Osteoarthritis is the fastest growing cause of disability worldwide. It is a condition affecting the whole joint.

It most commonly occurs in the hip and knees but can also affect the spine, hands and big toe. Cartilage breaks down and inflammation in the joint can lead to pain, discomfort and reduced quality of life.

My post on nutritional support for osteoarthritis focuses on whole foods, not supplements. Can nutrients and phytonutrients from whole foods help?

Photo by Katie Smith on Unsplash

Seven key nutritional supports for osteoarthritis

#1 Balance dietary fats

We often think of balancing dietary fats to reduce blood cholesterol levels, but choosing fats that reduce inflammation is also important.

There are two types of polyunsaturated fats found in food, omega 6 and omega 3. Omega 6 fats tend to increase inflammation whereas omega 3 fats reduce inflammation.

Eat less omega 6 fats

• Corn, grapeseed, safflower, and sunflower are examples of oils containing high levels of omega 6 fats.
• Oils high in omega 6 are best replaced with oils containing mostly mono-unsaturated oils, such as olive oil. Rice bran oil is also an option but it is more highly processed than olive oil.
• Food sources of mono-unsaturated oil include avocado, almonds, cashews, and peanuts.

Eat more omega 3 fats

• The best source comes from oily fish such as salmon, sardines, tuna and blue mackerel. Barramundi and flathead and scallops and mussels also provide a good source of omega 3 fats.
• Good plant sources include walnuts and chia seeds and linseed (flaxseed).
• Some omega 3 fats are also found in eggs, chicken, and beef.

Aim to have one to two oily fish meals per week and eat walnuts and seeds daily. About 30g of nuts a day is recommended for most of us. Check your individual requirements with your healthcare practitioner.

If you are unable to eat these foods, then discuss whether you require an omega 3 oil supplement with your healthcare practitioner.

#2 Blood cholesterol

Research has shown that people who have osteoarthritis also have raised blood cholesterol levels. There is some evidence showing that reducing blood cholesterol levels improves osteoarthritis.

General guidance:

• Balance dietary fats (see above).
• Increase dietary fibre, especially soluble fibre. For practical tips on how to eat more dietary fibre click here.
• Limit highly processed foods with added saturated fat and added sugars, such as cakes, biscuits, confectionary, fast foods and savoury snacks.

* Low fat dairy products may be recommended, but this depends on your total balance of foods. Your healthcare practitioner is best placed to offer personalised advice.

#3 Antioxidants

Antioxidants from food help to reduce oxidative stress in the body, which may be involved in the development and progression of osteoarthritis.

Vitamins A, C and E have antioxidant properties, as do a number of naturally occurring chemicals in foods, referred to as phytonutrients of phytochemicals.

Eating whole fresh fruits and vegetables provides the best source of antioxidants, see the table below.

#4 Vitamin D

Vitamin D is central to bone and cartilage health. Adequate sunlight is important but refer to safe sun guidelines. See food sources of vitamin D in the table below.

#5 Vitamin K

Vitamin K plays a role in making bone and cartilage and may be important in osteoarthritis. Leafy green vegetables provide a good source of vitamin K. There is some evidence showing that olive oil helps improve the absorption of vitamin K.

#6 Herbs and spices

Herbs and spices provide a range of phytonutrients, which can have antioxidant and anti-inflammatory properties.

Turmeric

Turmeric has been the most researched spice in regards to anti-inflammatory actions, but we do not have a clear dosage recommendation. You can safely add fresh or dry turmeric in cooking.

Ginger

Ginger has been used extensively in Ayurvedic medicine for its anti-inflammatory properties. Again, ginger can be used in cooking or in a warm drink.

Table – Key foods and nutrients

Nutrients	Food Source
Vitamin A	Carrots, Kale, Sweet Potato. Liver.
Vitamin C	Citrus fruits, blackcurrants, raw green and red peppers, but widely found in all fruits and vegetables.
Vitamin D	Egg yolks, oily fish.
Vitamin E	Nuts and seeds, whole grain cereals and vegetable oils.
Vitamin K	Broccoli, Brussels sprouts, kale, and lettuce.
Omega 3 fats	Salmon, sardines and other oily fish (see the warning for women below). Walnuts, chia seeds, flaxseed.
Mono unsaturated fats	Olive oil, avocado, almonds, cashews, and peanuts.
Soluble fibre	Fruits, vegetables, lentils, legumes, barley, oats, oat bran, psyllium, and flaxseeds.
Insoluble fibre	Skins of fruits and vegetables, nuts and seeds, lentils and legumes, wholegrain foods and brans from wheat and rice.
Resistant starch	Firm bananas, cold cooked potato, lentils and whole grains.
Herbs and Spices	Flavour your food with a range of fresh or dried herbs and spices. Follow recipe instructions. Turmeric can be added to non-traditional foods too, such as whole grain porridge. I usually use a ¼ teaspoon per serve.

#7 Healthy body weight

One of the most important links between diet and osteoarthritis is body weight. Carrying excess weight places stress on the joints. And excess body fat causes inflammation, which can increase the symptoms of osteoarthritis.

There is strong research evidence that losing weight reduces pain and improves mobility and function. If you are overweight or obese, even a 10% reduction in your weight is beneficial to your symptoms and overall health and wellbeing.

The best approach to working towards a healthy body weight is making mindful eating and lifestyle changes. What we eat, as well as how we move is equally important, as is good quality sleep.

Exercise support is best gained from a qualified healthcare practitioner such as an exercise physiologist, physiotherapist or occupational therapist. Discuss the most appropriate exercise options with your main healthcare practitioner.

Special warning for women

Women who are pregnant or breastfeeding should avoid fish with high levels of mercury e.g. swordfish, shark, king mackerel and some species of tuna. Smaller fish usually have lower levels. Cod liver oil should also be avoided due to the high vitamin A content. If you have concerns about this warning, then please discuss your personal requirements with your healthcare practitioner.

Summary of nutritional support

• Balance dietary fats, fibre, and nutrients by eating a range of whole foods.
• Use herbs and spices in cooking.
• Enjoy a healthy body weight by eating whole foods and being physically active every day.

For more information on each food group

1. Fruits and vegetables
2. Whole grains
3. Nuts, seeds and oils
4. Dairy and alternatives
5. Meat, fish, poultry, eggs, legumes

For personalised advice see your healthcare practitioner.

Sallyanne also offers online eating and lifestyle consults and courses. Inquire here.