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Eating wisely for Rheumatoid Arthritis - Diet for Rheumatoid Arthritis

Eating healthily as old as a Greek legend – but there’s something very true today about what a sensible diet can do for painful RA

Arthritis is a devastating condition and does not discriminate in terms of age, gender or ethnic origin. Anyone can be a target. It causes constant pain, stiffness and swelling in the joints and surrounding tissues. Those places in the body where bones come together – the knees, wrists, fingers, toes, and hips. The two most common types of arthritis are osteoarthritis and rheumatoid arthritis.

Osteoarthritis develops in joints with overuse while rheumatoid arthritis is an auto-immune disease, which means your immune system attacks your joints.

There are however many foods that can ease inflammation and may help relieve pain. In fact, one survey found that a quarter of those with rheumatoid arthritis said that their diet significantly reduced the severity of their symptoms.

Whilst there’s a thumbs up to green leafy vegetables, what you should be avoiding are red meats, processed foods, fried foods, sugar, refined flour, gluten, dairy products and of course anything with alcohol in it. Some, however, would extol the benefits of red wine consumed in moderation because it contains the compound resveratrol, with its well-established anti-inflammatory effects.

Using probiotics

Then there’s probiotics, which are thought to promote health by giving a boost to the so called ‘good bacteria’ that live in the gut – microbiota. Probiotics are present in or added to foods like certain yogurts, kefir, sauerkraut, tempeh, kimchi and kombucha. Then of course there are probiotic dietary supplements available in liquid capsule, powder, tablet and other forms. The jury is still out however as to the extent that these man made formulas do actually benefit us long term, although there are an awful lot of companies making a fortune from flooding the consumer market with them.

They seem to work in three ways: by maintaining a balance between the ‘good’ and ‘bad’ bacteria in the body; reducing the bad, which cause infections and illnesses and by topping up the good bacteria that are lost often after illness or from a course of antibiotics.

“People with inflammatory arthritis have been shown to have inflammation of the intestinal tract, which results in increased intestinal permeability,” says nutritional expert Sonya Angelone at the US Academy of Nutrition and Dietetics. “Probiotics may be able to help decrease the inflammation associated with increased intestinal permeability,” she says.

Best foods for RA sufferers

Here’s the Top 10 of the best foods to include in your diet if you have rheumatoid arthritis…

Oily Fish

salmon-fillets-arthritis

Salmon, mackerel, sardines and trout are high in omega-3 fatty acids, which have been shown to have potent anti-inflammatory effects. Omega-3 supplements decrease joint pain intensity, morning stiffness, the number of painful joints and use of pain relievers in patients with rheumatoid arthritis.

Fish is also a good source of vitamin D, which can help prevent deficiency. Multiple studies have found that rheumatoid arthritis may be associated with low levels of vitamin D, which could contribute to symptoms.

Tumeric

spice root curcuma arthritis

Many rheumatoid arthritis suffers search for homeopathic options. One supplement that has been used to treat arthritis for millennia is turmeric, that golden-coloured spice commonly used in curries. Turmeric contains a chemical called curcumin, and scientists believe that this chemical may have anti-inflammatory properties.

Garlic

garlic arthritis

It’s packed with health benefits. It’s been proven that garlic and its components have been shown to have cancer-fighting properties. They also contain compounds that may lower the risk of heart disease and dementia. For RA patients, garlic has been shown to have an anti-inflammatory effect that may help decrease symptoms of arthritis. Other research further and has shown that garlic may enhance the function of certain immune cells to help strengthen the immune system.

Ginger

ginger and lemons arthritis

Besides giving a boost of flavour to teas, soups and sweets, ginger may also help ease the symptoms of arthritis. One study found that ginger and its components blocked the production of substances that promote inflammation in the body. Consuming ginger in fresh, powdered or dried form may reduce inflammation and aid in reducing symptoms of arthritis.

Broccoli

Broccoli Arthritis

It’s widely appreciated that broccoli is one of the healthiest foods out there. In fact, its strongly believed to be associated with reduced inflammation. Broccoli has been associated with reduced inflammation. It also contains sulforaphane, which may have anti-inflammatory properties, according to test-tube studies. More research is needed to look at the effects of broccoli in humans.

Walnuts

Walnuts Arthritis

Never say nuts to these. They’re nutrient-dense and just packed with compounds that can help reduce the inflammation associated with joint disease. Analysis has shown that eating walnuts is associated with reduced markers of inflammation. They’re also especially high in omega-3 fatty acids, which have been shown to decrease the symptoms of rheumatoid arthritis.

Berries

Wild Berries Arthritis

They have loads of antioxidants, vitamins and minerals, which may part account for their unique ability to decrease inflammation. For example, those having two servings of strawberries a week are 14 percent less likely to have an elevated level of inflammatory markers in the blood. Berries are rich in quercetin and rutin -two plant compounds that boast a huge number of benefits for your health.

Spinach and other Leafy Greens

Spinach leaves Arthritis

These are full of nutrients and some of their components are said to help decrease inflammation caused by arthritis. Several studies have found that a higher intake of fruit and vegetables is linked to lower levels of inflammation. Spinach, in particular, contains the antioxidant kaempferol which has been shown to decrease the effects of the inflammatory agents associated with rheumatoid arthritis.

Grapes

Grape Arthritis

Nutrient-dense, high in antioxidants and they also have anti-inflammatory properties. Resveratrol is an antioxidant present in the skin of grapes. In one study, resveratrol showed potential for helping prevent the thickening of the joints associated with arthritis by blocking the formation of rheumatoid arthritis cells. Grapes also contain a plant compound called proanthocyanidin. Its extract reduces inflammation related to RA.

Olive Oil

 

Olive Oil Arthritis

Well recognised for its anti-inflammatory properties, olive oil can have beneficial effect on arthritis symptoms. Rheumatoid arthritis patients who consumed either a fish oil or an olive oil capsule each day for 24 weeks showed a near 40 percent decrease in symptoms in the olive oil group and 55 percent in the fish oil group. In a study of over 300 olive oil consumption was associated with a lower risk of RA.

The bottom line is that, when it comes down to what you eat, the right diet can play a major role in rheumatoid arthritis severity and symptoms. Many of the above foodstuffs combine what has become popularly known as the Mediterranean diet.

For many years the Mediterranean diet has been proven to help prevent heart disease and some forms of cancer. Now it’s discovered that it may also reduce the pain and swelling of joints stricken with rheumatoid arthritis – although its relief benefits may not begin to show for six weeks from start, studies have shown.

Significant improvements

However, three months down the line significant improvements were reported by the majority of the 26 arthritic patients in the US who followed a well-supervised Mediterranean diet regime. The diet includes olive and canola oils as the primary dietary sources of fat, along with plenty of fish, poultry produce and legumes – peas and beans – say researchers. By way of comparison, no relief was reported by another group of 25 patients who followed a typical Western diet. In addition to being provided with meals, the patients on the Mediterranean diet also received nutritional counselling on how to cook more healthfully. By the end of the study, they’d lost an average of seven pounds.

Meanwhile, those on a diet richer in dairy foods and red meat – typical in Europe and Scandinavia, as well as in the States of course – also received prepared meals but no counselling. They lost no weight and reported no measurable relief of symptoms. None of the study participants in either group had previously encountered the Mediterranean, or even a vegetarian-based, diet.

Benefits typical among Greeks

Their findings, published in the Annals of Rheumatic Diseases, clearly identify that arthritis relief may result from this eating plan, so typical among the inhabitants of many of the Greek isles. Meanwhile, University of Buffalo researchers found that mice fed high doses of fish oil and vitamin E had reduced levels of a specific protein that causes joint swelling and pain. Greek investigative scientists themselves found that a similar Mediterranean diet reduced the onset of rheumatoid arthritis by nearly three-fold – that’s compared with those who ate less olive oil and fewer fruits and vegetables.

So, it seems, the ingredients in these key cooking oils may be the key to pain relief. In addition to being good sources of heart-healthy fats, olive and canola oils are rich in oleic acid and vitamin E. Like vitamin E, oleic acid has an anti-inflammatory effect and is thought to reduce inflammatory protein levels.

Reduced disease risk

The fish eaten by the study participants in Greece didn’t have the same high levels of omega-3 and omega-6 fatty acids found in cold-water fish such as salmon, mackerel, and others associated with a reduced risk of heart disease and other conditions. Importantly, however, the nutrients in these oils may have a similar anti-inflammatory effect. And like green leaf veg, they’re also good sources of other antioxidant phytochemicals believed to reduce inflammation and inhibit tissue damage. The other foods in the diet research – legumes, poultry and cereals – are low in fat, which may further reduce inflammation.

The upshot of these dietary interventions show that a Mediterranean diet suppresses disease activity in patients who have stable and modestly active rheumatoid arthritis. Therefore, by eating a Mediterranean diet for three months, patients with RA can obtain better physical function and increase their activity. In theory, even a minor good effect that is persistent and accumulates over time is welcome. So why not try it? You may have nothing to lose but your waistline!

The scientific basis of yoga arthritis - Yoga for Arthritis: The science of Yoga

Take a deep breath and get started – Yoga could be your key

Yoga is a mind and body practice with its historical origins in ancient Indian philosophy. Like other meditative movement practices used for health purposes, various styles of yoga can combine physical postures with breathing exercises and meditation.

The word ‘yoga’ means union. It unites the mind, body and spirit. Those who get into a regular schedule of yoga invariably experience many health benefits.

Studies have shown the intrinsic value of dynamic exercise programs – with yoga and Tai Chi in particular helping to ease the symptoms of rheumatoid arthritis.  These same studies also suggest that practising yoga regularly might have other health benefits – like reducing heart rate and blood pressure as well as in the relief of anxiety and depression.

The evidence is clear

The evidence is clear that, when combined with a program of good medical care, yoga may provide important additional physical and psychological health benefits for arthritis patients. Many RA sufferers who have taken it up and stuck with it – maybe for years – consider it to be an important part of their lifestyle and disease management.

Yoga can be a safe and effective form of physical activity, but as with any new activity, it is important to take proper precautions. Talk with your doctor first and ask specifically if there should be any limitations or restrictions he thinks you should observe. For arthritis patients it is important to discuss your wish to take up yoga with your rheumatologist or orthopaedist.

You’ll want to find an instructor with a lot of experience, ideally one who has worked with people with RA. The most committed instructors are registered with the Yoga Alliance, based in the US, in which teachers bear the designations E-RYT 200 (completing a training regimen and teaching for a minimum of two years) and E-RYT 500 (even more qualified and four years plus of teaching).

An experienced teacher will know how to help you modify poses and, as important, won’t hold you back from doing what you are able to do. The experts suggest starting off with a private session or two with a yoga therapist, so you can learn adjustments to poses that work for you before you enter a main class.

Approved yoga styles for RA

People with rheumatoid arthritis are advised to look for these schools of yoga:

  • Iyengar – This method emphasizes precision and alignment in each posture, along with correct breathing techniques. A Iyengar instructor might suddenly shift your foot half an inch to put your hips in the proper place, which prevents you from putting excess pressure on the joints. Poses are typically held for a few minutes. The classes themselves include props which are particularly helpful for people with limited mobility.
  • Hatha – Technically refers to all forms of yoga involving postures. The term has however come to mean slower-moving classes – each pose is held for at least a few breaths. Separate breathing practices, known as pranayama, and a brief period of meditation are also typically included. With Hatha it’s easier to figure out how to modify poses that affect your joints. A deep relaxation period ends each session.
  • Restorative – An adaptation of Iyengar yoga, this practice is all about relaxation. Poses are held for five minutes or more with bolsters and blankets used to ensure each pose is comfortable. It allows you to get into a mental and physical state of deep rest. But don’t confuse restorative yoga with yin yoga, another practice that holds poses for a long time and aims to push the joints to their limit to improve flexibility. These stretches that can be too severe for people with RA.

Styles to avoid

On the subject of yoga styles RA suffers should avoid, there’s Bikram. Indian guru Bikram Choudhury developed this precise style, in which 26 specific yoga postures are done in a room kept at 105 degrees Fahrenheit and with 40 percent humidity! Its totally fatiguing, something people with RA don’t need more of, and the Bikram poses doesn’t allow for much adaptation. In fact, some of the poses particularly stress the joints.

Exercise enthusiasts are often drawn to vinyasa classes which encompass poses linked in a dynamic, flowing practice that is more aerobic than other yoga types. Instead of a hold you might immediately move into a twist, then a different stretch, then another – and so it goes on. Also, unlike the relaxing music you’ll find in most yoga classes, music here is often fast and furious to accompany the quick-paced movements.

While in theory a class of flowing movements can be fine for someone with RA, the face pace just doesn’t allow much time to alter poses that put pressure on the wrists or ankles. There are a small number of specialty vinyasa classes available that are geared for people with joint pain and in these classes participants are often able to use chairs.

Weight loss, diabetes and yoga

A person can burn anywhere between 200-500 calories during an hour of yoga but other forms of exercise may help to more efficiently burn calories.

However, the secret to weight loss and regulation of sugar with yoga may come from a different mechanism. Studies have shown the benefits of yoga in decreasing blood sugar levels in patients with diabetes. These yoga-based exercises are not based on aerobic activities but mostly on postures which are designed for spinal twisting and increasing intra-abdominal pressure.

New hormones produced by the intestine have been discovered only recently – namely, incretin hormones. These stimulate insulin secretion in response to meals. The two most important incretin hormones are called glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP).

The increase in intra-abdominal pressure from various yoga poses and the response from the intestinal nervous system may promote a rise in these hormones, subsequently promoting weight loss and regulating diabetes.

Hypoxia for better health

Pranayama is an ancient Indian yogic technique of regulation of breath included in the daily routine of the yogis. It involves gradual training of the respiratory apparatus for prolonging the time of being able to hold the breath.

In the yogic practice there are more than eight types of Pranayama, which involve breathing through one or the other nostril, or through the rolled tongue made like a tube. The breath is held after inhaling, let out in expiration, or somewhere between the two in rhythmic sequencing. Medical research shows that there are benefits of induced hypoxia and hyperventilation for short periods of time. It’s also well documented that these breathing techniques can reduce anxiety and improve the mood.

Many studies have demonstrated that yoga reduces the disease activity scores in RA patients as well as improving spine flexibility, range of motion and provides for the actual strengthening of joints.

Writing throught pain - Writing Through The Pain

It’s no secret that stress, anxiety and your emotional state can directly affect your arthritic symptoms. By writing down your feelings using a technique known as Expressive Writing, you may be able to alleviate some of the pain and tiredness you’re experiencing.

People use writing, whether creatively or through a journal for many different issues. They may be going through a stressful period in their lives, or they might need an escape into another world to deal with reality. Some of the best authors in the world wrote during difficult times and produced some of the most iconic work we know and love today. So why do you have to be any different?

Expressive writing is a little different to the usual diary-keeping habits you might be familiar with. The key to expressive writing is being able to focus on your entire experience, holistically. Writing about your physical symptoms and the pain you’re going through might be helpful, but this is about getting to the core of your emotional state.

Firstly you’ll want to sit with your feelings; the spectrum of emotions that you are going through at this exact moment. This involves being in the present and labelling the feelings that come up. It’s vital not to judge anything at this point – the goal is to write honestly and openly. Write about something important to you at this time, regardless of whether you think it’s good, correct, bad or wrong. These terms do not exist in this space.

You can write on paper, type on a computer or even speak into a dictaphone – just ensure you have a space in your life where you are not being disturbed and can think clearly. This writing is for you, and you alone. Expressive writing is a private endeavour – you can choose to share this with your loved and trusted ones – but the focus is on complete transparency for now.

Expressive Writing isn’t as long as a journalling session and doesn’t have to last weeks. Take about 3-4 days and spend about 30 minutes in seclusion, expressing yourself.

Don’t be alarmed if what you write surprises you – expressive writing is used as a tool to disclose our deepest thoughts and feelings to ourselves. Getting them outside of your head is the first step to acknowledging them.

The research on expressive writing with Arthritis sufferers is very promising. In studies, people have reported lessening joint pain, stiffness and stress levels. Arthritis may only clinically affect your joints and mobility, but remember we are all connected.

The effect of chronic pain on our mental health is a growing field of interest. You might be experiencing shock, grief and loss from the life you had before. This is not only natural, but it is manageable through techniques to improve your mood and outlook.

Don’t be afraid to reach out and get help when you want it. Expressive writing can be the first step to understanding yourself, learning about your emotional state in the moment and taking back some control of your life.

Why Is My Knee So Noisy - Why Is My Knee So Noisy?

Age comes to us all, steadily and readily and means we could soon find our joints a bit stiffer and noisier than we were used to in our heyday. Is that something to be concerned about?

Most health professionals agree, the knee is a really common joint to make noise. After all, we use our knees more than we realise; when we bend, stand up, crouch down, walk, run and jog. The new noises could be coming from naturally aging cartilage or ligaments – which when developing unevenly can cause tight patches and rough areas that rub when you move.

Keeping your knees healthy is fairly simple, and just involves adding to your regular routine. If you don’t exercise and are experiencing cracking and popping from your knees – now is the perfect time to start!

1. Stretch!

Even if you’re not planning on exercising today, stretching warms up the muscles for daily use. It has a lot of other benefits too – it makes you more awake and refreshed, ready for the day ahead. Or stretching at night can help your body wind down for a better sleep.

2. Start Gentle

If you’re not a regular gym-rat then you’ll need to start slow and short. Build up gradually – at your own personal pace – to longer and harder workouts. Too much too soon and you could end up with injuries.

3. Focus on the muscles around the knees

The knees work best when they are supported, so focus on the muscles around the knees for the best outcome. Cycling and climbing, even if it’s just some stairs, will help.

4. High Quality Shoes

Don’t waste your money buying cheap shoes you have to replace every few months. Invest in a pair of good shoes and make sure they fit well – all of your joints will thank you!

5. Try specific Exercises

Building up leg muscles to support your knees requires special exercises that target this area. Go for a walk up a hill or some steps, and don’t forget about weights – adding these to your ankles while you watch the TV can also help to keep your lower half strong.

6. Watch your Weight!

Obesity does more damage to our overall health than we realise. Extra weight puts more pressure on your hips, knees and legs and this can contribute to pain and weakness. Try to eat a balanced diet, exercise moderately and see your doctor if you require more help.

Overall, most knee noises bring little cause for concern. However, see your doctor if you experience any pain or swelling. Cartilage damage could be a sign of Arthritis and causes pain if it wears down too thin. Another section to check for is the Meniscus. This curved disc operates as your inbuilt shock absorber, but trauma or age-related damage can result in quite a lot of pain.

Dr Humeira Badsha Medical Center HBMC is moving its clinic to the Emirates Hospital - Dr. Humeira Badsha Medical Center (HBMC) is moving its clinic to the Emirates Hospital in Jumeirah, Dubai

From 2nd April 2018, Dr. Humeira Badsha Medical Center (HBMC) is moving its clinic to the Emirates Hospital in Jumeirah, Dubai. Providing the same level of excellent care as usual in a brand new location, we’re looking forward to seeing you there.

Our new address is: 2nd Floor, Emirates Hospital, Jumeirah Road, Dubai, UAE.

Contact us with any inquiries on +971 56 3643215 or email info@drbadshamedical.com

 

 

imaging injections to the hip knee ankle shoulder elbow and wrist - 2nd Emirates Society for Rheumatology Imaging Summit

This February marked the 2nd Emirates Society for Rheumatology Imaging Summit, taking place at the Oberoi Hotel in Dubai and lasting two days. This groundbreaking summit covered a wealth of new information and procedures for imaging techniques for Rheumatic conditions.
Dr Ghita Harifi was Course Director for the Ultrasound-Guided Joint Procedures Course, which ran from 9 – 10th February. Aside from speaking about the role of US imaging in Rheumatology, the course introduced new ideas on important topics such as injection scope, needling techniques and machine parameters.
Dr Harifi and other tutors presented the Hands-on sessions for guided imaging injections to the hip, knee, ankle, shoulder, elbow and wrist, giving participants the chance to practice what they had learned over the duration of the course.

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