Ask the Expert: Deborah McInerney, Nutritionist, Answers Your Questions on Nutrition & Arthritis
Q1. What are some foods that are a good source of vitamin D for people with arthritis?
Vitamin D is not the easiest vitamin to get from food, mainly because its food sources aren’t the most popularly consumed. Cod liver oil and swordfish are the best natural food sources, followed by fatty fish like salmon (especially wild-caught like sockeye) and mackerel. Next would be canned tuna fish and vitamin D-fortified milk, yogurt and orange juice. Sardines, eggs (yolk) and fortified cereals have fair amounts of vitamin D, but most people need to take a supplement, as the typical U.S. diet lacks a sufficient amount of vitamin D-rich foods.
Q2. What kind of foods should people with arthritis eat to keep their joints healthy?
There are no magic foods specific to joint health. The goal is to maintain a healthy weight (lose weight if overweight), and follow a diet rich in vegetables, fruit, low-fat dairy, lean protein and whole grains, to ensure you receive adequate amounts of protein, fat, carbohydrates, vitamins and minerals everyday. Many people who suffer from joint inflammation choose to focus on omega-3 fatty acids from fish oil and/or flaxseed (food or supplements).
Q3. I have gout – what foods and drinks should I avoid?
If you have gout, it is advisable to avoid foods high in purine, to reduce the amount of uric acid in the blood. High purine foods include alcoholic beverages, organ meats (liver, kidney, sweetbreads, tripe), fish and seafood (sardines, mussels, herring, fish roe/eggs, anchovies, scallops), meat (beef, poultry, pork), cured meats (bacon and hot dogs) and meat products like deli meat, gravies, broths and soups. It is also a good idea to limit quantities of lentils, beans, cauliflower, mushrooms, spinach, asparagus and peas, as well.
It is best (and easier) to focus on incorporating the following foods into your diet, that contain low levels of purine: low-fat dairy, eggs, fruit, nuts and vegetables (except the above mentioned ones).
Q4. Are there foods I should avoid to prevent my rheumatoid arthritis from exacerbating?
There are no foods proven to worsen Rheumatoid Arthritis symptoms, but some claim to benefit from eliminating nightshade vegetables such as tomatoes and tomato products (even ketchup), eggplant, potatoes and peppers. If you notice a positive change by eliminating these, it’s probably working; if you feel no different, then it’s probably not worth continuing.
For most medical conditions, the focus should be an overall healthy diet, rich in fruit, vegetables, whole grains, low-fat dairy and lean proteins such as fish, chicken, and beans. To help manage or decrease inflammation, try to incorporate salmon, tuna, mackerel, trout and herring into your diet on a regular basis, or adding flaxseed if you’re not a fan of fish.
Q5. My child has juvenile arthritis. Any recommendations on the types of nutrients and how much she should be getting to prevent her arthritis from getting worse?
Juvenile Arthritis does not have specific nutritional recommendations, but focus should be, as for all kids, on proper nutrition for growth and development. Calcium and vitamin D should also be a priority, as U.S. diets now seem to be deficient in foods rich in these crucial bone health nutrients. If your child is taking a corticosteroid, then bone health should absolutely be a focus, as long-term steroid use can have a detrimental effect on bone density.
Deborah McInerney is a clinical nutritionist at the Hospital for Special Surgery.