Most of us would like to lose a bit of weight, improve our diet and get fitter. As a nation we are getting fatter, with levels of obesity more than doubling over the last decade.1 Carrying extra weight not only puts you at increased risk of developing joint pain in the first place it also exacerbates any existing joint symptoms.
The two most common forms of joint pain are osteoarthritis (OA) and rheumatoid arthritis (RA). OA is a disabling condition which is characterised by low grade inflammation and breakdown of cartilage (the tissue that cushions the ends of bones at the joints). In contrast, RA is an autoimmune condition in which the body’s immune system starts attacking its own joint tissues, creating inflammation with swollen, painful and sore joints. In short, arthritis pain hurts, and it can get in the way of doing the kind of things most of us take completely for granted like walking upstairs or opening a jar.
Taking the strain
Carrying extra weight raises your risk of osteoarthritis (OA) in two main ways:
- putting additional pressure and strain on all your weight-bearing joints (particularly the knees but also the hips, back and ankles)
- increasing levels of inflammatory chemicals, produced by fat and liver cells, which contribute to pain in all joints, including non-weight bearing ones such as those found in your hands.
Obviously, the more weight you have bearing down on a joint the more stress you put on it and the more likely it is to become worn down and damaged. New research shows that if you are obese (defined by the NHS as having a body mass index, BMI, of over 30)2 you are four or five times more likely to develop knee osteoarthritis than you are to develop high blood pressure or type 2 diabetes.3
In all cases of arthritis, being overweight or obese will make it worse. Losing weight will reduce that strain on your joints and, in the process, you might find you don’t need to take as many painkillers.4
Many studies have linked being overweight with OA of the hand. As the hands are not weight bearing joints, it appears that inflammatory substances released by fat cells either cause or worsen the damage in these joints. These inflammatory chemicals are also implicated in RA and have been identified as a type of protein called cytokines. These act as cell signalling molecules that stimulate the activity of immune cells involved in inflammatory responses, which is why being overweight can exacerbate an already inflamed condition. The more weight you are carrying, the more fat cells you have and the more inflammation this can cause.
Measure the blood of an obese person and you will find higher levels of inflammatory chemicals than in someone who is not overweight. Lose that weight and those levels of inflammatory cells return to normal.
Food for thought
Unfortunately, many of the factors of a modern lifestyle - like getting little or no exercise and following a diet that is high in sugar and 'bad' fats such as those found in processed foods - appear to make it easier for cells to produce inflammatory cytokines.
While there is no one magical food or supplement that can reduce this inflammation components in some foods may be able to regulate or dampen it down. These components can be found in a typical Mediterranean diet, rich in vegetables and fruit, fish, nuts, seeds, pulses and olive oil has been shown to reduce symptoms of inflammatory conditions like rheumatoid arthritis.
Many people with arthritic conditions find changing their diet improves their symptoms. Evidence also shows that some herbs and spices appear to stimulate anti-inflammatory effects in the body - ginger and turmeric (the root that gives much Indian cooking its distinctive yellow-orange colour) are good examples.
Switch from a diet that is high in processed foods to one containing more healthy and anti-inflammatory foods like omega-3 rich oily fish, nuts and olive oil and plenty of low calorie, nutrient-rich vegetables and fruit and you will probably lose weight without even trying. Nobody becomes overweight overnight and just as fat slowly increased over time, the most sustainable and healthy way to lose it is slowly while ensuring you are getting a varied and nutrient-rich range of food. According to Arthritis Research UK, ‘Most people gain weight gradually often by just eating a few extra calories a day. For example, 100 calories per day more than you burn off will add about 500 g (1 lb) of fat per month. On the other hand, if your food contains fewer calories than you use, your body will burn stored fat and you’ll lose weight.'
It all sounds simple enough – burn more calories than you consume and lose weight - but if it was this easy none of us would be overweight!
Low and slow
If you want to shed a few pounds how you do it largely depends on you – different approaches work for different people. Some have found success with newer dieting trends like intermittent fasting or 5:2, while others prefer high protein, low carbohydrate diets such as New Atkins or the Keto plan. Research shows that those who join a commercial slimming club (like Weight Watchers or Slimming World)5 are more successful at getting the weight off than those who are simply given dietary advice from their GP. Having the encouragement and support of people around you and watching others reach their target weights appears to help spur you on. You can also get online support from the free NHS Weight Loss Guide, a 12 week diet and exercise plan which encourages you to lose an achievable 1lb-2lbs a week.6 And a lighter you will mean you lighten the load on your joints: a 2005 study of overweight and obese adults with OA of the knee found that every 1lb of weight you lose results in 4lbs of load being removed from the knee – when you walk thousands of steps per day, this can have a significant effect on knee pain.7
Eating healthier and losing weight should go a long way to helping reduce joint pain but other lifestyle changes can also contribute. It’s difficult to find something exercise doesn’t help and joint health is no exception. Many people credit yoga and Tai Chi with helping them not just to get fitter and slimmer but also to manage their pain and increase the flexibility in their joints.
Improving your diet should give you the nutrients you need for healthier joints but if you are not getting enough anti-inflammatory oily fish, say, you could get benefit from fish oil supplements. Other supplements which have anti-inflammatory effects include glucosamine, rosehip and turmeric. It is also thought that probiotic foods (like natural yogurt and fermented foods including sauerkraut) or supplements could have a beneficial role in overweight and obese people with inflammatory arthritic diseases.8
If you’re interested in learning more about how to keep your joints healthy, head over to our advice centre for more information.