Osteoarthritis Diet – Food & Nutrition Guidelines

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Osteoarthritis is a chronic condition that affects the joints. In normal joints, the end of each bone is covered with a firm rubbery material, which is called a ‘cartilage’. This cartilage acts as a cushion between the bones and enables a smooth joint motion. However, in case of osteoarthritis, there is a breakdown of cartilage, thus making the cartilage rough and thin. This further causes pain, inflammation, redness, swelling and restricted motion. As the condition deteriorates, further the edge of the joint may grow outwards and lead to the formation of spurs called osteophytes. The synovium is a thin layer of tissue that lines the joint space may produce excess synovial fluid thus causing the joints to swell.

In extremely severe cases, the cartilage may become so thin that it won’t be able to cover the ends of the bones. During this period, the bones may rub each other when movement takes places leading to unbearable pain and more severe symptoms. Osteoarthritis can affect any joint, but it commonly occurs in big toe, bases of the thumb, small joints of the fingers, lower back and neck, hips and knees.

Osteoarthritis Symptoms

Pain: The intensity of pain increases with the severity of the condition. With each movement of your joint, this pain tends to worsen. For example – climbing stairs becomes extremely difficult for a person with knee osteoarthritis.

Restricted motion: Breakdown of cartilage affects the flexibility of the joints. Thus, movement becomes difficult. One may not be able to move their joint freely.

Stiffness: After a period of rest or inactivity, joints may feel stiff. In normal cases, one can move easily even after period of rest, but in case of osteoarthritis one may take time to move. Such stiffness is usually seen when one wakes up in the morning after resting for 6 to 8 hours.

Bone Spurs: Bone spurs are bony projections that may develop around the affected joint and look like hard lumps.

Grating Sensations: Popping and crackling sounds or sensation may be heard or felt each time when the affected joint is moved.

Risk Factors

Obesity: Obesity is one of the most preventable risk factors for osteoarthritis. Research has found a strong and positive association between body mass index (BMI) and osteoarthritis of knee, hip and hand. Obesity may increase the biomechanical loading and is associated with alterations in the gait (a person’s manner of walking). Obesity is also associated with altered limb alignment, which further leads to osteoarthritis.

Age: One of the greatest risk factor for osteoarthritis is ‘age’, in fact osteoarthritis is also known as an age-related disorder. With increasing age, the changes in the musculoskeletal system also increase. With old age, changes may occur outside the joint such as loss of muscle as well as within the joint such as changes in cells and matrix (extracellular substance of bone) in joint tissues.

Gender: The incidence of osteoporosis is greater in women as compared to men. In addition to this, women are at a higher risk of developing osteoarthritis of knee, hip and hand. Furthermore, research has showed that the risk of developing osteoarthritis in women increases by 3.5 times during menopause. This may be due to some hormonal changes, but there is no strong evidence as of now.

Genetics: Genetic factors are strong determinants of osteoarthritis. The genetic influence of osteoarthritis is 35% to 65%. In addition to this, the incidence of osteoarthritis is greater in an individual with family history of osteoarthritis as compared to those who do not have a family history.

Joint Injury: Joint injury is a common cause of osteoarthritis in young individuals. Participation in sports can increase the risk of joint injuries and can lead to a clinical syndrome called trauma-initiated joint degeneration that leads to permanent and progressive joint pain and dysfunction. Immediate diagnosis, appropriate treatment and certain exercises can reduce joint injuries and the risk of post-traumatic osteoarthritis.

Joint Abnormalities: Presence of joint abnormalities since the child is born or development of such abnormalities in childhood can lead to early osteoarthritis.

Test & Diagnosis

Physical Examination: Your doctor may examine the joints for swelling, stiffness, tenderness, pain and redness. The doctor may further even test the range of motion of the affected joint.

X-rays: X-ray can reveal the presence of narrow space between the bones in the joints. It may also reveal the presence of bone spurs around the joints.

Magnetic Resonance Imaging (MRI): As compared to X-rays, MRI provides a better image of bone as well as the cartilage.

Blood Tests: Blood tests are not necessary and may not be needed to confirm the diagnosis, but they are required to rule out other possible causes.

Dietary & Nutritional Management of Osteoarthritis

Weight Loss

Being overweight or obese is a major risk factor for osteoporosis. Increased body weight puts additional stress on the weight bearing joints. Therefore, it becomes very important to lose weight in order to reduce the risk of osteoporosis. A healthy low calorie diet and regular exercise (after seeking medical advice) will surely promote weight loss and reduce the incidence of osteoporosis.

Read More about Losing Weight: Weight Loss Diet

Increase Intake of Fruits and Vegetables

Different fruits and vegetables are loaded with different antioxidants, thus it becomes important to include these different fruits and vegetables in the daily diet. They reduce inflammation and fight oxidative stress. Include at least 2 to 3 servings of fresh fruits and 3 to 4 servings of vegetables per day.

Add Soy Protein

Supplementing a diet with soy protein has shown to reduce osteoarthritis-associated symptoms such as range of motion, better flexibility, improvement in movement, reduction in several factors associated with pain and thus, improves the overall quality of life. Foods rich in soy protein include:

  1. Tofu
  2. Soy chunks
  3. Soy nuts
  4. Soybean
  5. Soymilk
  6. Soy protein powder can also be added to diet.

Increase Your Intake of Vitamin E

Research has shown that vitamin E may play an important role in protecting against further damage caused in osteoarthritis. Oxidative stress may play an important role in cartilage degeneration related to osteoarthritis. Vitamin E is a potent antioxidant that scavenges the reactive oxygen species and regulates antioxidant enzyme systems. This reduces oxidative stress and prevents further deterioration of the joints. Thus, vitamin E is an effective remedy to reduce free radical mediated deterioration of musculoskeletal tissues in osteoarthritis. Food sources rich in vitamin E include:

  1. Wheat germ
  2. Sunflower seeds
  3. Almonds
  4. Peanuts
  5. Avocado
  6. Spinach
  7. Mustard greens
  8. Beet greens
  9. Swiss chard

Get More Vitamin D

Research has shown that vitamin D may play a small, but beneficial role in osteoarthritis. Vitamin D intake reduces knee pain in individuals with knee osteoarthritis. Evidence further suggests that deficiency of vitamin D may play an important role in the development of knee osteoarthritis. Vitamin D may also improve functional disability. During summer months, getting vitamin D from the sunlight becomes easier. However, it is important to maintain a vitamin D balance by getting it through both sunlight as well as diet. Foods rich in vitamin D include:

  1. Fish such as sardines, tuna and salmon
  2. Shiitake mushroom
  3. Egg
  4. Dairy products

Add More Vitamin K to Your Diet

Poor intake of vitamin K is very common. Studies have showed that low levels of plasma vitamin K are associated with increased risk of osteoarthritis of hand and knee. Therefore, to lower the incidence of osteoarthritis one should consume more vitamin K through diet. Foods rich in vitamin K include:

  1. Spinach
  2. Mustard greens
  3. Beet greens
  4. Kale
  5. Swiss chard
  6. Turnip greens
  7. Broccoli
  8. Brussels sprouts

Add Omega-3 Fatty Acids to Your Diet

Omega-3 fatty acid may reduce the markers of inflammation and thus, reduce pain and improve flexibility. Thus, one can reduce osteoarthritis related symptoms by adding at least 2 servings of fish per week in their diet. Rich sources of omega-3 fatty acid include:

  1. Flaxseeds
  2. Walnuts
  3. Salmon
  4. Mackerel
  5. Trout
  6. Sardines
  7. Herring

Increase Intake of Vitamin C

Vitamin C is a powerful antioxidant that scavenges the free radicals and reduces oxidative stress. Besides this, vitamin C is also required for the production of cartilage and connective tissue. Thus, vitamin C may help to reduce some damage caused by osteoarthritis. Rich food sources of vitamin C include:

  1. Kiwi
  2. Orange
  3. Grapefruit
  4. Berries
  5. Lemon
  6. Broccoli
  7. Cabbage
  8. Bell peppers
  9. Papaya
  10. Parsley

Sample Menu Plan for Osteoarthritis

Meal timingMenuReason behind
Breakfast1 cup herbal tea/ green tea/ ginger tea + 1 bowl porridge made with skim milk (oats/ wheat cracks/ barley) OR 2 boiled egg whites/ 1 whole egg with 2 slices of whole grain or multi-grain breadHerbs are rich in antioxidants and thus help in relieving pain.
Mid-morning1 whole fruit + 4 almondsPrefer whole fruits over fruit juice
Lunch1 bowl salad with 1 teaspoon sunflower seeds + 1 small bowl tofu/ soy/ pulse/ chicken (2 pieces) + 1 serving whole grain cereal (rice or chapatti) + 1 glass buttermilkSunflower seeds are a good source of vitamin E and healthy fat.

Include more soy products if possible

Mid-eveningSoy nuts (fistful)
Evening1 bowl vegetable soup or 1 glass vegetable juice (unstrained)Unstrained vegetable juice and vegetable soup are good sources of antioxidants and a tasty way to add vegetables in your daily diet.
Dinner1 bowl salad with 1 teaspoon flaxseeds seeds and lemon dressing + 1 small bowl tofu/ soy/ pulse/ chicken (2 pieces) + 1 serving whole grain cereal (rice or chapatti) + 1 glass buttermilkInclude more green vegetables in the salad. Lemon dressing will improve the vitamin C content of your diet.
Bedtime1 glass milkCalcium and potassium present in milk help the muscles to relax.


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