Joint Pain, Could Your Nutrition Be At Fault?

Joint Pain, Could Your Nutrition Be At Fault?

Moving freely without pain

The ability to move freely without pain, restriction and for some without fear of falling are all significant factors that contribute to living a healthy fulfilling and active lifestyle through lifespan. It therefore makes good sense to pay  attention to joint health and important relationships with the food we eat. Discomfort, pain or inflammation arising from any part of a joint including cartilage, bone, ligaments, tendons or muscles can have a  number of causes that are often related to our own historical and ongoing relationship with both food and exercise.

A common condition affecting many joints is osteoarthritis (OA), which typically affects weight bearing areas including the knees, hips and feet as well as body parts used a lot in everyday life such as the hands and wrists. In the UK, OA is the fastest growing cause of disability where approximately one in 10 adults have symptomatic clinically diagnosed OA, the knee being the commonest.¹ Normally related to a mechanical abnormality, this disease results from the breakdown of cartilage and subchondral bone in joints. People suffering from osteoarthritis typically have symptoms that include pain, stiffness, and tenderness, though joint locking and effusion is often reported. Because there is currently no cure for OA treatment options are generally limited to the pain management and ameliorating the symptoms.

Diet and OA

Diet and OA are often intrinsically linked to our body weight which can therefore be considered a modifiable risk factor for joint health. ^{2 3} Being overweight or obese puts excessive strains on joints above that which would occur due to normal wear and tear associated with ageing. Similarly much of the chronic inflammation and exacerbated symptoms found in these joint conditions, can be related to body fat and ageing⁴ reinforcing a view held here at RRMG that paying particular attention to factors influencing body composition is also key.

Eating a healthy diet is therefore important  to joint health and also the management of painful joint conditions not least through its influence on our body weight, body composition and ability to remain active. RRMG patients benefit from dietary analysis,  lifestyle assessment and subsequent dietary manipulations to redress excess weight, obesity and nutrient imbalances that negatively impact joint health. There also a number of healthy food choices, joint treatment options and exercise prescriptions that can have important roles to play when joint become troubled.

The Mediterranean Diet (MD) has emerged from the traditional cuisines and customs associated with countries bordering the Mediterranean Sea and is seen to have positive outcomes for joint health. Both clinical and experimental studies have found that a MD has health benefits that seem to have some correlation with the actions of nonsteroidal anti-inflammatory drugs (NSAIDs). Using food is always favourable to taking medicines and evidence suggests that the MD diet has a number of anti-inflammatory properties conferred to those who regularly follow this approach to eating. Further, the greater the adherence to a MD the greater the benefits⁵  which can include reduced joint pain as a consequence of its ability to reduce inflammation. MD’s tend to include the consumption of low glycaemic index fruits (e.g., oranges, grapes, apples, blueberries), vegetables, olive oil consumption/high unsaturated fats, a low level of dairy products and red meat, moderate to high level of wild fish and modest alcohol intakes. Olive oil is the ultimate pillar of the MD containing a substance called oleocanthal that possesses strong anti-inflammatory activities once consumed.

Other foods and spices

A wide variety of other foods and spices have anti-inflammatory properties that can further help prevent and ease joint pain caused by inflammation. Omega-3 found in oily fish including salmon, mackerel, Nuts (Walnuts, Pecans), Seeds (Flax, Chia, Mustard) and also available as a supplement have been shown in many studies to have anti-inflammatory actions that can reduce joint pain and inflammation and hence stiffness when consumed in sufficient quality and quantities in the diet. In fact so powerful are these groups of fats that they have also been associated with effective treatments for rheumatoid arthritis, inflammatory bowel disease, and dysmenorrhea⁷. Consuming oily fish has clear benefits for joint health and this may be extended to a supplements called Glucosamine which is made from the shells of crabs, lobsters and shrimp. Although studies have produced mixed results regarding the use of glucosamine in humans, some show that supplementation may be of particular use for people suffering from osteoarthritis of the knee and that it may even contribute to cartilage repair.⁸

Spices not only add flavour to food but also have significant health benefits that extend to our joints and beyond. Numerous results from both preclinical and clinical studies over several decades have demonstrated an efficacious role for spices and their active ingredients in the prevention of diseases including arthritis , asthma, diabetes and more.⁹ Most of us never cook without adding some form of spice and I regularly add a spice mix to my food given a rather wonderful piece of research published a few years ago. In this study a group of researchers created a spice mix of basil, bay leaf, black pepper, cinnamon, coriander, cumin, ginger, oregano, parsley, red pepper, rosemary, thyme, and turmeric. Then they recruited 12 men between the ages of 40 and 65, who suffered from a number of risk factors for cardiovascular disease such as being obese, overweight and to which some had joint pain. Each person ate three versions of a meal high in saturated fat and refined carbohydrates—coconut chicken curry, a corn muffin, and a cinnamon biscuit—on three separate days. One meal had two grams of the spice blend, one had six grams of the mix, and one had no spices at all. Researchers found that after eating the meal that contained six grams of the spice mix, the participants had significantly lower levels of inflammation, both immediately after the meal and four hours later.¹⁰ Consuming a variety of spices including Turmeric and Black Pepper which have been particularly associated with their efficacy for treating joint pains would seem more than sensible. Many of these spices can also be purchased in Joint supplement forms.

Eating a diet rich

Eating a diet rich in fruit and vegetable sources of vitamin C has also been identified as beneficial to joint health, not least because it has been shown to have the ability to prevent and also maintain joints that suffer from OA.⁶  Vitamin C, is an essential to humans and allows the body to make collagen, an important part of cartilage that protects the ends of bones in joints. Additionally Vitamin C is an anti-oxidant helping the body protect joint tissues from unstable molecules that the body produces. Regularly consuming healthy meals that achieve the powerful combination of calcium for bone health, omega-3 and vitamin C, can play an important role in maintaining bone, muscle and ultimately joint health as well as reducing the severity and duration of joint disease related symptoms.

Here at RRMG exercise is considered medicine and appropriate levels of physical activity are also considered central to managing joint health and disease through lifespan which confer even greater benefits when appropriate foods are consumed.

Stay well
Kunle

Dr Kunle Odetoyinbo
Nutrition and Exercise Specialist RRMG
Chartered Scientist
Accredited Sport Science

References

1. Swain S, Sarmanova A, Mallen C, Kuo CF, Coupland C, Doherty M, Zhang W. Trends in incidence and prevalence of osteoarthritis in the United Kingdom: findings from the Clinical Practice Research Datalink (CPRD). Osteoarthritis Cartilage. 2020 Jun;28(6):792-801. doi: 10.1016/j.joca.2020.03.004. Epub 2020 Mar 14. PMID: 32184134.
2. Iannone, F and G Lapadula. “Obesity and inflammation–targets for OA therapy.” Curr Drug Targets. 2010 May;11(5):586-98.
3. Richmond SA, RK Fukuchi, A Ezzat, K Schneider, G Schneider, and CA Emery. “Are joint injury, sport activity, physical activity, obesity, or occupational activities predictors for osteoarthritis? A systematic review.” J Orthop Sports Phys Ther. 2013 Aug;43(8):515-B19.
4. Vo, N, LJ Niedernhofer, LA Nasto, L Jacobs, PD Robbins, J Kang, and CH Evans. “An overview of underlying causes and animal models for the study of age-related degenerative disorders of the spine and synovial joints.” J Orthop Res 2013;31(6):831-837
5. Bonaccio M., Di Castelnuovo A., De Curtis A., Costanzo S., Persichillo M., Donati M.B., Cerletti C.H., Iacoviello L., de Gaetano G., Moli-sani Project Investigators Adherence to the Mediterranean diet is associated with lower platelet and leukocyte counts: Results from the Moli-sani study. 2014;123:3037–3044. doi: 10.1182/blood-2013-12-541672.
6. Carr AC, McCall C. The role of vitamin C in the treatment of pain: new insights. J Transl Med. 2017;15(1):77. doi: 10.1186/s12967-017-1179-7.
7. Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain. 2007 May;129(1-2):210-23. doi: 10.1016/j.pain.2007.01.020. Epub 2007 Mar 1. PMID: 17335973.
8. Sun Y, Wang C, Gong C. Repairing effects of glucosamine sulfate in combination with etoricoxib on articular cartilages of patients with knee osteoarthritis. J Orthop Surg Res. 2020 Apr 16;15(1):150. doi: 10.1186/s13018-020-01648-z. PMID: 32299482; PMCID: PMC7164152.
9. Opara EI, Chohan M. Culinary herbs and spices: their bioactive properties, the contribution of polyphenols and the challenges in deducing their true health benefits. Int J Mol Sci. 2014;15(10):19183–202
10. Ester S Oh, Kristina S Petersen, Penny M Kris-Etherton, Connie J Rogers, Spices in a High-Saturated-Fat, High-Carbohydrate Meal Reduce Postprandial Proinflammatory Cytokine Secretion in Men with Overweight or Obesity: A 3-Period, Crossover, Randomized Controlled Trial, The Journal of Nutrition, Volume 150, Issue 6, June 2020, Pages 1600–1609, https://doi.org/10.1093/jn/nxaa063