Transcription:

Melanie Cole: Although there's no diet cute for arthritis, certain foods and certain exercises have been shown to fight inflammation, strengthen bones and boost the immune system. Adding these foods and these exercises to your balanced diet may help ease some of the symptoms of your arthritis. My guest today is Jaimie Russell. She's a nurse practitioner with the Arthritis Center of Nebraska. We’re going to talk about exercise, but nutrition itself, how has that been shown to help with arthritis symptoms?

Jaimie Russell, APRN-NP: There are certain types of foods that are considered proinflammatory and so, in general, more inflammation equals more pain specifically in the joints in this particular instance. Foods like sugar, saturated fats, trans fats, refined carbohydrates, MSG, aspartame and even alcohol have all been implicated as "proinflammatory" or increasing inflammation. Even foods that are high in sodium have also been implicated in increasing inflammation, so it's important that you try to limit these types of foods in your diet and then also use different types of foods that are considered anti-inflammatory like omega 3's, which include fish like salmon or dark leafy greens and olive oil. Cherries are also helpful for different types of arthritis like gout. They have been shown to lower uric acid levels, which can prevent gout flares. Green tea is also anti-inflammatory, full grains, citrus fruits like pineapple and other citruses like oranges and things like that are also great, including high fiber foods as well. Those are all options that people have to include in their diets to help fight inflammation.

Melanie: Those are all really great foods and you mentioned sugar is something that we stay away from. What else do you want people with arthritis to steer clear of? Are some of these difficult to steer clear of?

Jaimie: I think for most people in America especially, we tend to have diets that are high in saturated fats and trans fats, so it’s important that you always look at food labels and make sure that these are limited, if not, completely eliminated from the types of foods that you're eating. In general, we say walk around the outside of the grocery store, try to avoid the inner aisles of the grocery store because most of the time, these types of foods contain those refined carbohydrates and the things that we need to stay away from that actually increase inflammation, plus these are more likely going to be your processed foods. For the most part, if you can't pronounce the ingredient on the label, it’s probably not a good choice.

Melanie: We do like to say shop the perimeter, go to the produce, but not everybody knows what to do with some of those things. What do you tell people when they say ‘I really like to eat Brussel sprouts and kohlrabi, and I hear that kale is really great, but I don’t know what to do with any of them?’

Jaimie: As far as preparation or things like that, I think here locally we have a lot of opportunities at grocery stores and things like that where dieticians are present and they can be extremely helpful especially if you let them know you have a certain type of arthritis, they can steer you in the right direction and provide recipes and ways to prepare the foods. A great resource for recipes as well as other information about types of foods that you should be able to eat or can eat is arthritis.org. That’s a great resource for patients because it helps explain it in a way that people can understand a lot better than other types of websites like Mayo that may be a little bit more difficult to understand.

Melanie: We also hear about omega 3’s and they hear about supplements like chondroitin and glucosamine, vitamin D to help strengthen your bones. Are we looking for these things in our foods, fatty fishes, salmon and those things, or if someone has arthritis, is it preferable that they need a little bit of extra of some of these so they might have to look to supplements?

Jaimie: Omega 3’s, the best way to get those is from foods, but like you said, a lot of times, that’s included in certain fishes and things like that. Not everybody tends to like fish, some love it, some hate it, so the option would be to use an omega 3 supplement on a regular basis and it’s also good for heart health too, not just for arthritis. Other options can include nuts too that are also full of omega 3’s. You talked about glucosamine and chondroitin and all of that, those are either extremely beneficial for people I find, or they don’t find as much benefit from that. Our general rule with supplements like glucosamine is you give it a try for about three months, see if you notice a difference in your joints and your joint pain, and if not, go ahead and stop the medication. Many times, what people find is after they stop it, that’s when they really notice it was doing something for them and making it different. I have several patients that absolutely swear by glucosamine and chondroitin. Vitamin D is another good option. There's really no good studies that tell us that vitamin D is helpful for joint pain, but certainly by vitamin D is important for bone health and bone strength. If you're vitamin D deficient, it’s definitely important to get on a vitamin D supplement because it’s really difficult to get vitamin D from foods, to get enough to actually make a difference.

Melanie: Now, onto exercise. As we think about the different exercises and because certain types of arthritis are rheumatoid in nature and inflammatory in nature, then they can build on themselves and certain exercises are contraindicated. How do people know what exercises will help ease some of that joint pain?

Jaimie: This can be directed a lot of times by a trainer or someone that is trained in how the body moves specifically and these different types of arthritis conditions, so that way it can be tailored to each individual, but in general for people with arthritis, we like to say low impact exercise, things that aren't putting a lot of pressure, especially on the knees and the ankles, all of the weight-bearing joints. Options that include these types of exercises would be something like swimming. We recommend that a lot for arthritis patients. It’s a great way to use weight lifts in the water, but you're actually getting a really good workout at the same time and you're not putting undue stress or pressure on your joints. Other options include machines like a NuStep, that’s an option too where you're just moving back and forth but you're not putting all of that weight on your knees.

Outside of that, just a gentle walking program is also very helpful for people trying to get those 10,000 steps in a day to stay healthy and stay active. Weightlifting is a good option, but also under probably the guide of a trainer that can tell you ways that you can lift weights that are protective to your joints. If people have arthritis in their hands, built up grips that are using hand protection so that way they are not using power grips and irritating the small joints of the hand. Outside of that, I think other options besides just the cardiovascular side of exercise, it’s important that people participate in a regular strengthening, therapeutic stretching type program. Options include yoga or Taiichi is very helpful for people with arthritis. It helps you move your body in a way that maybe you don't on a normal basis, plus it's very easy on the joints themselves. I think there's also a good mind-body benefit to things like yoga and Taiichi as well.

Melanie: What a great answer. In just the last few minutes here, what about weight loss? Does that play a role in easing some of the symptoms of arthritis? People hear about all the medications you can go on and maybe they're trying Taiichi or swimming and some of these things. What about easing some of the body weight that is also contributing to some of that pain?

Jaimie: Weight loss is huge and it’s a very difficult thing because it’s not easy to lose weight and especially when you have arthritis, that limits that things that you can do to try to lose weight but incorporating things like diet and exercise are always very important. One thing that I always tell patients, especially with knee osteoarthritis, and that’s the wear and tear of the joints of the knees, is every one pound that you're overweight, that puts four extra pounds of undue stress and pressure on your knees. Simply being 10 pounds overweight puts 40 additional pounds on the knees. Weight control and weight loss are very important. That being said, some of the other arthritis conditions that we treat here that are inflammatory arthritis conditions. Increased weight actually doesn't allow the medicines to work as well as they could if the weight were less or in a regular body mass index or regular weight for their height or age. All of those things together on weight is very important and it's important that people try to lose weight if they do have extra weight that they're carrying around because it's just easier on the body overall, especially the weight-bearing joints like the knees and ankles.

Melanie: Wrap it up for us with more of your great advice on how nutrition and exercise can affect arthritis in a positive way and help ease some of those limits to range of motion and some of those pains.

Jaimie: Overall, as we've discussed, using food as almost a medicine is a great way to think about it. We’re not using food as something that fulfills us, but more as a medicine and something that keeps up going and keeps our energy levels high. Those types of foods that do that are the ones that we previously discussed that keep inflammation low. With inflammation low, we have more energy to be able to get out and exercise and do the walking programs and stretching and those sorts of things. Sometimes people need a little bit of direction, so working with a personal trainer or a nutritionist is a wonderful option and we like to use those resources frequently if we can for patients because I think knowledge is power. The more you know about your disease process, the more you know about nutrition, the more you know about exercise, overall, the better that you're going to feel and you're going to be better with your arthritis and be able to cope better and function better on an everyday basis.

Melanie: Thank you so much for such great information and sharing your expertise with us today. What a great topic and a special thank you to our podcast partner, Mapes Industries. This is Bryan Health Podcast. For more information about today’s topic, please go to nebraskaarthritis.com. That’s nebraskaarthritis.com. I'm Melanie Cole. Thanks so much for listening.