What foods are good for arthritis?

Why does your diet affect arthritis?

Arthritis is a common condition that causes pain and inflammation in a joint. Although there are many types, the two most common are osteoarthritis and rheumatoid arthritis.

Osteoarthritis tends to affect people over the age of 40, but it can occur at any age as a result of an injury. It affects the smooth cartilage lining of the joint, which causes stiffness and pain and makes movement more difficult. This lining can become thinner, putting more pressure on other areas of the joint, including the tendons and ligaments. Severe loss of cartilage can lead to bone rubbing on bone and change the shape of the joint too, causing pain.

Rheumatoid arthritis is less common than osteoarthritis and typically starts when a person is between 30 and 50 years old. In rheumatoid arthritis, the body's immune system targets affected joints, which leads to pain and swelling. The outer covering of the joint is affected first, but the problem can spread and cause the bone and cartilage to break down too.

Martin Lau, Arthritis Action's dietitian and services development manager, says the relationship between diet and arthritis is complex. There are many reasons why what you eat can help with the symptoms.

Firstly, body weight can directly affect arthritis. "Carrying more body weight is not good for any musculoskeletal condition like arthritis," Lau says. "A landmark study found one pound of weight-loss lessens four pounds of pressure on the knees, per step¹."

One of the key symptoms of arthritis is persistent pain, but what we eat has the potential to ease the discomfort. In 2018, a systematic review of 72 studies examined the role of nutrition and persistent pain and found that it may be possible to reduce chronic pain with a healthy diet².

Lau recommends a diet that includes colourful fruit and vegetables, wholegrains and essential fatty acids, omega 3 and omega 6, such as those found in salmon. "We should also avoid dehydration throughout the day, and limit ultra-processed food," he says.

Staying hydrated can help ease pain caused by inflammation in the joints. Around 80% of cartilage tissue - a connective tissue that protects your joints and bones - is made up of water. Drinking plenty of water helps nutrients travel within the tissue, which maintains healthy cartilage³.

Patient picks for Arthritis

Bones, joints and muscles

What are the symptoms of arthritis?

Arthritis means pain and inflammation in one or more joints of the body and sometimes redness and warmth in affected joints. There are many different causes of arthritis and having it can significantly affect your quality of life. Treatments for arthritis include pain relief and physiotherapy but differ depending on the type.

by Dr Doug McKechnie, MRCGP

Bones, joints and muscles

Calcium pyrophosphate deposition

Calcium pyrophosphate is a substance produced in the cartilages of the joints. It can become deposited as crystals on joint tissues. This is called calcium pyrophosphate deposition. Calcium pyrophosphate deposition can cause a number of problems of which the most well known is pseudogout. This is almost identical to gout, causing attacks of pain and swelling in one or more joints. Some people develop damage to the joint, causing a type of long-term arthritis. Calcium pyrophosphate deposition may cause no symptoms and is sometimes picked up on an X-ray done for an unrelated condition. Unlike gout, there is no special treatment for pseudogout. Rest, ice packs and anti-inflammatory medicines are the main forms of treatment.

by Dr Hayley Willacy, FRCGP

Best foods for arthritis

Oily fish

Oily fish, including salmon, sardines, mackerel and trout, contain long-chain omega-3 fats, which are important for overall health and can reduce inflammation and disease activity in people with rheumatoid arthritis. It's recommended that you have two portions of oily fish a week.

rthritis - omega-3 fatty acids found in fish oil may have an anti-inflammatory affect in patients with rheumatoid arthritis⁴.

Nuts and seeds

Many nuts and seeds contain polyunsaturated fats - so-called healthy fats - as well as protein, vitamins and minerals. They also contain linoleic acid (ALA), a type of omega-3 fatty acid with anti-inflammatory properties⁵. Almonds, hazelnuts, peanuts, pecans, pistachios, and walnuts are all healthy options, but make sure you choose unsalted types.

Fruits and vegetables

Broccoli, cabbage, bok choy, and cauliflower all contain sulforaphane, a compound which research suggests may act as an anti-inflammatory and help slow down cartilage damage in osteoarthritis⁶.

Sweet potatoes, oranges, carrots, and red peppers contain beta-cryptoxanthin, a chemical with antioxidant properties that helps to fight inflammatory conditions such as arthritis⁷.

Olive oil

Research suggests that the oleic acid and antioxidants in olive oil can help reduce inflammation. One study found that the antioxidants in olive oil may work in a similar way to the drug ibuprofen, an anti-inflammatory pain reliever⁸.

A separate study suggested that ingesting olive oil significantly reduced joint pain, stiffness and hand muscle grip in people with arthritis⁹. Cooking food in olive oil rather than vegetable oil is a simple switch that may help boost your health. You can also add a teaspoon of olive oil to salads, sauces or vegetables to boost your intake.

Whole grain foods

Whole grain foods, including whole grain bread and pasta, are rich in nutrients, fibre and antioxidants and have anti-inflammatory benefits¹⁰.

Foods to avoid with arthritis

Sweets

It's important to avoid sugary foods, which may worsen symptoms of arthritis such as pain and stiffness. A study involving 217 people with rheumatoid arthritis found that sugar-sweetened fizzy drinks and desserts were the most frequently reported to worsen symptoms of rheumatoid arthritis¹¹.

Red meat

Eating a lot of red and processed meats has been linked to a higher risk of heart disease, cancer and diabetes¹². According to the study examining rheumatoid arthritis and sweets, red meat may also worsen the symptoms of rheumatoid arthritis¹³.

Highly processed foods

Ultra-processed items like fast food, breakfast cereal, and baked goods are typically high in refined grains, added sugar, preservatives and other potentially inflammatory ingredients, all of which may worsen arthritis symptoms.

Alcohol

As alcohol may worsen arthritis symptoms, anyone with inflammatory arthritis should restrict or avoid it. Drinking alcohol can increase uric acid levels - a waste product found in blood - which can increase the risk of inflammatory joint conditions, including osteoarthritis and gout¹⁴.

Lau adds that it is important to think about your overall diet, rather than individual foods. “The aim shouldn’t be to just eat one type of food or diet, but instead to eat a well-balanced diet and keep to a healthy weight,” he says.

Further reading

1. Messier: Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis.

2. Brain et al: A systematic review and meta-analysis of nutrition interventions for chronic non-cancer pain.

3. Fox et al: The basic science of articular cartilage: Structure, composition, and function.

4. Kostoglou-Athanassiou et al: The Effect of Omega-3 Fatty Acids on Rheumatoid Arthritis.

5. Pablo et al: High erythrocyte levels of the n-6 polyunsaturated fatty acid linoleic acid are associated with lower risk of subsequent rheumatoid arthritis in a southern European nested case-control study.

6. Davidson et al: Sulforaphane represses matrix-degrading proteases and protects cartilage from destruction in vitro and in vivo.

7. Pattison et al: Dietary beta-cryptoxanthin and inflammatory polyarthritis: results from a population-based prospective study.

8. Lucas et al: Molecular mechanisms of inflammation. Anti-inflammatory benefits of virgin olive oil and the phenolic compound oleocanthal.

9. Berbert et al: Supplementation of fish oil and olive oil in patients with rheumatoid arthritis.

10. Milesi et al: Whole grain consumption and inflammatory markers: A systematic literature review of randomised control trials.

11. Tedeschi et al: Diet and rheumatoid arthritis symptoms: Survey results from a rheumatoid arthritis registry.

12. Cancer Research UK: Does eating processed and red meat cause cancer?

13. Tedeschi et al: Diet and rheumatoid arthritis symptoms: Survey results from a rheumatoid arthritis registry.

14. To et al: The association between alcohol consumption and osteoarthritis: a meta-analysis and meta-regression of observational studies.