risk of heart attacks and stroke. RA differs from OA,
too, in the joints that it most commonly affects—often
the fingers, wrists, knuckles, elbows, and shoulders.
RA is typically a bilateral disorder, which means that
both sides of the patient’s body are affected. In addi-
tion, patients with RA often feel sick, feverish, or
generally unwell, while patients with OA usually feel
normal except for the stiffness or discomfort in the
affected joints.OriginsThe role of diet and nutrition in both OA and RA
has been studied since the 1930s, but there is little
agreement as of 2007 regarding the details of dietary
therapy for these disorders. One clear finding that has
emerged from seven decades of research is the impor-
tance of weight reduction or maintenance in the treat-
ment of patients with OA, and the need for nutritional
balance and healthy eating patterns in the treatment of
either form of arthritis. Findings regarding the use of
dietary supplements or CAM therapies will be dis-
cussed in more detail below.
Various elimination diets (diets that exclude spe-
cific foods from the diet) have been proposed since the
1960s as treatments for OA. The best-known of these
is the Dong diet, introduced by Dr. Collin Dong in a
book published in 1975. This diet is based on tradi-
tional Chinese beliefs about the effects of certain foods
in increasing the pain of arthritis. The Dong diet
requires the patient to cut out all fruits, red meat,
alcohol, dairy products, herbs, and all foods contain-
ing additives or preservatives. There is, however, no
clinical evidence as of 2007 that this diet is effective.
Another type of elimination diet, still recom-
mended by naturopaths and some vegetarians in the
early 2000s, is the so-called nightshade elimination
diet, which takes its name from a group of plants
belonging to the family Solanaceae. There are over
1700 plants in this category, including various herbs,
potatoes, tomatoes, bell peppers, and eggplant as well
as nightshade itself, a poisonous plant also known as
belladonna. The nightshade elimination diet began in
the 1960s when a researcher in horticulture at Rutgers
University noticed that his joint pains increased after
eating vegetables belonging to the nightshade family.
He eventually published a book recommending the
elimination of vegetables and herbs in the nightshade
family from the diet. There is again, however, no
clinical evidence that people with OA will benefit
from avoiding these foods.Description
Osteoarthritis
WEIGHT REDUCTION.The major dietary recom-
mendation approved by mainstream physicians for
patients with OA is keeping one’s weight at a healthy
level. The reason is that OA primarily affects the weight-
bearing joints of the body, and even a few pounds of extra
weight can increase the pressure on damaged joints when
the person moves or uses the joint. It is estimated that
that a force of three to six times the weight of the body is
exerted across the knee joint when a person walks or
runs; thus being only 10 pounds overweight increases
the forces on the knee by 30 to 60 pounds with each
step. Conversely, even a modest amount of weight reduc-
tion lowers the pain level in persons with OA affecting the
knee or foot joints. Obesity is a definite risk factor for
developing OA; data from the National Institutes of
Health (NIH) indicate that obese women are 4 times as
likely to develop OA as non-obese women, while for
obese men the risk is 5 times as great.
Although some doctors recommend trying a veg-
etarian or vegan diet as a safe approach to weight loss
for patients with OA, most will approve any nutrition-
ally sound calorie-reduction diet that works well for
the individual patient.
DIETARY SUPPLEMENTS.Dietary supplements are
commonly recommended for managing the discom-
fort of OA and/or slowing the rate of cartilage
deterioration:
Chondroitin sulfate. Chondroitin sulfate is a com-
pound found naturally in the body that is part of a
large protein molecule called a proteoglycan, which
imparts elasticity to cartilage. The supplemental
form is derived from animal or shark cartilage. Rec-
ommended daily dose is 1200 mg.
Glucosamine. Glucosamine is a form of amino sugar
that is thought to support the formation and repair
of cartilage. It can be extracted from crab, shrimp, or
lobster shells. The recommended daily dose is 1500
mg. Dietary supplements that combine chondroitin
sulfate and glucosamine can be obtained over the
counter in most pharmacies or health food stores.
Botanical preparations: Some naturopaths recom-
mend extracts of yucca, devil’s claw, hawthorn berries,
blueberries, and cherries. These extracts are thought
to reduce inflammation in the joints and enhance the
formation of cartilage. Powdered ginger has also been
used to treat joint pain associated with OA.
Vitamin therapy. Some doctors recommend increas-
ing one’s daily intake of vitamins C, E, A, and B 6 ,
which are required to maintain cartilage structure.Arthritis diet