Arthritis | Diet Supplements | Part 3

leg with knee arthritisIn closing out this three part series on arthritis, I am going to briefly add two more common nutrients and diet supplements that have shown at least some evidence-based benefit for helping support arthritis joint pain relief.

In Part One you learned how exercise and food can help alleviate arthritis and joint inflammation. You know the shiny white cartilage layer on the ends of your bones, as well as the synovial lining that makes joint lubricating fluid, depends on a regular supply of nutrients, vitamins, minerals and movement.

In Part Two I gave you a list of  five common natural polyphenol phytonutrients to support arthritis relief including:

1. Curcumin (turmeric spice)
2. EGCG – epigallocatechin gallate – (green tea)
3. Resveratrol (grapes and grape seed extracts)
4. Nobiletin, naringin and hesperidin (citrus fruits)
5. Genestein (soy)

Remember, the foundation for good nutrition starts with eating real food from nature, not from a machine. This is how you were designed to eat. Start with a healthy prediabetes diet and exercise as discussed in Part One. If your food quality is sometimes lacking, consider using supplements to fill nutrient gaps to help minimize arthritis and/or decrease the amount of arthritis drugs you may need – Information for you to discuss with your doctor.

Diet supplements to help arthritis inflammation with some evidence-based support:

A. Polyphenols – The five common natural polyphenol arthritis supplements listed in Part Two.

B. Omega-3 DHA/EPA “fish oil”

C. Glucosamine and Chondroitin

B. Omega-3 for arthritis relief

pure encapsulations epa/dha omega-3 supplementThis one’s a no-brainer. Pre-diabetics should be taking in adequate omega-3 whether they have arthritis or not. Omega-3 for support of arthritis pain and inflammation relief is an easy one. Besides influencing inflammation in several ways, omega-3 fatty acids are tremendously important to your overall health. Many, if not most, people should consider taking a fish oil supplement whether they have arthritis or not, and that goes double for prediabetics.  If you regularly eat food containing omega-3 fats, you do not need to take a supplement every day, but consider it if there are gaps in your diet. How much fish do you eat?

Fish oil is rich in nutrients called omega-3 fats

Because of poor public health information over the past 30 years, most people hear the term “fat” and automatically think, “I should not eat that.” I recall mentioning omega-3 fats to a patient a couple of years ago, her response was, “I can’t have that, I have too much fat in my diet already.”  In my opinion, America has “low-fatted” itself into a diabesity epidemic. Omega-3 fats are part of the category of so-called “healthy fats.” Fortunately, the public health information in this complicated area of dietary advice regarding fats appears to be changing for the better.

Although the dose seems a bit high, an analysis of omega-3 fats for the treatment of rheumatoid arthritis found that patients were able to decrease their rheumatoid arthritis medicines with the daily use of omega-3 for three months.

If your arthritis is not too far advanced, avoid eating foods containing vegetable oils, and eat more fish.  This may help your arthritis without medicine or diet supplement. Omega-3 fats appear to be anti-inflammatory. One way in which they may decrease inflammation in your body is by being turned into anti-inflammatory compounds that travel throughout your bloodstream called resolvins. Interesting stuff…food is medicine.

no vegetable oilSo, why did I write to avoid foods containing vegetable oils? The term “vegetable oil” is a sales and marketing euphemism to describe processed and concentrated oils that have been squeezed from various seeds.  They are commonly found in – and served up with – refined carbohydrate processed foods. A nasty combination that will send your metabolism-train careening off its tracks, down the embankment and into diabetes-ditch. This is food typically found in a package.  Read the ingredients on the label. It will typically say wheat flour and some “vegetable oil” such as sunflower oil, safflower oil, corn oil, Canola oil, etc.

Not only can these foods work against arthritis relief, this combination of grain-carbs and vegetable oils are harmful to your metabolism. These food products have contributed to the epidemics of obesity, prediabetes and diabetes around the world. In addition to making you pack on inflammation producing midsection fat, seed oils are directly inflammatory to your system. You’ll remember from Parts One and Two, I continuously talked about eating anti-inflammation foods to help minimize joint arthritis discomfort and stiffness.

Many nutritionists and nutrition researchers believe the current American diet has far too many omega-6 fats, and this is contributing to our country’s collective ill-health. Others believe that it is not so much the amount of omega-6 fats, but an insufficiency of omega-3 that is the main culprit. Regardless, minimize your consumption of omega-6 fats from “vegetable oils.”  I’ll write it again so you know what to look for: avoid processed oils from the seeds of sunflower, safflower, rapeseed (Canola), corn, etc. These “vegetable oils” are pro-inflammatory. Do not eat them regardless of whether you have prediabetes, or diabetes.

C. Chondroitin and Glucosamine

pure encapsulations chondroitin sulfateChondroitin and glucosamine have also been shown to support the health of joint cartilage. A recent study looked at the health benefits of fish oil along with glucosamine and chondroitin in almost 10,000 adults to try to find out how helpful this could be for arthritis. In this large group of 10,000 people there was an association between the use of these supplements and reduced inflammation throughout the body.

Glucosamine for support of arthritis pain and inflammation relief

Studies looking at the benefit of glucosamine for relief of arthritis, in my opinion, as a whole, have not been that stellar. I have read most of them. They range from one study showing that a dose of 1500 mg significantly reduced symptoms of arthritis in knee joints, to a 1500 mg dose possibly not being enough in another study. The variation in the quality of glucosamine products can also present a problem. Actually, this is true for all supplements – if you are taking any supplements to fill diet gaps, know where your supplements are coming from. The most recent official health guidelines on glucosamine do not give it much support. (1)

Chondroitin for support of arthritis pain and inflammation relief

Overall, I see more medical research support for chondroitin as a potentially helpful supplement for arthritis pain including the painful foot arthritis that I treat on a regular basis.

I put more stock in chondoitin, but both chondroitin and glucosamine are often found mixed together in one supplement. If it’s between using one or the other, go with the chondroitin. Chondroitin sulfate is a commonly recommended diet supplement for foot arthritis.

A study published in the journal Arthritis and Rheumatism (Sept. 2011) looked at the potential ability of the supplement chondroitin sulfate to alleviate hand arthritis pain and improve hand function.  The study participants had to exceed a certain amount of hand pain and dysfunction to be included in the study. The researchers gave 80 people 800 mg of chondroitin sulfate daily and another 82 people took a placebo. After 6 months the researchers looked at:

  • spontaneous pain and level of functional impairment.
  • improvement in grip strength
  • how long morning stiffness lasted
  • acetaminophen use
  • the study participants’ overall impression of efficacy.

In those people who received the chondroitin supplement, hand pain decreased significantly and hand function improved significantly.

There was also a statistically significant decrease in how long morning stiffness lasted and an overall positive impression on how beneficial the chondroitin was in helping the arthritis pain.

Improvement in grip strength and acetaminophen use were not significantly different between the two groups.

Chondroitin also seems to be a very safe supplement with some potential benefit for sore joints from arthritis. In addition to alleviating symptoms of inflammation, chondroitin also seems to actually help maintain the health of the cartilage. (3)

I have patients that claim a benefit from chondroitin for their foot arthritis. It is safe, so I would not discourage you from trying it. Take it for 4-6 weeks before you even think about evaluating its benefit.

As you know the polyphenols and omega-3 can be found in plants, fish and other meats, but they are also available as supplements. If your diet is lacking in these areas, first see what you can do to improve this with food, then consider supplements to fill gaps, not to replace real food that does not come in a package.

Diet supplements help support reduced arthritis symptoms mostly by decreasing inflammation

The diet supplements I have listed in this series have all shown some benefit toward decreasing inflammation. So, bottom line… If you want to consider a more “natural” way to reduce arthritis and its symptoms, consider curcumin, chondroitin, and/or omega-3 since they each help work against inflammation in a somewhat different way.

cup of green teaThese along with the other polyphenol supplements such as green tea appear to have multiple health benefits. You do not necessarily need to take these products as supplements. Add them to your diet in the form of turmeric spice (curcumin), fish (omega-3) and bone broth could be considered as a replacement for chondroitin.

As I said in the introduction to this article, chronic low-grade inflammation is associated with a number of medical conditions. If you can do something to decrease inflammation, even if you do not have arthritis, you should do it as long as it is safe, and has a reasonable assurance of being effective. The food you eat is the first place to start.

We all know a healthy diet with proper nutrition is very important for health, including bone and joint health, but dietary advice for arthritis has not been a big part of the approach to managing this potentially debilitating condition. I hope this has been helpful. Leave a comment. We welcome your feedback.

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About Robert Creighton

Dr. Creighton is a podiatrist and foot surgeon with over 26 years in podiatric practice treating thousands of patients afflicted with the physiological, physical, and psychological side effects and complications of diabetes and pre-diabetes metabolic syndrome. He believes these disorders present a pressing public health concern that need to be more actively addressed in a multidisciplinary way. Dr. Creighton graduated from what is now the Temple University School of Podiatric Medicine after receiving his undergraduate degree in Biology. He is certified by the American Board of Foot and Ankle Surgery, a member of the American Public Health Association, an American College of Sports Medicine certified personal trainer and a Member of the American Nutrition Association.

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