maintain healthy joints, while research shows that vitamin K can help reduce inflammatory markers.6 You can increase your vitamin K intake through vegetables like broccoli, spinach, lettuce, kale and cabbage.

Olive oil

Olive oil has anti-inflammatory properties;7, 8 some scientists estimate that oleocanthal, an antioxidant that gives extra virgin olive oil its bitterness, works in a similar way to the non-steroidal anti-inflammatory drug, ibuprofen, which is often prescribed to treat arthritis pain and inflammation.

Fish

Eating at least two portions of oily fish is recommended every week to get enough omega-3, for health benefits. Many studies have concluded that there is a consistently strong link between higher omega-3 intake and reduced inflammation.9, 10, 11, 12, 13

If you’re not a fan of eating fish, then taking an omega-3 supplement will help you reach the recommended intake of at least 450mg long-cahin omega-3 (EPA and DHA) per day.

Red wine

Red wine contains an antioxidant called resveratrol which has been linked to many different health benefits, including a reduction of inflammation.14, 15, 16 However, too much red wine can increase inflammation due to the presence of substances called biogenic amines. A commonly suggested intake that maximises the benefits while minimising the health risks associated with excess alcohol is to drink just one glass of red wine per day. Within the Mediterranean diet, wine is mainly enjoyed with food, rather than on its own, too.

Water

Muscles are largely composed of water which, surprisingly, makes up 75% of muscle weight as it's key for muscle elasticity. Similarly, water is important for maintaining the flexibility of joint cartilage and your joints' lubricating synovial fluid. Continuing to hydrate throughout the day is better than waiting to become thirsty to maintain flexibility.

Herbs and Spices

Turmeric is a common feature in Asian foods, and its distinctive orange-yellow colour, that is especially used in curries, provides a warm, bitter, pepper-like flavour. This spice has been used in traditional medicine for thousands of years and is now increasingly used as a therapeutic herbal remedy due to its beneficial properties.17

Turmeric has anti-inflammatory affects and fights inflammation at a molecular level; turmeric contains curcumin which suppresses the production of immune chemicals such as TNF-alpha, to reduce pain and swelling.18, 19, 20, 21

Some turmeric supplements have added vitamin C to further support your immune health and collagen formation for the normal function of bones and cartilage; if you are going to supplement, make sure to thoroughly research and make the right decision for you.

Foods to avoid

Many foods will promote inflammation rather than decreasing your discomfort and avoiding these may give you a better chance at increasing flexibility and lessening pain.

Fried and processed foods

Researchers from the Mount Sinai School of Medicine report that cutting back on the consumption of processed and fried foods can reduce inflammation and aid in restoring the body’s natural defences.22 Avoid 'convenience foods' like microwave meals or ready meals, white bread, cakes and biscuits.

Sugar based foods

Consuming a high-sugar diet drives inflammation.23 So, avoiding foods like sweets, processed foods and fizzy drinks will help keep your inflammation under control; swap them out for different fruits to satisfy your sugar craving.

Trans fats

Studies have shown that trans fats (formed during artificial hydrogenation of oils to solidify them) are an important driver of inflammation,24, 25 so the more you eat, the more likely your joints will become inflamed and sore. Although trans-fat is naturally occurring in dairy and meat, these natural versions are less associated with harm. It’s the artificial trans-fats found in cakes, biscuits, margarine, microwave popcorn, fried fast foods, frozen pizza and other foods with a short shelf-life that you need to avoid. Check labels for any listing of trans fats, hydrogenated fats or hydrogenated vegetable oils – these are best avoided if you have stiff or painful joints.


References
1Sköldstam, L., Hagfors, L. and Johansson, G. (2003). An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis, Annals of the rheumatic diseases, 62(3), pp.208-214
2Hagen, K.B., Byfuglien, M.G., Falzon, L., Olsen, S.U. and Smedslund, G. (2009). Dietary interventions for rheumatoid arthritis, Cochrane Database Syst Rev, 1
3Casas, R., Sacanella, E., Urpí-Sardà, M., Chiva-Blanch, G., Ros, E., Martínez-González, M., Covas, M., Salas-Salvadó, J., Fiol, M., Arós, F. and Estruch, R. (2014). The Effects of the Mediterranean Diet on Biomarkers of Vascular Wall Inflammation and Plaque Vulnerability in Subjects with High Risk for Cardiovascular Disease. A Randomized Trial, PLoS ONE, 9(6), p.e100084
4Koloverou, E., Panagiotakos, D.B., Pitsavos, C., Chrysohoou, C., Georgousopoulou, E.N., Grekas, A., Christou, A., Chatzigeorgiou, M., Skoumas, I., Tousoulis, D. and Stefanadis, C. (2016). Adherence to Mediterranean diet and 10-year incidence (2002–2012) of diabetes: correlations with inflammatory and oxidative stress biomarkers in the ATTICA cohort study, Diabetes/metabolism research and reviews, 32(1), pp.73-81
5Oliviero, F., Spinella, P., Fiocco, U., Ramonda, R., Sfriso, P. and Punzi, L. (2015). How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis, Swiss Med Wkly, 145, p.w14190
6Pearson, D.A. (2007). Bone health and osteoporosis: the role of vitamin K and potential antagonism by anticoagulants, Nutrition in Clinical Practice, 22(5), pp.517-544
7Basu, A., Devaraj, S. and Jialal, I. (2006). Dietary factors that promote or retard inflammation, Arteriosclerosis, thrombosis, and vascular biology, 26(5), pp.995-1001
8Yoneyama, S., Miura, K., Sasaki, S., Yoshita, K., Morikawa, Y., Ishizaki, M., Kido, T., Naruse, Y. and Nakagawa, H. (2007). Dietary intake of fatty acids and serum C-reactive protein in Japanese, Journal of epidemiology, 17(3), pp.86-92
9Calder, P.C., (2006). n− 3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases, The American journal of clinical nutrition, 83(6), pp.1505S-1519S
10Li, H., Ruan, X.Z., Powis, S.H., Fernando, R., Mon, W.Y., Wheeler, D.C., Moorhead, J.F. and Varghese, Z. (2005). EPA and DHA reduce LPS-induced inflammation responses in HK-2 cells: Evidence for a PPAR-γ–dependent mechanism, Kidney international, 67(3), pp.867-874
11Kiecolt-Glaser, J.K., Belury, M.A., Andridge, R., Malarkey, W.B. and Glaser, R. (2011). Omega-3 supplementation lowers inflammation and anxiety in medical students: a randomized controlled trial, Brain, behavior, and immunity, 25(8), pp.1725-1734
12Li, K., Huang, T., Zheng, J., Wu, K. and Li, D., 2014. Effect of marine-derived n-3 polyunsaturated fatty acids on C-reactive protein, interleukin 6 and tumor necrosis factor α: a meta-analysis, PloS one, 9(2), p.e88103
13Simopoulos, A.P. (2002). Omega-3 fatty acids in inflammation and autoimmune diseases, Journal of the American College of nutrition, 21(6), pp.495-505
14Das, D.K., Mukherjee, S. and Ray, D., (2011). Erratum to: resveratrol and red wine, healthy heart and longevity, Heart failure reviews, 16(4), pp.425-435
15Bagchi, D., Das, D.K., Tosaki, A., Bagchi, M. and Kothari, S.C. (2001). Benefits of resveratrol in women's health, Drugs under experimental and clinical research, 27(5-6), pp.233-248
16Brown, L., Kroon, P.A., Das, D.K., Das, S., Tosaki, A., Chan, V., Singer, M.V. and Feick, P. (2009). The biological responses to resveratrol and other polyphenols from alcoholic beverages, Alcoholism: Clinical and Experimental Research, 33(9), pp.1513-1523
17Funk, J., Frye, J., Oyarzo, J., Kuscuoglu, N., Wilson, J., McCaffrey, G., Stafford, G., Chen, G., Lantz, R., Jolad, S., Sólyom, A., Kiela, P. and Timmermann, B. (2006). Efficacy and mechanism of action of turmeric supplements in the treatment of experimental arthritis, Arthritis & Rheumatism, 54(11), pp.3452-3464
18Singh, S. and Aggarwal, B.B., (1995). Activation of transcription factor NF-κB is suppressed by curcumin (diferuloylmethane), Journal of Biological Chemistry, 270(42), pp.24995-25000
19Goel, A., Boland, C. and Chauhan, D. (2001). Specific inhibition of cyclooxygenase-2 (COX-2) expression by dietary curcumin in HT-29 human colon cancer cells, Cancer Letters, 172(2), pp.111-118
20Aggarwal, B. and Harikumar, K. (2009). Potential therapeutic effects of curcumin, the anti-inflammatory agent, against neurodegenerative, cardiovascular, pulmonary, metabolic, autoimmune and neoplastic diseases, The International Journal of Biochemistry & Cell Biology, 41(1), pp.40-59
21Akhtar, N. and Haqqi, T. (2012). Current nutraceuticals in the management of osteoarthritis: a review, Therapeutic Advances in Musculoskeletal Disease, 4(3), pp.181-207
22Vlassara, H., Cai, W., Goodman, S., Pyzik, R., Yong, A., Chen, X., Zhu, L., Neade, T., Beeri, M., Silverman, J., Ferrucci, L., Tansman, L., Striker, G. and Uribarri, J. (2009). Protection against Loss of Innate Defenses in Adulthood by Low Advanced Glycation End Products (AGE) Intake: Role of the Anti-inflammatory AGE Receptor-1, The Journal of Clinical Endocrinology & Metabolism, 94(11), pp.4483-4491
23Hu, Y., Costenbader, K.H., Gao, X., Al-Daabil, M., Sparks, J.A., Solomon, D.H., Hu, F.B., Karlson, E.W. and Lu, B., (2014). Sugar-sweetened soda consumption and risk of developing rheumatoid arthritis in women, The American journal of clinical nutrition, 100(3), pp.959-967
24Han, S.N., Leka, L.S., Lichtenstein, A.H., Ausman, L.M., Schaefer, E.J. and Meydani, S.N., (2002). Effect of hydrogenated and saturated, relative to polyunsaturated, fat on immune and inflammatory responses of adults with moderate hypercholesterolemia, Journal of lipid research, 43(3), pp.445-452
25Baer, D.J., Judd, J.T., Clevidence, B.A. and Tracy, R.P., (2004). Dietary fatty acids affect plasma markers of inflammation in healthy men fed controlled diets: a randomized crossover study, The American journal of clinical nutrition, 79(6), pp.969-973

Nothing beats a healthy, balanced diet to provide all the nutrients we need. But when this isn't possible, supplements can help. This article isn't intended to replace medical advice. Please consult your healthcare professional before trying supplements or herbal medicines.

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