In my rheumatology practice I often treat patients suffering from painfully arthritic joints who have been unable to get relief, despite seeing many doctors. I tell them that one of the most important things they can do for their arthritis is to change their diets. After just a few weeks on my pain-free diet plan, I’ve had many patients cut back on their anti-inflammatory medications and even put off joint-replacement surgery. The diet helps alleviate pain and stiffness in most types of arthritis, including rheumatoid arthritis and osteoarthritis.

How it works: The pain-free diet guides you toward healing foods that are known to reduce inflammation and boost the immune system. It helps you eliminate those foods that promote inflammation and might trigger symptoms. The diet also includes recommendations on nutritional supplements. Bonus: This nutritional approach makes it easier to maintain a healthy body weight, which is essential for patients who need to take pressure off their joints. Maintaining a healthy body weight also produces metabolic changes that lessen the body’s inflammatory response.

Helpful: It’s easier to maintain a healthy weight when you eat frequent, smaller meals. Instead of three large meals, eat about six mini-meals throughout the day. In addition to a breakfast, lunch and dinner of about 300 calories each, eat three snacks between meals of about 150 to 200 calories each.

FOODS THAT HEAL

Foods that are high in antioxidants and other inflammation-fighting nutrients can noticeably reduce arthritis pain and stiffness when consumed daily. The following are especially effective…

High-antioxidant fruits and vegetables. Antioxidants help reduce inflammation.

Several years ago, the US Department of Agriculture ranked the following foods according to their antioxidant activity. Among the top 10 fruits and vegetables from highest to lowest were blueberries, kale, strawberries, spinach, Brussels sprouts, plums, broccoli, beets, oranges and red grapes. Eat a variety of these foods, raw and cooked, to get the greatest benefit. Also beneficial: Asparagus, cabbage, cauliflower, tomatoes, sweet potatoes, avocados, grapefruit, peaches and watermelon.

Oil-rich fish. Research has shown that the omega-3 fatty acids contained in anchovies, mackerel, salmon, sardines, shad, tuna, whitefish and herring help reduce inflammation — particularly levels of leukotriene B4, a chemical that contributes to many types of arthritis. Researchers have found that women who ate at least three servings of baked or broiled fish weekly had about half the risk of getting rheumatoid arthritis as those who ate only one serving.

Soy. Studies have found that a diet rich in soy may help reduce inflammation-related pain and swelling. Try tofu, soy milk, soy yogurt, soybeans or miso, a traditional Japanese food consisting of fermented soybeans and made into a thick paste.

Green and black tea. Green tea contains a polyphenol (a chemical found in plants that acts as an antioxidant) called EGCG, which can inhibit a key gene involved in the arthritis inflammation response. Research suggests that the more you drink, the more benefit you’ll get. Black tea, while processed differently than green, also provides benefits. It contains anti-inflammatory chemicals of its own called theaflavins. The Iowa Women’s Health Study found that women who drank three or more cups of tea (not including herbal tea) reduced their risk of rheumatoid arthritis by 60%.

Pineapple. This tasty fruit contains bromelain, an enzyme that reduces inflammation associated with arthritis. Fresh pineapple is the most beneficial, but canned is also good.

Onions and apples. Both of these foods are especially high in flavonoids, which are also inflammation-fighting compounds. Eat a variety of these foods, both raw and cooked.

FOODS TO AVOID

The only way to know which of the foods below affect your joint pain is to eliminate each one for at least two weeks and assess your symptoms. That way, you’ll know which type of food increases your inflammation and pain.

Avoid foods that increase inflammation. There are a variety of foods that trigger the body to produce cytokines — naturally occurring proteins that can promote inflammation, leading to pain and deterioration of cartilage in the joints. These include beef and other red meat… foods cooked at high temperatures, particularly fried foods… and any foods containing man-made trans fats (often called partially hydrogenated fats or oils on food labels), including junk food and commercial baked goods. Eat these types of foods sparingly.

Reduce intake of foods from animal products. I tell my patients to eat turkey and chicken in moderation. But the fact is that all animal products — including poultry, some farm-raised fish, egg yolks and other dairy products — contain arachidonic acid, a fatty acid that is converted by the body into prostaglandins and leukotrienes, two other types of inflammation-causing chemicals. I’ve had many patients tell me that they reduced arthritis symptoms by adopting a “modified vegetarian” diet.

Key:Decrease your intake of animal protein and increase the amount of protein you get from fish and plant sources, such as beans, nuts, soy, portobello mushrooms (a common meat substitute) and whole grains. Start by substituting one-fourth of the animal protein you normally eat with plant-based foods, cold-water fish and low-fat dairy. After two or three months, increase the substitution to half — adding more vegetables, fruits, lentils, beans, fish, whole grains and low-fat dairy. After a while, many of my patients choose to give up all animal protein because they enjoy the benefit of reduced pain and inflammation.

Note: A small percentage of people find that certain vegetables — including tomatoes, white potatoes, peppers and eggplant — make their arthritis worse. These nightshade family plants contain solanine, a substance that can be toxic if not sufficiently digested in the intestines. Eliminate all of these foods, then add them back one at a time — as long as you do not have pain or inflammation.

Stay away from foods with a high glycemic index. While high-glycemic foods (foods that quickly raise your blood sugar) should be avoided by people with diabetes or prediabetes, they pose problems for people with arthritis as well.

Reason:They increase insulin production, which promotes accumulation of body fat and causes a rebound sensation of hunger a few hours after eating — making it harder to maintain a healthy weight, which is important for reducing arthritis symptoms. High-glycemic foods include table sugar, baked white potatoes, French fries, pretzels, white bread and rolls, white and brown rice, potato and corn chips, waffles, doughnuts and corn flakes.

Supplements that Can Ease Arthritis

The following supplements may also help reduce arthritis inflammation. Always check with your doctor before taking any dietary supplement — even a “natural” one.

Glucosamine (1,500 mg/daily). While the data on this nutritional supplement are mixed, it’s perfectly safe. Some studies suggest that it may slow arthritis progression. It’s often combined with chondroitin (1,200 mg), another nutritional supplement that may help relieve arthritis symptoms for some people.

Vitamin C (500 mg to 1,000 mg/daily) plays a key role in building and protecting collagen, an important component of cartilage. Among other things, it contains antioxidants that fight inflammation and help regenerate damaged joint tissue.

Bromelain. This anti-inflammatory enzyme is found in pineapple, but it’s also available in pill or capsule form. Include fresh pineapple (two servings daily) in your diet or take capsules (follow directions on label for amounts) — or do both.

Fish oil capsules. For people who aren’t eating two or more servings of fish per week, this is a good option. Your dose should provide 600 mg of combined DHA and EPA in a 2:1 ratio — the ratio that occurs naturally in wild salmon. Read your product’s label for its DHA/EPA content.

Ginger. Clinical studies have found that this herb reduces arthritis symptoms and inflammation. It can be taken in the form of tincture, capsules, as a spice added to foods or as a tea made from boiling ginger root. You may benefit by drinking ginger juice or extract. Since ginger inhibits blood clotting, don’t consume more than four grams a day.