Anti-inflammatory diet: do's and don'ts?
August 9, 2014 5:18 PM   Subscribe

I'd like to make adjustments to my diet in an effort to overcome my chronic joint inflammation and poor circulation.

Please provide me with your tried and true tips on what foods and beverages to remove from my diet, as well as what foods may be beneficial to add. I'm open to vitamins and/or herbal supplements. Also, should my strategy be to first try an elimination diet?

Some specifics: I'm 27, have suffered from rheumatoid arthritis since I was 16, I do not currently take any prescription anti-inflammatory meds (I used to take diclofenac when I was in college, but ceased to take it after a while and never went back to a rheumatologist), I exercise regularly (moderate/intense cardio as well as yoga/weights - 5-6 days a week for 30-45 minutes at a time), I am of tall build for a woman (6'0) which I've been told may contribute to the poor circulation issues (cold hands/feet, even with the regular exercise and stretching).

Right now I eat a flexetarian diet - chicken and fish, infrequently red meat, am not a picky eater, and am also a 1-2 cup of coffee drinker at breakfast who also really enjoys red wine at night. I am diligent about water consumption and drink about 2-3 liters of water a day. I know that my affinity for red wine makes my joint inflammation worse because I feel the most stiff/sore the morning after I consume it. I feel relatively better on mornings where I do not imbibe, but even when I go for a couple of weeks without any wine or other alcohol, I still have painful swelling in my joints that I can't seem to overcome with the regular exercise and OTC anti-inflammatory meds. I take some supplements right now - collagen (which has legitimately helped the osteo-arthritis in my left knee), vitamin C, flax seed oil - but don't always remember to take them every day.

I realize I may need to just see a rheumatologist again, but I'd prefer to make dietary and lifestyle changes alone as opposed to relying mostly on prescription medication.

Thank you in advance!
posted by nightrecordings to Health & Fitness (19 answers total) 24 users marked this as a favorite
I am in a similar boat, and while I finally decided to go back to a rheumatologist (he prescribed methotrexate, which seems to be working,) avoiding gluten is the #1 thing that helps my joints. I wish it were otherwise, but I've tested it any number of times, and a solid dose of gluten means my hands swell within a day or two. I'm still pissed off about it.
posted by restless_nomad at 5:26 PM on August 9, 2014 [2 favorites]

Turmeric helped me for a little while. Get one of those enormous day of the week pill organizers to help you remember to take your pills.
posted by travertina at 5:55 PM on August 9, 2014 [1 favorite]

This site lists the inflammatory footprint for individual foods. I found it was too clunky to use long term as a regular tracker, but it's a good reference to figure out if there are any hidden culprits in your daily food habits, in terms of how it all balances out (you can add up foods to see what a cumulative effect would be for a given day/meal etc.).

So I know nothing about people joint pain, but we had a 14 year old dog (so presumably no placebo effect) who no longer whined in pain while standing up after a month or two on glucosamine supplements (bought from the people aisle in the drug store).
posted by blue suede stockings at 6:07 PM on August 9, 2014

Don't take flax seed oil, take fish oil, or at least in addition to your flax seed. You need a decent amount too. More than you would get from one capsule a day, I take three myself.

Also, seconding turmeric. Just make sure you take it with black pepper or black pepper extract, and a meal with a little fat as turmeric is very, very poorly absorbed by the body on it's own. I like to make my own capsules from organic turmeric and (just a touch) of black pepper, and several times a week I make a turmeric tea "latte" from turmeric, black pepper, and warm soy milk. I put off trying turmeric tea for ages because I thought the taste would not suit a tea, but actually it's a really unique delicious taste.

Also, take ginger capsules, and perhaps boswelia (holy basil). Eliminate as many or as much of the omega 6 oils in your diet and replace it with omega 3 oils (or omega 3 heavier oils). You want to get the omega 6 -omega 3 "balance" much more equal in your diet (pretty close to one to one). To do that you really have to try and get much more omega 3 and much less omega 6 as omega 6s are much, ,much more prevalent on our diet. Excessive (like daily) animal protein is not thought to be good for inflammation either.

There is tons you can do to address inflammation without prescription drugs. Though I'm sure no one on Askmetafilter likes him, I highly recommend reading some of Andrew Weil's books to understand not only what to do, but why you're doing it. His "thing" or his focus is very much on inflammation's role in health and disease so you'll find lots of stuff in his work and a much better perspective that trying to piece together information from the internet.
posted by Blitz at 6:50 PM on August 9, 2014 [2 favorites]

I do not have rheumatoid arthritis but I have chronic problems with one wrist from an old injury, and my knees aren't, well, great, and were a bit complainy when I took up jogging a while back. Someone at some point recommended tart cherry juice to me, and I have no idea if it works scientifically, but it seems to help. I am not sure percentage-wise how much of this improvement can actually be attributed to the fact that I really, really like tart cherry spritzers, but I'm getting good use out of my Sodastream this way, anyway. (I do about 1/4 cup of juice to a cup or so of seltzer. It helps that I tend to like sour things.) The wrist is still a problem from time to time, the knees are now usually fine, YMMV. I buy the real 100% juice in the glass bottles, not anything marketed as a supplement.
posted by Sequence at 6:54 PM on August 9, 2014

What about your salt intake? Lots of salt makes me all swelly as does an imbalance of potassium without being balanced out with proper hydration. Keep a really watchful eye on both.

Cutting out booze was huge for me. I also suggest getting tested for things like Reynauds - that ended up being my main reason for cold hands and feet (like frostbite from running outside with gloves on a cold day). As a total shot in the dark, have you had your kidneys checked out? For me it ended up being CKD3 which is awful, but I'm still an active thirty something lady and have managed to work around it. Getting daily exercise/a good sweat session is so cleansing.

For joint stiffness/pain I take two tablespoons of liquid fish oil every morning. It sounds gross and is a little spendy, but it's the equivalent of taking like, 20 capsules. You can get it at whole foods, trader joes or even some stop n shops. I like the lemon omega swirl Of this brand. It seriously had any joint pain and morning swelling gone within 2 weeks of regularly taking it.

I tend to naturally shy away from red meats, but going more towards the vegetarian side if the spectrum has helped. I also really limit things like pasta.

Have you seen 180 degree health? There are some awesome articles on diet and inflammation as well as raising metabolism. Highly recommend it.
posted by floweredfish at 6:54 PM on August 9, 2014 [3 favorites]

I realize I may need to just see a rheumatologist again, but I'd prefer to make dietary and lifestyle changes alone as opposed to relying mostly on prescription medication.

While I would encourage any lifestyle changes that might be helpful, avoiding regular check-ups with a good rheumatologist is the fastest way to buy yourself irreversible joint damage or worse with this condition. I just saw someone in the hospital who ended up needing a lung transplant for unattended rheumatoid lung. Please don't let magical thinking about what you're eating get in the way of medical care that you may need.
posted by drpynchon at 7:15 PM on August 9, 2014 [7 favorites]

Yes, do go see a rheumatologist. There are a lot of good RA therapies to choose from these days. Your diet already sounds okay. You're most likely going to need to be on at least some medicine, or at least have it available to you via an ongoing relationship with a doc, to avoid progression of your disease. A specialist clinician is also the best person to help you think through diet and lifestyle changes. The rest of us are just speculating.
posted by killdevil at 7:23 PM on August 9, 2014

The Paleo Mom website has tons of great info, especially regarding AIP (auto-immune protocol). What to cut out varies significantly, but AIP should give you a good starting point as well as recipes.
Tomatoes make my joints hurt like crazy. Potatoes & peppers (also Nightshades) not so much. Vegetable oils like corn, soy, and canola also hurt. But that's me. YMMV.

Ginger helps me immensely. So does getting more omega 3 and properly balancing it with omega 6 oils.
posted by Neekee at 8:16 PM on August 9, 2014

drpynchon is right - don't let your work on improving your diet/lifestyle keep you from regularly seeing your rheumatologist. You're an adult and you can choose to use or not use prescription medication for RA after discussing it with your doctor, but at least keep seeing them and having the discussions so you stay well informed as to what their recommendations are, whether you choose to follow them or not.

also, I admire your dedication to your health, but don't blame yourself if you cannot control your RA through lifestyle modification alone. not everything that happens in our bodies is something we can change without medical assistance. Sadly, many have suffered or died while trying to disprove that fact. It's not a personal failing if you get a chronic illness. Best wishes as you find your solution...
posted by treehorn+bunny at 9:20 PM on August 9, 2014 [4 favorites]

I'm open to vitamins and/or herbal supplements.

Omega 3 fatty acids and turmeric are two of the things you're supposed to consume a lot more of than you can probably manage from diet alone so getting those in supplement form might help. I like OmegaBrite and Turmeric Force.
posted by Jacqueline at 9:30 PM on August 9, 2014

There are many explanations for how a placebo-like effect might be explained in animals, and, from the same site, a short bit about diet and inflammation... Most people past a certain age feel a certain soreness after drinking. I have joint problems and do not mean to sound quite so without empathy, but I have never seen solid evidence for dietary changes and joint ~itises. I want to say gentle exercise is your best long-term bet, but IAN[Y/A]D.
posted by kmennie at 4:37 AM on August 10, 2014

I have rheumatoid arthritis and found that when I stopped eating acidic foods (for another condition) that my joints felt better. For me that list is alcohol, citrus, strawberries, pineapple, tomatoes, chocolate, cranberries. The list my doctor gave me also included soy, coffee, and cigarettes, which I don't eat or use anyway, and lima beans, black beans, and tea, which are fine for me.

I'll nth going back to your rheumatologist. Diet and lifestyle management can help, but medication has helped a lot more.
posted by bile and syntax at 5:13 AM on August 10, 2014

I made a lot of dietary changes over the years to get my inflammatory condition under control. I can't possibly explain it in one comment on AskMe. Here are a few of the highlights:

I gave up peanut oil permanently and I severely limit peanut products, which I avoided as much as I could for 4 years before they became tolerable.

I added more alkaline foods to my diet, like lettuce and white corn.

I supplemented calcium, magnesium and few other things until I stopped being symptomatic for being deficient. I will suggest you look around and try to figure out what, specifically, you might be deficient in. Calcium and magnesium deficiency tend to go hand-in-hand. Both are alkaline minerals. The body strips calcium from the bones when your tissues are too acid in order to maintain an acceptable blood ph, so it's a fairly safe bet that this is one thing you could stand to get more of. And that is why I am mentioning those two in specific but Best Practices: Figure out what you are symptomatic for being deficient in and address those things.

I used to have joint problems. That was one of a long list of issues I had which commonly occur for people with my genetic disorder. I don't have those problems anymore.

Best of luck.
posted by Michele in California at 2:04 PM on August 10, 2014 [1 favorite]

Response by poster: Thank you everyone for your recommendations. I'm now definitely going to listen to your collective wisdom and schedule an appointment with a rheumatologist. And I'll be adding the fish oil and turmeric to my diet with the black pepper supplements, as well as the calcium and magnesium.
posted by nightrecordings at 3:54 PM on August 10, 2014

Forgot to mention my rheumatologist also put me on vitamin D supplements (after a blood test) - since it seems like *everyone* is low, it's probably something to expect.
posted by restless_nomad at 9:22 PM on August 10, 2014

I was diagnosed with RA at age 21, and my blood tests stopped showing RF and ANA as positive about a year after I went gluten free (which I've done for the last three years or so). Yes, it totally sucks. But my joints stopped degrading and so many symptoms improved when I was a few weeks clean of gluten that it's at least worth a shot.

Now, when I eat gluten it causes all kinds of problems that I had just accepted as being part of my normal. Turns out, they're only part of my normal when I'm fucked up on gluten.

It's a tough change, but it is DEFINITELY something to consider.
posted by guster4lovers at 12:36 AM on August 11, 2014

The Whole30 is pretty much THE standard for anti-inflamatory diets.
posted by Brittanie at 11:45 AM on August 11, 2014

* Get low-sulfite wine, it's less inflammatory

* Possibly do less exercise. Exercise does actually increase inflammation, infuriatingly enough (this doesn't feel fair!). You may be able to do less but still reap significant health benefits. Look into HIIT.

* Get into a routine where you include anti-inflammatory foods in your meals. Someone already mentioned turmeric and ginger; these are great. Someone mentioned pineapple as a food to avoid, but I don't agree with that unless you specifically have an intolerance to it. The bromelain in fresh pineapple is anti-inflammatory (it's more concentrated in the core, so make sure you eat the core too).

* Quality--not just type--of food matters a great deal. You currently aren't eating red meat, but red meat has many health benefits if it's raised and prepared properly. Get pastured beef or lamb, preferably organic and local; there's a big difference between this and red meat from CAFOs. Pastured meat has a far better omega-3/omega-6 ratio. You also want to cook it without charring, so no grill or high-heat roasting; stewing is best.

* Black pepper is something a lot of people have a problem with without realizing it. I'd stay away from it unless you're prepared to do a really well-done test where you change nothing else about your diet and then keep daily notes about how you're doing.
posted by mysterious_stranger at 9:56 AM on January 1, 2015

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