Avocado soybean unsaponifiables (ASU). ASU is a
compound of the fractions of avocado oil and soy-
bean oil that are left over from the process of making
soap. It contains one part avocado oil to two parts
soybean oil. ASU was first developed in France,
where it is available by prescription only under the
name Piascle ́dine, and used as a treatment for OA in
the 1990s. It appears to work by reducing inflamma-
tion and helping cartilage to repair itself. ASU can
be purchased in the United States as an over-the-counter
dietary supplement. The recommended daily dose is
300 mg.
CAM DIETARY THERAPIES.Two traditional alterna-
tive medical systems have been recommended in the
treatment of OA. The first is Ayurveda, the traditional
medical system of India. Practitioners of Ayurveda
regard OA as caused by an imbalance among the
threedoshas, or subtle energies, in the human body.
This imbalance produces toxic byproducts during
digestion, known asama, which lodges in the joints
of the body instead of being eliminated through the
colon. To remove these toxins from the joints, the
digestive fire, oragni, must be increased. The Ayurve-
dic practitioner typically recommends adding such
spices as turmeric, cayenne pepper, and ginger to
food, and undergoing a three-to five-day detoxifica-
tion diet followed by a cleansing enema to purify the
body.
Traditional Chinese medicine (TCM) treats OA
with various compounds containingephedra, cinna-
mon, aconite, and coix. A combination herbal medi-
cine that has been used for at least 1200 years in TCM
is known asDu Huo Ji Sheng Wan, or Joint Strength.
Most Westerners who try TCM for relief of OA, how-
ever, seem to find acupuncture more helpful as an
alternative therapy than Chinese herbal medicines.
Rheumatoid arthritis
DIETARY ALTERATIONS.There is some indication
that patients with RA benefit from cutting back on
meat consumption or switching entirely to a vegeta-
rian or vegan diet. One follow-up study of RA patients
on a vegetarian diet showed that improvement contin-
ued after one and two years on the diet.
Another dietary adjustment that appears to bene-
fit some people with RA is switching from cooking oils
that are high in omega-6 fatty acids (which increase
inflammation) to oils that are high inomega-3 fatty
acids(which reduce inflammation. This second group
includes olive oil, canola oil, andflaxseedoil.
DIETARY SUPPLEMENTS.The most common dietary
supplements recommended for patients with RA are
as follows:
Fish oil. The oils from cold-water fish have been
reported to reduce inflammation and relieve joint
pain in some patients with RA. The recommended
daily dose is 1 to 2 teaspoons.
Plant oils that are high in gamma-linoleic acid
(GLA), which reduces inflammation in the joints.
These plant oils include evening primrose oil, borage
oil, and black current oil. The recommended daily
dose is 200 to 300 mg.
Green tea. Drinking 3 to 4 cups of green tea per day is
thought to benefit RA patients by reducing inflam-
mation in the joints.
CAM DIETARY THERAPIES.Ayurvedic medicine rec-
ommends a compound of ginger, turmeric, boswellia,
and ashwaganda to relieve the pain and fever associ-
ated with RA.
Traditional Chinese medicine (TCM) uses such
plants as hare’s ear (Bupleurum falcatum) and thunder
god vine (Tripterygium wilfordii) to reduce fever and
joint pain in patients with RA.Function
Osteoarthritis
The function of dietary treatment for OA is to
lower (or maintain) the patient’s weight to a healthy
level in order to minimize stress on damaged weight-
bearing joints; to maintain the structure and composi-
tion of the cartilage in the joints; to protect the general
health of tissues by including bioflavonoids andanti-
oxidantsin the diet; and by conducting food chal-
lenges when appropriate to determine whether specific
foods are affecting the patient’s symptoms.Rheumatoid arthritis
Dietary treatment of RA is primarily adjunctive,
as the disease cannot be managed by nutritional
changes alone. Patients with RA must take a combi-
nation of medications, usually a combination of
disease-modifying anti-rheumatic drugs (DMARDs)
and nonsteroidal anti-inflammatory drugs (NSAIDs),
to control pain, inflammation, and slow the progres-
sion of the disease. A well-balanced and healthful diet,
however, can help to offset the emotional depression
that often accompanies RA and to enable patients to
maintain a normal schedule of activities. It also helps
to prevent nutritional deficiencies in these patients
that may be caused by the use of prescription drugs
to control the disease.Arthritis diet