Ann’s Experience of Rheumatoid Arthritis and Diet
“I was worried about my hands. They were red, swollen and I couldn’t hold the steering wheel to drive the car. They ached so much that I couldn’t sleep.
I changed my entire eating pattern at once. Expecting it would take at least six weeks to notice a difference, I was surprised to find improvement in only two. I found that my shoulders and knees were a lot better. That feeling spread. I hadn’t even realized about the problems in my feet.
The approach is based on the book “Foods That Fight Pain” by Neal Barnard, but amended to suit my experiences.”
“I know this has worked. Moreover, I cannot help but be amazed how quickly small transgressions affect the flexibility of Ann’s hands and fingers.”
OUTLINE OF THE DIET THAT WORKED FOR ANN
SACRIFICES THAT PAY
There is no absolute rule here. You have to learn to watch for the signs of adverse reactions and to judge which factors are most pressing in your own particular case. You need also to avoid use of the collective term ‘arthritis’. This case study is for rheumatoid arthritis specifically. Ann did not have elevated uric acid levels yet some of her experience parallels that for gout arthritis.
1. NO MEAT
No meat, red or white, except for some fish. That is; no beef, lamb, pork, poultry. I have left in some fish although Barnard suggests none at all. Serving size is up to 5oz usually once per week, although maybe as many as three times. The primary thing to be wary about is purines. So, for me;
- o What works – salmon, white fish, occasional but limited shellfish
- o What doesn’t work – anchovies and sardines (high purines), also tuna fish
2. NO EGGS
3. NO DAIRY
I wasn’t prepared to follow this recommendation because of already established risk of osteoporosis. So I have substituted plain calcium enriched SOY milk at breakfast. I still use skim milk in coffee (decaffeinated only) and eat non-fat yoghurt a few times each week. Also I have a small slice of cheese a few times each week.
4. NO NUTS
I have been avoiding peanuts for the last twenty years. Quite some time ago I put cashews in the same category. Initially I allowed both almonds and walnuts. But I now sense that a handful of almonds causes problems, so I use them as garnish infrequently. I continue with walnuts because of the good oils. Similarly, flax seed adds good oils, but I personally have a allergy to this seed. Also, only olive oil and canola oil should be use in cooking.
5. NO CORN
6. NO WHEAT, RYE or OATS
The thing we are concerned here is gluten sensitivity. This experience is magnified in developed / developing economies by modern dietary focus on a narrow range of intensely farmed grains rather than a wide selection of seeds. If you experience this sensitivity, eliminate wheat, rye and oats. I have also excluded BARLEY (that I put in soups). A lot of wheat-free products contain corn. So, read ingredient lists very carefully. Do not trust non-specific descriptions.
What is left? Rice – pick and choose between various ones. They give different tastes. There are also buckwheat, amaranth and quinoa. Use arrowroot in place of cornstarch.
7. NO TOMATOES
8. NO POTATO
The plant family Solanaceae (Nightshade) is strongly implicated in gout and gout arthritis. So I avoid all of this family: eggplant, sweet peppers, tomatillos. I do still use paprika, chili powder and cayenne in cooking although not daily. A little Tabasco is a nice luxury sometimes.
9. NO CITRUS
10. NO TEA or COFFEE (CAFFEINE)
There are varying discussions about caffeine, dark chocolate and green tea to be found at different web sites. Note that many of those discussions relate to extreme of excessive responses in the absence of any other positive steps at control. I drink decaffeinated coffee (up to five mugs daily). My mother went to an acupuncturist for treatment associated with arthritis when in her seventies. He would not treat her unless she had abstained from tea and coffee for a month beforehand. She felt so much better when doing that, she never drank them again. Water, water and lots of water! The urine must be almost clear, otherwise you are dehydrating.
PLEASURES TO ENJOY
Check the spelling of salivation, because you need to have some taste pleasures.
Eat as much fruit as you want subject to fitness, shape and whatever suits your fancy. But no bananas or peaches! Cherries are particularly well regarded for gout and gout arthritis. In all cases, you would need to eat a mountain to drive a positive change in the face of continued intake of detrimental foods.
Look for variety within each vegetable group as this gives taste and texture. Cabbages and squash have many varieties and are good. Serve every day.
The Morning Glory family provides an important source of taste, texture and fiber in your food. This includes sweet potatoes and also jicama which is a starchy tuberous root eaten raw in salads or cooked as a vegetable. Sweet potatoes are a fundamental part of my diet. They marketed also as yams (jewel and garnet yams).
Explore the produce section, be adventurous, try all the ones you don’t know as well as those you do.
You won’t be getting required starches from cereal crops. The stalwart is rice – pick and choose between various ones. They give different tastes that you will welcome. There are also buckwheat, amaranth and quinoa. Use arrowroot in place of cornstarch.
Don’t be bashful. Eat and enjoy beans, including edame (soybean pods).
This will become a staple, so try different brands and textures to see what you like.
Learn to shop where vegetarians are special customers. Buy low salt, wheat-free TAMARI for soy sauce. Be careful to get the required protein levels. Experiment to find taste and texture experiences that will please! Suddenly it isn’t nearly as bad as it sounds – especially when the pain goes away.
Veggies to avoid are the nightshade family, asparagus and mushrooms. What an elephant won’t eat in a zoo is not for you! Think what it would be like for an elephant with gout. Taste excursions are allowed provided you watch the frequency and expect the consequences. Perhaps buy a little credit from time to time so you can put shitakes in your Chinese cooking. I do!
PRUDENCE IS WISE
1. Be careful of sulphites. They are in things like dried mango. We often have dried fruits after dinner but I choose carefully to avoid added sugar and sulphites.
2. Food & eating trends. There were clear trends in my food choices, although they weren’t conscious choices. For example, I stopped cooking pizza for the family and reduced the potato content of meals – because I didn’t want to eat them. These are the pieces of information that you need t look for as initial guide as to what changes to make. Some type of diary is important and any interaction with or shielding effects by medications should be worked out. Also, unusual relapses need to be reviewed as there could be additives or ingredients that don’t work for you and that you only encounter now and then – or when your supplier changes something. One change we found undesirable occurred in dried apricots. In the end, this meant that we stopped buying the Costco item and went elsewhere.
3. Wine. The literature about alcohol and wine includes contradictory information. But that trends toward greater caution as time passes. Older people should be more conservative. Whether my election was driven by age or arthritis, I don’t know but I have switched to alcohol-free wine except for special occasions. I enjoy the Fré and Ariel brand names.
UNDISCIPLINED MEALS AND SNACKS
Snacking is a risky habit at the best of times. But we have snacks because we need to top up along the way as we consume our nutrient stores. GENSOY products are good. Remember not to add too much soy; soy nuts, rice cakes, black sesame rice crackers. These can be very satisfying. Read the labels on every flavor to be sure what you are getting. I tried vegetable crisps which are a mix of sweet potatoes, yams, parsnip…but found they were not good for my joints.
Eating out can be fun but you need a flexible host and a varied menu choice. It is convenient to trade items between dishes. You can usually get jasmine rice. Be suspicious of pilafs. Select grilled salmon on salads. Go for steamed veggies.
Additives and supplements are the stock in trade of the food industry and also alternative therapy proponents. You need to be cautious and informed as any major shift in diet will alter the nutritional balance of your body. While good nutrition might not secure ideal health, bad nutrition underwrites ill health. I avoided a multivitamins that were high in vitamin A as this increases osteoporosis risk. Because there is no meat in my diet, I needed vitamin B complex. The one I take (from Costco) also has vitamin C and folic acid. I resisted adding glucosamine because is it is a shellfish product. But I have now added a glucosamine product that has MSN in it as well. The MSN has an immediate benefit (within days). To see this you need to have your eating pattern established properly and beneficially before starting this route.
Yummy tastes are important to us all! We can get those form spices. Good ones are ginger, cumin and turmeric. Last thing at night, it’s nice to have some dark chocolate with a small amount of crystallized ginger. Yumm…but keep the quantities under control. Lots of web sites propose gorging on this stuff. But you must surely lose the special sensation! It can also be adverse to health if you have low blood platelets for example – as Colin does. Each delightful chomp takes it toll in many ways – including adding dimension to your girth. When all is said and done, poor fitness and excess weight correlate most strongly with arthritis and all the other autoimmune disease that target affluent societies.
The National Health Interview Survey (NHIS) for 2003–2005 findings indicated that an estimated 21.6% of the adult U.S. population (46.4 million persons) had doctor-diagnosed arthritis, and a further 8.3% (17.4 million) had arthritis-attributable activity limitations. These numbers grow in time as the population ages, gets increasingly obese and indolent. Arguably the funds spent on researching treatment should be directed in large part to prevention…teaching youngsters about crucial lifestyle choices at the youngest of ages…setting optimal choices contrary to the dictate of social fashion…but that is not the American way.
THE BROAD CHANGES – ON A DAILY BASIS
This used to be very simple:
1) Grapefruit juice
2) Muesli with non-fat milk
3) One banana
It now takes some time to prepare and you shouldn’t expect to find the ingredients at a regular supermarket:
1) Pure juices of cranberry, pomegranate or black cherry mixed to taste (~6oz)
2) Chopped prunes (five) as a good source of potassium
3) Gluten-free cereal with soy milk
Hot cereals are based on buckwheat, quinoa or amaranth. Erewon rice crispies make a good cold cereal. Top the cereal with ground seeds. I grind one teaspoon each of pumpkin sesame and sunflower together in a coffee grinder. This mix adds a bit of fat that you need to last until lunch. Add psyllium for fiber. Psyllium or Ispaghula is the common name used for several members of the plant genus Plantago whose seeds are used commercially for the production of mucilage. Note it is a useful anti-cholesterol agent and also a bulk forming laxative.
I have a small green salad with homemade honey mustard dressing and some whole veggies;
4) Rice crackers (~1oz)
I dip these in hummus, but again you have to take care to read the labels for all packaged food and avoid contents like roasted peppers, etc.
I finish off with fruit and I find a good apple to be particularly satisfying.
Here it is a good idea to try keeping to your regular framework and substitute for the things that should be withdrawn. I do end up eating a lot of tofu with mustard, tamari or cranberry sauce (on grill if the family is having steak or the like) or chopped and reheated in the microwave with the flavors.
Walnuts and green peas are a good flavor combo for example on rice pasta with parmesan. Use cabbage (e.g. napa) or leaf lettuce in place of tortillas. My fajita filling has tofu, green beans and onions. Remember the Chinese use lettuce as a foil for lots of things. I make a delicious Thai green curry with tofu, butternut squash and green beans, or broccoli, or both.
Always have fruit to finish the meal. Pineapple/ strawberry; melon, papaya and other berries make it interesting.
Everyone in the family has to learn that eating habits and diet are personal. You don’t have to conform to other’s regimes. For example, Colin follows a traditional Mediterranean dietary pattern with zero alcohol and as close to zero processed sugar as possible. Standard servings of meat or fish are 5oz of lean flesh.
Breakfast: grapefruit juice, wheaties with non-fat milk, bagel with marmalade and some low cholesterol margarine. No eggs, no cheese and no meat. This is a high carbohydrate meal deficient in protein.
Lunch: carrot, cucumber, radish, tomato, peppers and also cheese on crisp bread crackers (low calorie / low fat / low salt). No meat. Grapes (or an apple) after the meal. This provides protein and is likely supplemented late afternoon by some further cheese and crisp bread.
Dinner: Good variety of vegetables and fruit afterward. No bread or crackers, sugar, salt or eggs. Fish is once or twice a week and red meat once only. Fat is minimized.
Finally: Decaf coffee (black) – one small snickers bar, one small chocolate bar.
Other Liquids: Water, Diet Squirt.
Some of his rewards: BP 120/68, Total cholesterol 113, HDL cholesterol 27, Blood Glucose 93, IgA 374, IgG 1150, IgM 99, CRP normal.
THERE IS A LOT OF INFORMATION ABOUT
The trick is to discover what works for you. Remember that the overriding majority of medical treatments for rheumatoid arthritis do not address the cause. They are concerned with eliminating the inflammation caused mainly by the innate immune system (macrophages) attacking IgM/IgG complexes that lodge in the joints.
Recommended by Arthritis Foundation
“Mayo Clinic On Arthritis” is recommended by the Arthritis Foundation. The book is written in a conversational style and is easy to read and understand. The 180-page book is comprehensive and packed with valuable information tapped from the experts. Since 1983, the Mayo Clinic has published health information including various award-winning newsletters, books, and online services. It is highly regarded as a reliable health information resource. The editor-in-chief of “Mayo Clinic On Arthritis”, Gene G. Hunder, M.D., is a practicing arthritis specialist at Mayo Clinic and an authority on rheumatology. Hunder worked closely with over two dozen Mayo Clinic colleagues in preparation for this book which is an excellent resource for arthritis patients.
And a particularly useful look at the world of supplements:
Arthritis Diet Claims: Fact or Fiction
“Pain from arthritis might lead you to try anything to relieve it, including a change in diet or taking supplements. Make sure you know what works first. ”
By Leanna Skarnulis
…Many people with osteoarthritis (OA) and rheumatoid arthritis (RA) seek relief by buying the latest book or nutritional supplement claiming to relieve or cure arthritis, or they take advice from a neighbor who swore that eating gin-soaked raisins eased her symptoms.
How do you navigate this gray area of unregulated therapies to know if what you’re doing can help or harm? WebMD talked with two experts who provided insight into the claims made for arthritis diets and supplements. Hayes Wilson, MD, is a rheumatologist in Atlanta and medical adviser for the Arthritis Foundation. Christine Gerbstadt, RD, MD, practices in Pittsburgh and is a spokeswoman for the American Dietetic Association.
This article gives a guide to help you sort fact from fiction.