Osteoarthritis and the Mediterranean Diet
There are an estimated 7.4 million people over the age of 45 living in the UK with a diagnosis of osteoarthritis (OA). NICE (the National Institute of Health and Care Excellence) is in the process of reviewing the guidelines in relation to OA. The review has 3 key messages: exercise more, lose weight and avoid use of paracetamol and other pain killers. They acknowledge that support is needed to achieve these goals. “Exercise more” and “lose weight” are both easy to say. They are however much harder to achieve in practice. What can you do to help yourself? This blog post looks at the evidence behind Osteoarthritis and the Mediterranean Diet and how eating this way may bring some pain relief.
Weight, Inflammation and Osteoarthritis
There is no doubt that carrying extra weight puts strain on the large, weight bearing joints of the knee and hip. Losing weight will reduce the load on these joints and have a positive impact on pain and quality of life. However, it is clear in the research that people carrying excess weight also experience a higher incidence of OA in small, non-weight bearing joints – the fingers, wrists and elbows. So, there is more to it than just weight loss. Whilst we need more research, it is likely that the heightened levels of inflammation associated with overweight, affect the joints and cause pain. The Mediterranean Diet could be the perfect pill. It is anti-inflammatory in nature with a focus on fresh, whole ingredients. It helps to lower inflammation and will assist with weight loss at the same time.
Osteoarthritis and the ‘Mediterranean Diet’ – what are the links?
One diet type that is discussed regularly in nutrition and health circles, is the ‘Mediterranean Diet’. It has been shown to be beneficial for cardiovascular disease, certain types of cancer and cognitive health. Speak to anyone from areas of the Mediterranean who eat such a diet and they are likely to tell you that there is no one ‘Mediterranean Diet’. However, there are similarities between the varying cultures and nationalities eating in this way and much we can learn.
How can we in the UK start to eat in a more ‘Mediterranean’ way?
Swap No. 1 Bring on the Olive Oil
Stop cooking with seed oils, such as sunflower and rapeseed. Get excited about olive oil! This mono-unsaturated fat is high in phenols, the anti-inflammatory compounds of the plant kingdom. Use for sauteeing vegetables. Keep the temperature low by ‘steam frying’ (adding drops of water to the oil and vegetables) and keeping a lid on whilst frying. Make most of your olive oil use ‘raw’ at the table though and be generous. 2-3 tbsp of raw olive oil daily is good. Read more about olive oil here.
Swap No. 2. Let your Rainbow Shine
Less of a swap; more like a ‘budge over’. Picture your dinner last night. Mentally separate it, pie-chart style, into bright colours (the rainbow of vegetables) and beige elements (pasta, bread, potato). Does the rainbow transcribe a full arc, filling half your plate? Or is it more like a tease of rainbow, full of promise, but not really delivering much in the way of ta dah? If the latter, then give your rainbow more room to shine on your plate! Increase the vegetables, make it colourful, aim for half the plate to be filled.
Tell those potatoes to budge over. Give your rainbow a chance.
Swap No. 3. The Power of Fermented Foods
Swap shop-bought salad dressing for some homemade sauerkraut. This hits the spot in so many ways:
- Shop-bought salad dressings tend to be high in omega-6 fats, which, when out of balance with omega-3’s, contribute to inflammation.
- Sauerkraut gives you the sharp, vinegary taste you desire but something else besides: bacteria! Yes, unpasteurised sauerkraut is teeming with bacteria and we need more of them. We are good at destroying our bacteria – anti-bac soaps, frequent washing, certain medications, stress, ultra-processed foods and alcohol all contribute to the destruction.
- Sauerkraut can help restore the balance of bacteria and whilst it might seem unlikely, there are certain ‘microbiome’ profiles (the whole garden of bacteria in our digestive tract) that are being associated with lower risk of developing OA. Read more about it here.
Swap No. 4. Bring on the Nuts!
Looking for something crunchy? Ditch the crisps, bring on the nuts! And seeds for that matter. Mediterranean diets tend to have higher proportions of nuts and seeds than other western diet patterns and there are studies showing anti-inflammatory health benefits from these power houses of nutrition. Go for variety – they all have their unique properties, so the more varieties, the better.
Osteoarthritis and the Mediterranean Diet – If you have been diagnosed with osteoarthritis and would like to discuss your own situation and how nutrition and lifestyle changes may be able to help, you can book a free call with me. I’ve worked successfully with OA clients, who report reduced pain and improved quality of life. I will dispel the myths and discuss practical, delicious ways for you to make a difference to your health every day. It is worth investing in your health so you can get your life back on track. Call me to find out more.
If you are looking for some recipes, grab a free eBook with 10 delicious recipes focusing on cruciferous vegetables. Good for our livers and the creation of the master antioxidant, glutathione, which can help modify pain. Grab it here!
Osteoarthritis and the Mediterranean Diet: A Systematic Review Isabel Morales-Ivorra, Montserrat Romera-Baures, Blanca Roman-Vinas, et al, Nutrients. 2018 Aug 7;10(8):1030
Osteoarthritis: Care and Management. NICE https://www.nice.org.uk/guidance/indevelopment/gid-ng10127/consultation/html-content-2
Mediterranean diet and knee osterarthritis outcomes: A longitudinal cohort study Nicola Veronese, Ai Koyanagi, Brendon Stubbs et al, Journal of Nutritional Science 2020 Aug 27;9:e37
Health effects of a low-inflammatory diet in adults with arthritis: a systematic review and meta-analysis Furkan Genel, Michael Kale, Natalie Pavlovic, et al,