Do restaurant meals and snack attacks leave you with rheumatoid arthritis aches? Find out which foods trigger flare-ups and how to pick tasty substitutes...
When you have rheumatoid arthritis (RA), a restaurant menu or open refrigerator can seem like a test: Can you find foods that satisfy your cravings without making joints swell, ache and stiffen?
Definitely. It’s easier than you think.
You can still eat meat – as long as you choose leaner cuts. Crave salty snacks? Eat nuts instead of chips.
The key is following an anti-inflammatory diet, which helps you avoid RA flares. And these smarter food choices aren’t necessarily boring ones. Antioxidant-rich fruits and vegetables, high-fiber grains and healthy fats can all help you reduce RA aches – in a matter of days.
“I start my RA patients on a general anti-inflammatory diet, and they feel better within a week,” says internist Leo Galland, M.D., whose book The Fat Resistance Diet (Three Rivers Press) is based on anti-inflammatory foods.
“Their pain and stiffness is greatly reduced.”
We asked RA experts how to avoid flare-ups without sacrificing your favorite treats. Here’s what they said:
1. Red meat, pork, poultry, eggs, butter
Why they’re RA triggers: These animal products contain harmful saturated fat, which increases inflammation in the body.
“After a single meal high in saturated fat, blood cells produce more inflammatory signals for several hours,” Galland says.
“Continue eating like that, and blood cells stay in this inflammatory state,” he adds.
For RA sufferers, that means joint and muscle pain, heartburn, fatigue and even acne.
Eat this instead: Love omelets? Whip one up with egg whites (the saturated fat is in the yolk).
Proud of your milk mustache? Switch to skim. Can’t give up meat? Choose leaner cuts like sirloin steak, chicken breasts and pork loin chops.
If it’s protein you crave, get it from salmon or mackerel, which are rich in healthful omega-3 fatty acids (you’ll learn more about their health-boosting benefits in the next section).
But “get more fats from plant sources than animal,” says David Rakel, M.D, director of Integrative Medicine at the University of Wisconsin School of Medicine.
“Fat isn’t bad, but we need more polyunsaturated and monounsaturated fats, such as those found in olive oil, nuts and avocados.”
2. Store-bought chips, margarine
Why they’re RA triggers: These snacks and spreads contain trans-fatty acids (TFAs), oils that are chemically processed to make them more solid and stable.
A diet high in TFAs increases C-reactive protein, a marker doctors use to indicate the amount of inflammation in the blood, according to a 2004 Harvard Medical School study published in the American Journal of Clinical Nutrition. The study showed that TFA-rich foods had a profound effect on inflammatory markers, making them twice as dangerous as saturated fats.
“Adding TFAs to the American diet was one of the worst things we could have done. The body requires a lot more energy to break down trans-fats, which creates inflammation,” Rakel says. (Click here to learn more about his recommended steps for a healthier diet.)
TFAs show up in many packaged and processed foods, but they’re easily detected: Just look at the nutrition label. Since 2008, the Food and Drug Administration (FDA) has required that all U.S. food manufacturers list trans fats.
But watch out: Even if a label proclaims zero trans fats, it’s not necessarily free of them. Federal regulations allow products containing up to half a gram of trans fat per serving to be labeled as “trans-fat free.”
That means consumers can easily exceed the maximum daily recommended amount of trans fats (1.11 grams) with just three pieces of toast spread with “trans-fat-free” margarine.
A safer bet: Stay away from products that include partially hydrogenated oils on the ingredient list; that’s code for trans-fat content.
Eat this instead: Nuts and seeds contain omega-3 fatty acids, a healthier fat that reduces levels of C-reactive protein, according to a 2009 study published in the European Journal of Clinical Nutrition.
“When you crave a crunchy snack, dump the chips and scoop up a handful of walnuts, a great source of omega-3,” says Joan Levinthal, a registered dietitian in Woodland Hills, Calif.
Replace margarine with trans-fat-free spreads, such as Smart Balance Omega-3 Buttery Spread, which contains omega-3-rich flaxseed and fish oil.
3. Cakes, cookies, white bread, potatoes and white rice
Why they’re RA triggers: These comfort foods rank high on the glycemic index (GI). They quickly break down into sugar, making insulin levels rise, which can cause inflammation.
In fact, each 10-point increase in a diet’s glycemic status is associated with a 29% rise in C-reactive protein, according to a 2008 Netherlands study published in the Journal of Clinical Nutrition.
“Sugar increases the inflammatory [process],” says nurse practitioner Marcelle Pick, R.N.C., Ob/Gyn N.P., author of The Core Balance Diet (Hay House) and co-founder of Women to Women, a holistic medical clinic in Maine.
"If you must have something sugary, eat it with some protein to slow its breakdown into glucose."
Eat this instead: By replacing white bread, potatoes and rice with moderate servings of whole-grain bread, sweet potatoes and brown rice, you’re eating on the lower end of the GI index. Plus, you’re adding more fiber to your diet, which fights inflammation, according to the Arthritis Foundation.
Check out these 7 High-Fiber Recipes.
Bing cherries have been found to reduce inflammatory markers, according to a 2006 study in The Journal of Nutrition.
Apples and pears are also low on the glycemic scale. Baked and flavored with cinnamon, they’ll taste like a decadent dessert.
“Cinnamon has been shown to help regulate blood sugar; plus, it has a sweet taste all its own,” says registered dietitian Angela Ginn, a spokesperson for the American Dietetic Association.
4. Milk and wheat products
Why they’re RA triggers: Some foods trigger food-intolerance reactions, such as bloating, irritable bowel syndrome (IBS) and headaches.
If you have food sensitivities, your immune system creates antibodies every time you eat them, causing an inflammation cycle, according to Pick.
To prevent this, eliminate foods that disturb your gastrointestinal tract.
Eat this instead: Because intolerances differ by person, find out your food allergies first, then pick healthier substitutes.
In month one, Pick’s patients follow a strict month-long elimination diet that excludes common food triggers: sugar, dairy, wheat, eggs, citrus, caffeine, soy. They also keep track of physical reactions in a food diary.
In month two, they slowly reintroduce missing foods, one at a time. Any foods that produce a negative reaction are permanently removed from the plate.
“After changing diets, some patients are able to go back to their doctors and ask to be taken off their RA medications,” Pick says.
RA Resources
Learn more about this chronic inflammatory disorder in our Rheumatoid Arthritis Health Center.
And read these articles for more ways to manage symptoms:
Healthy Cooking with Rheumatoid Arthritis
8 Best Foods for Healthy Joints
10 Tools to Ease Joint Pain
Doctor-Recommended Tips to Ease RA Pain
14 Questions to Ask Your Doctor About Rheumatoid Arthritis
What’s Your Inflammation IQ?
Inflammation has become a hot topic over the last few years. The latest scientific research indicates that inflammation is behind more than 80% of the conditions we suffer from – everything from arthritis to heart disease. Dr. Mark Hyman, author of The UltraSimple Diet, agrees that inflammation leads to a host of health problems. Fighting it can get you on track to a healthier, happier life.
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