Arthritis is a chronic disease process, which involves the joints. Perhaps because of its chronicity and its accompanying discomfort and pain, many arthritics become the victims of food faddists, self-appointed “arthritis experts” or quacks, who advocate quick and miraculous cures with bizarre diet plans. At present, there is no known dietary cause or cure arthritis and the medical treatment is palliative, not curative.
Osteoarthritis or degenerative joint disease occurs in the older age group, more frequently in women than in men. The disease is due to structural changes in the articular cartilage in the joints, usually, those which weight-bearing such as the spine and knees. As the process progresses the joints become stiff and often painful. For this reason, activity may be curtailed, and there is a tendency to overweight in this group of patients, placing additional strain on the affected area.
Dietary Recommendations: Sufficient protein, calcium, iron and vitamins are needed to maintain good health. Only the energy needs are somewhat reduced since the activity is lessened. The overweight arthritic will benefit from a further decrease in calories. Sometimes a moderate reduction in energy intake will accomplish this purpose.
RHEUMATOID ARTHRITIS occurs more frequently than osteoarthritis. It may be seen in children, but usually appears between the ages of 25 and 50. It is three times more common in women than in men. The disease is due to an inflammatory process of synovium or lining of the joints, accompanied by swelling and eventual deformity. It is a disfiguring, debilitating, and chronic disease, marked by exacerbations and remissions.
Dietary Recommendations: In contrast with the osteoarthritic, the patient with rheumatoid arthritis is frequently underweight. Also, many patients have such severe involvement of the joints of the fingers and hands that they have difficulty feeding themselves. In order to achieve adequate energy and nutrient intake they often need to be trained to use the adaptive equipment.
Therapeutic doses of aspirin are used in the treatment of both types of arthritis. Because aspirin can cause gastric distress it is recommended that it is to be taken after meals. Occasionally corticosteroids are used in the treatment of rheumatoid arthritis. Since these medications promote sodium retention, the diet may be moderately restricted in sodium. Frequently the patient taking aspirin or steroids is advised to use a bland diet and antacids.
Gout or tropic arthritis is due to an inborn error of purine metabolism, characterized by an increase in blood uric acid levels and the deposition of urate crystals in the soft tissues and in the joints, particularly of the fingers and toes. Very occasionally it appears in children, but the incidence is greatest in men after the age of thirty. It is relatively rare in women.
In primary gout, the metabolic error in the majority of subjects results in overproduction of uric acid or both. Secondary gout is due to reduced excretion of uric acid, under excretion of uric acid or both. Secondary gout due to reduced excretion of uric acid occurs in chronic renal disease, hypertensive cardiovascular disease, and starvation in the treatment of obesity.
Dietary Recommendation: Some physicians restrict foods that are very high in purine content such as liver, kidney, brains and sweetbreads. Otherwise, the diet is adequate to meet the individual’s needs. Patients with gout should be cautioned about fasting, whether it is practised to lose weight or, unintentionally, on an alcoholic spree, because it has been observed that fasting, even for 1 or 2 days, leads to an increase in blood uric acid.
Osteoporosis is a disease characterized by demineralization of the bone. It occurs in the latter decades of life and is much more common in women than in men. There may be back pain due to compression or fracture of the weight-bearing lumbar vertebrae. The frequency with which older women, as compared with men, sustain hip fractures is thought to be due to the greater incidence of osteoporosis in women.
Bone formation and bone reabsorption for the maintenance of adequate calcium levels in the blood are part of the normal homeostatic process, regulated by normal activity. The parathyroid hormone affects bone reabsorption, while calcitonin affects bone formation. The reciprocal relationship of parathyroid hormone and calcitonin, long-term inadequate intake of calcium during adult life leads to the development of osteoporosis. Lifetime consumption of 1gm. Of calcium supplement and sometimes use fluorine supplement can prevent osteoporosis.