Eating Right with Arthritis: Arthritis Nutrition FAQs

A Public and Patient Education Department Program presentation


Laura Allman, RD
Nutritionist, Food and Nutrition Services Department
Hospital for Special Surgery

How can following a proper diet help my arthritis?

Researchers continue to look at the role diet plays in arthritis. While evidence is accumulating, anyone with arthritis can benefit from a diet that provides adequate macronutrients and micronutrients to prevent deficiencies. Some examples of these nutrients include vitamins, minerals, proteins and carbohydrates. Doctors recommend a balanced diet with variety and moderation.

Is weight management important in helping with my arthritis?

Yes, weight management can help lower cholesterol and blood pressure. Having a healthy weight can also improve mobility, and contribute to overall well being and health.

What are corticosteroids and how might they affect my diet?

Corticosteroids are medications used to control inflammation and pain associated with arthritis. Corticosteroids are some of the oldest, most effective and fastest-working drugs for many forms of arthritis. When used properly and sparingly, corticosteroids have the power to spare joints, eyes and internal organs from damaging inflammation.

Unfortunately, they also have the potential to do great harm by causing increased risk of diabetes and osteoporosis. You may experience sodium retention, loss of potassium and weight gain. Corticosteroids also can increase your appetite. If you are taking corticosteroids, it is reasonable to avoid adding extra salt to your food. Also, watch your calorie intake carefully to avoid weight gain.  Itís especially important for women on corticosteroids to take calcium and vitamin D supplements.

One should consume the recommended 5-7 servings of fruits and vegetables daily to help counteract the symptoms (sodium retention/potassium loss), and to provide essential potassium and help balance any sodium retention. If a patient cannot manage their own weight gain, they can see a nutritionist for a consult and personalized meal plan.

Are sugar substitutes safe to use?

Yes.

Which one is best to use?

I like using Splenda® because it measures exactly like sugar when baking.

Are eggs okay to eat?

Eggs are a great source of protein, but also contain cholesterol and saturated fat in the yolk.

What is an appropriate amount to eat each week?

If you are watching the cholesterol in your diet, you should have less than 4 whole eggs a week.

What about egg substitutes?

Egg whites and egg substitutes do not have the yolk, so they are fat and cholesterol free.

Do nightshade vegetables contribute to arthritis?

There has been no recent data or research to show that nightshade vegetables contribute to arthritis. However, if eliminating these foods from your diet improves your symptoms, then you can choose to do so. Nightshade vegetables include white potatoes, peppers, tomatoes, and eggplant.

Does chocolate influence arthritis?

I have not seen research that shows a correlation between chocolate and arthritis. But if you find that it worsens your symptoms, try eliminating it and see if your body responds.

What is the difference between an Omega-3 fatty acid and an Omega-6 fatty acid?

Omega-3 and Omega-6 belong to a family of fats called essential fatty acids (EFAs). These EFAs are found in polyunsaturated fats. Two of the Omega-3 fatty acids are called eicosapentaenoic acid (EPA) and docosahexanoic (DHA).

EPA and DHA are found primarily in oily cold-water fish such as tuna, salmon, and mackerel. The third omega-3 fatty acid is called alpha-linolenic acid (ALA), which is found in dark leafy vegetables, flaxseed oils, and certain vegetable oils.

Studies have shown that having Omega-3 acids in your diet may reduce the severity of inflammation. Omega-6 fatty acids convert in the body producing gamma linoliec acid (GLA). Omega-6 fatty acids are found in meats, poultries, and eggs, which may contribute to inflammation.

How much fish is okay to eat without having to worry about consuming too much mercury?

Mercury is not found in all fish, and it is safe to consume fish low in mercury on a daily basis. If you eat a high mercury fish, you will not feel sick immediately. However, eating fish with high amounts of mercury regularly causes it to build up in your blood over time.

Which kinds of fish are high in mercury?

Following is data obtained from the National Resources Defense Council, which compiles their information from the Food and Drug Administration and the Environmental Protection Agency:

Highest Mercury (Avoid when possible)
King Mackerel
Orange Roughy
Shark
Swordfish
Tilefish
Tuna (Bigeye, Ahi)
High Mercury (Limit to 3 or less servings per month)
Bluefish
Grouper
Spanish Mackerel
 
Sea Bass (Chilean)
Tuna (Canned Albacore)
Tuna (Yellowfin)
Moderate Mercury (Limit to 6 servings per month)
Bass (Striped, Black)
Carp
Cod (Alaskan)
Croaker (White Pacific)
Halibut (Atlantic and Pacfic)
Jacksmelt
Lobster
Mahi Mahi
Monkfish
Perch
Sablefish
Skate
Snapper
Tuna (Chunk light canned)
Tuna (Skipjack)
Weakfish (Sea Trout)
Least Mercury (Enjoy these fish)
Anchovies
Butterfish
Catfish
Clam
Crab
Crayfish
Crawfish
Flounder
Haddock
Hake
Herring
Mackerel (North Atlantic)
Mullet
Oyster
Pollack
Salmon (fresh and canned)
Sardine
Scallop
Sole
Tilapia
Squid
Trout (Freshwater)
Whitefish
Whiting

Summary by the HSS Education Division

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