Individuals following a typical Western diet, characterized by large portions, high calories, and excess sugar, tend to have higher rates of metabolic syndrome, which can exacerbate arthritis. A recent study revealed that higher metabolic syndrome severity correlates with worse osteoarthritis progression, indicated by more severe bone sparing, bone marrow lesions, and cartilage defects.
Alternative weight loss options exist for those not opting for surgery. A network meta-analysis compared different weight loss treatments for knee osteoarthritis, including data from 30 clinical trials with 4600 patients. The most effective interventions were found to be bariatric surgery, a low-calorie diet combined with exercise, and intensive weight loss with exercise. The study indicated that weight loss, particularly when combined with exercise, significantly improves arthritis symptoms. Another systematic review and meta-analysis, incorporating data from seven clinical trials with over 1100 patients, determined that a 5% weight loss produced a small positive effect on pain, self-reported disability, and quality of life in adults with obesity and mild to moderate knee osteoarthritis. A 10% weight loss had moderate to large effects on these measures. The role of diet in managing arthritis symptoms is crucial. Anti-inflammatory diets, such as the Mediterranean diet, offer numerous health benefits, including improved brain health, lower risk of heart disease, cancer, diabetes, and weight management.
These diets are typically rich in plant-based foods with high dietary fiber, which can alter the gut microbiome’s composition and metabolic activity, leading to further anti-inflammatory effects. Clinical trials have shown that low-inflammatory diets can significantly reduce symptoms and inflammatory biomarkers like C-reactive protein and interleukin-6 in arthritis patients, with particularly notable effects in rheumatoid arthritis patients. The systematic review and meta-analysis comparing anti-inflammatory diets (Mediterranean, vegetarian, and vegan) to omnivorous diets found that patients on anti-inflammatory diets reported less pain, better health questionnaire scores, and lower swollen joint counts. These diets also led to more weight loss and BMI reduction. The Mediterranean diet showed the greatest effect on outcomes, and longer intervention periods yielded more significant results. Despite the high risk of bias in the studies, the benefits of anti-inflammatory diets in reducing arthritis symptoms are evident. Conducting studies on diet poses challenges, including difficulty in blinding participants to the foods they eat and the tendency to misreport food intake.
Despite these limitations, anti-inflammatory diets have shown independent benefits in reducing arthritis symptoms and inflammatory markers, potentially slowing disease progression. These diets are also effective for weight loss, further improving arthritis symptoms. Foods commonly included in an anti-inflammatory diet will be outlined, emphasizing the importance of incorporating a variety of colorful foods, each representing different beneficial phytochemicals and antioxidants. Berries, pomegranates, cherries, kiwis, grapes, and citrus fruits are high in antioxidants. Leafy greens and cruciferous vegetables, such as kale, spinach, cabbage, broccoli, cauliflower, and Brussels sprouts, are particularly high in antioxidants. Other colored vegetables like carrots, eggplants, tomatoes, beets, onions, and garlic also reduce inflammation.
High fiber foods, essential for a healthy digestive system and cardiovascular health, promote feelings of fullness and support weight management. Examples include oats, brown rice, quinoa, barley, and whole wheat. Fatty fish rich in omega-3 fatty acids, such as wild-caught salmon, sardines, mackerel, herring, trout, tuna, and anchovies, along with nuts (almonds, walnuts, cashews, pistachios) and seeds (chia seeds, flax seeds), provide healthy fats and protein. Olive oil and avocados also offer healthy fats.
