Arthritis, particularly inflammatory arthritis, is subject to remissions, which means that symptoms sometimes disappear by themselves. If you remember this you are less likely to believe that eating or avoiding a particular food caused the improvement.

About one person in everv three is likely to respond to the 'placebo effect'. This means that if you really believe a product or special diet,will help your arthritis, chances are it may for a short time. However if the improvement is due only to this belief and nothing else, it will soon tend to disappear.

Arthritis and Overweight

Being overweight leads to increased stress on weight-bearing joints such as the hips, knees and lower spine. It is important for people with arthritis to avoid this extra burden.

Because physical activity may be difficult and painful for the person who has arthritis, he or she may exercise less. Unless energy intake (measured in kilojoules) is also restricted somewhat, the unused energy will turn into body fat.

It is important to choose foods wisely because a person with arthritis has the same requirements as anyone else for vitamins, minerals and other nutrients. Eat foods which give good nutritional value for money, and limit those which contribute 'empty kilojoules' such as pastries, cream and soft drinks.

Before embarking on a large-scale weight reduction program it is wise to consult your doctor or your dietitian. Many hospitals and community health centres conduct weight reduction programs.

Exercise combined with a lower energy intake has been shown to lead most effectively to weight loss. The Arthritis Foundation can assist with information about low impact activities such as water exercise, which involves less stress on painful joints.

What about Vitamin and Mineral Supplements?

If you do not or can not eat a normal diet, supplements are useful. Otherwise,  there is no evidence that they are helpful. It is preferable to obtain your nutrients through eating complete foods.

Most supplements which are sold contain doses far higher than the recommended daily requirements. At best these are unhelpful; at worst they can be downright dangerous and expensive. So vitamin or mineral supplements should only be taken if your doctor thinks it is sensible.

Recent Research into Diet

Possible links between diet and arthritis are continually being studied. Some interesting recent findings are:

• Certain fish oils (in a group called the Omega 3 fatty acids group) seem to have a mild anti-inflammatory effect upon rheumatoid and osteoarthritis when taken in very large doses. Because of the expense, the'fishy'smell and fattening properties of these supplements, they are not a practical choice for many. Cod liver oil is not a source of these particular oils and should not be taken in large amounts.
• A recent study in Cambridge, England, involved 80 people with rheumatoid arthritis (40 in the 'experimental' group and 40 in the 'control' group). The experimental group were taken off all normal foods and given only a special powder which provided full nutrition for a period of four weeks. Foods were then slowly re-introduced one at a time. None of the group showed a reaction to any particular food, though in a few people dairy fats showed a slight tendency to cause an increase in symptoms. No statistically significant differences between the experimental group and the control group (who were not given the experimental diet) were found.
• Some people have thought that allergic reactions to foods can cause arthritis. It is very rare to show a genuine allergy to food. Foods containing microbes, certain trace elements or antibiotics may release histamines, causing an adverse reaction, but this does not involve the body's immune system and therefore cannot be called an allergy.
• Recent studies confirm that excess weight contributes to osteoarthritis of weight-bearing joints such as the knees.

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Some sensible advice

• Keep your weight within normal limits.
• Make sure your diet contains adequate nutrients. Calcium and iron are especially important for women.
• Attend to any other health problems which may need a special diet . As a general health measure, think about decreasing dairy fats and animal fats in general. Use low fat dairy products and ensure only lean cuts of meat are eaten. In this way you may help to prevent other health problems which can make it more difficult to cope with arthritis.
• Pin a good nutrition chart on your refrigerator or kitchen wall.

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If you wish to go further..."

• It is wise to consult a doctor or registered dietitian first.
• You could inquire about increasing your intake of fish oils referred to earlier. Further research is needed to find the most helpful ways of using fish oil supplements.
• Test and re-test yourself with any foods which you believe make your symptoms worse, especially if you enjoy those foods.

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