Arthritis literally means ‘inflammation of a joint’ and is common as we get older.
According to Arthritis New Zealand, arthritis affects more than 624,000 New Zealanders and is the greatest cause of disability in New Zealand. There are more than 140 recognised forms of arthritis, but the three most common types are osteoarthritis, rheumatoid arthritis and gout.
Osteoarthritis Osteoarthritis is the most common type of arthritis. It usually affects the 50-plus age group, and is slightly more common in women than men. It involves the breakdown of the protective cushion of the cartilage covering the ends of the bones, where two bones meet to form a joint.
Rheumatoid arthritis Rheumatoid arthritis can start at any age but usually occurs between the ages of 20 and 55. Three times as many women than men are affected. If not properly treated, ongoing inflammation can progressively damage joints and cause joint deformities. As an autoimmune condition, rheumatoid arthritis can also affect other systems of the body.
Gout Gout causes sudden attacks of pain in some joints. It can affect any joint but the first attack usually affects the big toe or another part of the foot. The joint becomes painful and swollen and the skin over the joint can become red and shiny. If not treated, gout can become chronic, causing damage to the joints and bones.
While anyone can be affected by arthritis at any stage of life, there are five groups most at risk:
Overweight people – the heavier we get, the more pressure on our joints.
Older people – ageing increases the chance of getting arthritis, particularly osteoarthritis due to wear and tear on joints.
Sports people – injuries from contact and other very physical sports are likely to lead to osteoarthritis. Prompt and appropriate treatment at the time of injury lessens the risk of long-term damage.
Women – more women get arthritis than men, particularly rheumatoid arthritis. The onset of rheumatoid arthritis tends to be in young women or those of middle age.
Maori and Pacific men – New Zealand Maori and Pacific men have the highest incidence of gout in the world.
Other risk factors include:
having a family history of arthritis
if you have had a joint injury or joint infection
having worked in heavy physical occupation.
Arthritis in children
Children can develop arthritis too. Juvenile idiopathic arthritis (JIA) is a term used to describe arthritis in children. It has also been called juvenile chronic arthritis (JCA). Around 1 in 1000 is affected by juvenile arthritis. It is commonly diagnosed between ages 1 and 4 years, but can occur at any age.
You may have arthritis if you have:
swelling in one or more joints
early morning stiffness for more than a few minutes
recurring pain or tenderness in one or more joints
obvious redness or warmth in one or more joints
unexplained weight loss, fever or weakness combined with joint pain.
If you have any of these symptoms for more than two weeks, see your doctor.
Treatment depends on the type and severity of arthritis. It's important a correct diagnosis is made before beginning any treatment. Generally, for most types of arthritis, the treatment will include:
rest and/or exercise
in some cases surgery to correct or prevent deformity, increase mobility and improve quality of life.
A variety of self care practices can help people control and reduce the effects of arthritis. These may include:
physical activity (see videos in treatment section)
weight control to prevent extra stress on weight-bearing joints
evidence-based complementary therapies.
Self care courses and programmes
Research has shown that people who exercise regularly, practice relaxation and/or use other self care techniques have less pain and are more active than people who are not self-managers. Courses are designed to give you the skills needed to take a more active part in your arthritis care, together with a healthcare team.
Arthritis NZ employs skilled educators. They can give you information and advice, refer you to other health professionals and/or agencies, put you in touch with support and exercise groups throughout the country.
They can also help you obtain special equipment and aids for daily living.
Credits: Arthritis New Zealand and Health Navigator, May 2017. Images 123rf.com. Reviewed By: Editorial team
Last reviewed: 20 Jul 2017
For most forms of arthritis no specific diets are advised, other than a nutritious balanced diet, including plenty of fruits and vegetables. People with gout, however, should watch their intake of certain foods and alcohol to help avoid attacks.
Keeping to a healthy weight through healthy eating and exercise is recommended to improve arthritis symptoms, and for overall benefits. Talk to your doctor or dietitian before cutting out any food groups (eg, a vegetarian diet) to ensure you still get the required vitamins and minerals.
Overall benefits from good diet
Healthy eating can help you manage your arthritis as well as reduce your risk of other long-term conditions such as type 2 diabetes, heart disease, certain types of cancer and osteoporosis. It can help protect you against some potential side effects of drugs. If you are overweight and have osteoarthritis, even a small weight loss can greatly improve your mobility and health.
What is a healthy diet?
A healthy diet is the key to better health. Aim to reduce the amount of fat, salt and sugar that you eat and drink. Most New Zealanders don’t eat enough wholegrains, vegetables and fruit. A good diet includes choices from each of the four food groups.
The four food groups are:
vegetables and fruits
wholegrain bread and cereals
milk and dairy products (reduced-fat products are a better choice for most people)
lean meats, poultry, fish, eggs.
The New Zealand Ministry of Health recommends we eat at least five portions of vegetables and fruit every day. Choose colourful vegetables and fruit as these are rich in protective substances known as antioxidants as well as vitamins.
Aim to eat oily fish such as kahawai, tuna, salmon, sardines, herring and mackerel at least twice a week. Current evidence suggests that omega-3-fatty acids found in oily fish are likely to be beneficial if you have an inflammatory type of arthritis.
Why is my weight so important?
The most important link between your diet and arthritis is your weight. Being overweight puts an extra burden on your weight-bearing joints (back, hips, knees, ankles, feet) when they are already damaged and under strain. Because of the way joints work, the pressure in your knee joints is more than your body weight when you walk. If you are overweight and have arthritis in any of your weight-bearing joints, losing weight will help you more than any food supplements. Talk to your doctor or dietitian about the best diet for you to lose weight.
On the other hand, some people with rheumatoid arthritis may struggle to maintain a healthy weight. Small frequent meals (five or six a day) will help avoid undesirable weight loss. Also increasing your intake of foods high in healthy fats (mono and polyunsaturated fat) may help; for example, oily fish, avocado, nuts, olives and oils.
Can changing diet help my arthritis?
Gout is the only type of arthritis that can be substantially improved by changing your diet and lifestyle. Choose small servings of meat, chicken and seafood. Enjoy low-fat dairy foods every day. Drink less alcohol (beer, wine and spirits) and fizzy drinks. Drink plenty of water.
Do I need to avoid any foods?
Some people feel that cutting out ‘acidic fruit’ such as oranges and grapefruit, and vegetables from the nightshade family (potatoes, tomatoes, sweet and hot peppers, and eggplants) helps arthritis. There is no scientific evidence that leaving out either of these types of foods does help, and such diets may have the undesired effect of reducing beneficial nutrients.
There is some evidence that a vegetarian diet is helpful for some people with inflammatory arthritis. If you decide to try this, it can become difficult to obtain sufficient energy, protein and minerals (eg, iron and calcium) from your food and it would be best to have personalised dietary advice from a dietitian.
Keeping a food diary for up to three months may be useful to see if there is a correlation between your diet and your symptoms. You might be able to identify a possible link. The problem with this approach is that, for many, symptoms can vary as a normal part of the condition, and any correlation with your diet may be just a coincidence.