Arthritis Sufferers Benefit From Low-Fat Diet

Can diet cure arthritis, a disease that afflicts one of every six Americans?

No, authorities say - particularly not the “miracle diets” advertised in magazines and supermarket tabloids. But what you eat can have an effect.

“There’s a lot of serious scientific work directed toward the interplay of diet and arthritis,” says Dr. David Pisetsky, professor of medicine at Duke University Medical Center and an adviser to the Arthritis Foundation.

As it turns out, he says, the best diet to relieve various forms of arthritis is the same low-fat, high-carbohydrate regimen beneficial against heart disease, cancer and other chronic ailments.

On a broad scale, research is showing that obesity, especially over many years, contributes to stress on joints and to the development of osteoarthritis, one of arthritis’ most common forms.

More specifically, in cases of rheumatoid and other inflammatory arthritis, saturated fats in the diet actually can aggravate the disease, says Pisetsky. Some newer research indicates that too much protein also may increase inflammation in the joints.

In general, arthritis falls into two broad categories, Pisetsky says: inflammatory and non-inflammatory.

The most common form of non-inflammatory joint distress is osteoarthritis, in which the cartilage breaks down or degenerates over time. Types of inflammatory arthritis, including rheumatoid, affect the lining of the joints, he says. Inflammation occurs because of damage to the cartilage from injury or as a reaction to some as-yet-undetected infection, perhaps from a virus or bacteria lodged in the joint.

Some benefits of a good diet and exercise are general. Because cartilage doesn’t have its own blood supply, it gets nutrients from fluids that flow through it. Regular exercise of the less-strenuous cardiovascular sort, such as walking, swimming and bicycling, promotes the influx of those fluids and is good for building muscle mass.

There is evidence that diet can be helpful for inflammatory forms of arthritis, but the situation is complex, says Pisetsky.

“Research shows that dietary intake of fat affects the production of prostaglandins, which promote inflammation,” he says. Prostaglandins actually are responding to what your body senses as an injury or infection. They also indirectly promote weakening of the bone and loss of cartilage, and they may add to tissue destruction, he says.

“What seems to be the worst, as far as production of prostaglandins are concerned, is the saturated fats.”

Although the evidence is not fully in, a diet low in fat or in which the fats are fish oils may minimize the inflammation process, says Pisetsky. In experimental studies, at least, the substitution of unsaturated fats for more saturated fats leads to clinical improvement in arthritis.

The amount of meat arthritis patients eat should be no more than the size of two decks of playing cards, Pisetsky says, adding: “And it is better if those two decks are marine-based rather than land-based protein.

“I also recommend eliminating butter and whole milk, but calcium is important. Just get it in its lowest fat form, such as skim milk, and keep animal protein to a limited amount.”

With gout, another form of arthritis that results from an overproduction of uric acid crystals, dietary recommendations call for reducing or eliminating foods high in purines, such as liver, sweetbreads, mussels, fish roe, anchovies and sardines.

Also, if you have gout, you probably should not drink alcohol at all because it can raise uric acid levels in the blood. As gout often affects the obese, weight reduction is always recommended, Pisetsky says.

Because arthritis is so common, yet so difficult to treat, many alternative remedies have been proposed. Some people believe that certain foods cause arthritis while others prevent it, so the temptation to follow this or that type of diet is great, says Pisetsky.

Profit-minded entrepreneurs have been quick to cash in. All types of diets for arthritis are common in books, magazines and the tabloids. “I don’t find the scientific evidence compelling in any of these,” Pisetsky says.

More frustrating, it still is difficult to say what level of benefit there is in pursuing a diet low in fat and low in saturated fat as Pisetsky advises.

“The prescriptions can only be looked at over a long period of time,” he says.

“But besides arthritis, several conditions are worsened by high-fat diets - heart disease, cancer, diabetes - so reducing fat makes good medical sense regardless of its effects on arthritis.”

When the body is sick with rheumatoid and inflammatory arthritis, weight loss can result, Pisetsky says.

Many people with these conditions are thin and need a diet that is not restricted in calories and will promote weight gain.

But limited saturated fats are still a good prescription, he says.