Maintaining healthy joints with an anti-inflammatory diet

What is inflammation?

Inflammation is your body’s reaction to foreign substances, such as pollen, chemicals and microbes (eg bacteria, viruses and fungi). It occurs to protect your body, however, if inflammation goes on for too long it can start to have a negative impact on your health. 

Chronic (long-term) inflammation occurs in several diseases, including arthritis, cancer, diabetes and heart disease. When chronic inflammation affects your joints, it can cause them to become painful and swollen. Over time, inflammation can damage the tissues that make up your joints, including the bones, cartilage, ligaments, tendons and the membranes that line your joints.

Changing your diet can help reduce inflammation in your body as certain foods and drinks contain anti-inflammatory substances. 

What is an anti-inflammatory diet?

If you have chronic joint pain and/or arthritis, an anti-inflammatory diet can help relieve your symptoms. Although there isn’t a strict anti-inflammatory diet for people with arthritis or joint pain to follow, incorporating certain anti-inflammatory foods into your meals can help control your inflammation.

Types of anti-inflammatory diet

Two well-known diets that help reduce inflammation are the Mediterranean diet and the DASH (Dietary Approaches to Stop Hypertension) diet.

The Mediterranean diet focuses on eating fish and vegetables and cooking with olive oil. The DASH diet was originally designed to help reduce high blood pressure and focuses on eating vegetables, fruits and low-fat dairy foods, as well as incorporating whole grains, fish, nuts and chicken in your diet.

In general, anti-inflammatory diets avoid fried and processed foods, and foods high in trans fats and charred meats, in favour of fresh fruits and vegetables, whole grains, lean protein and foods rich in omega-3 fatty acids. Anti-inflammatory diets also focus on reducing the amount of salt in your meals and snacks, and instead use spices and herbs to add flavour.

How do anti-inflammatory foods reduce inflammation?

Certain foods (eg fried foods) make inflammation worse by increasing the production of free radicals in your body. Environmental factors, such as air pollution and pesticides, and lifestyle factors, such as smoking and drinking alcohol, can also raise free radical levels in your body.

When levels of free radicals get too high, oxidative stress occurs — this process damages your body’s cells and is linked to several diseases, including rheumatoid arthritis.

Your body produces its own antioxidants to counteract free radicals but following an anti-inflammatory diet ie a diet containing natural antioxidants can help.

What are antioxidants?

Antioxidants counteract free radicals by neutralising them — this effectively ‘turns off’ the free radicals so they can’t damage your cells.

Your body needs to have a balance between free radicals and antioxidants. It is, therefore, possible to overcompensate for the free radicals in your body by taking antioxidant supplements that raise your antioxidant levels too much. Eating a diet rich in antioxidants and other nutrients is therefore recommended instead of taking antioxidant supplements.

Foods rich in antioxidants include berries, citrus fruits, garlic, kale, red peppers and tomatoes. Eating a lot of any one of these foods won’t cure your joint pain and inflammation. However, combining an anti-inflammatory diet with a healthy lifestyle, including regular exercise, will help protect your joints.

What anti-inflammatory foods are good for your joints?

Anti-inflammatory foods include foods rich in antioxidants, nutrients and healthy fats. These foods are good for joints, bones and cartilage and are therefore worth incorporating into your diet if you have a condition that affects your joints, such as arthritis.

Foods that reduce inflammation include:

Oily fish

Oily fish are rich in omega-3 fatty acids, which can help reduce levels of proteins that cause inflammation, specifically C-reactive protein (CRP) and interleukin-6.

Oily fish include anchovies, fresh tuna (not tinned), salmon and sardines. Salmon also contains calcium and vitamin D, which help maintain strong bones.

Try to eat around 140g of cooked oily fish each week — this is equivalent to one meal serving.

Richly coloured fruits and vegetables

Colourful fruits and vegetables are rich in antioxidants, which help your body reduce the damaging effects of free radicals that cause inflammation.

Try to eat around 400g of fruit and vegetables every day, split roughly equally between fruits and vegetables. Try to eat raw fruit and vegetables where possible and if you are cooking your vegetables, avoid overcooking them as this reduces nutrients and antioxidants.

Richly coloured fruits

Colourful fruits that are rich in antioxidants include blueberries, blackberries, cherries and strawberries.

The antioxidants in cherries are called anthocyanins and give cherries their deep red colour. Eating cherries and drinking cherry juice have been linked to fewer flare-ups in people with gout. 

Richly coloured vegetables

Colourful vegetables that are rich in antioxidants include beetroot, broccoli, red cabbage and red peppers. 

Eating dark, leafy greens, such as broccoli, kale, pak choi and spinach is also good for your joints as they are rich in the antioxidant beta-carotene and vitamin C. Vitamin C helps your body produce collagen, which makes up the cartilage, ligaments and tendons that hold your joints together. 

Spinach and kale are also rich in calcium, which helps to maintain strong bones. 

Beans and legumes

Beans and legumes contain antioxidants and are also a good source of fibre, folic acid, protein and several minerals including iron, magnesium, potassium and zinc. Magnesium in particular works alongside calcium to maintain strong bones.

Try to incorporate a variety of beans as part of your anti-inflammatory diet, such as black beans, chickpeas, pinto beans and red kidney beans. Eat around 250g each week.

Nuts and seeds

Nuts and seeds are rich in monounsaturated fatty acids, which are anti-inflammatory and are also a good source of protein and fibre.

Almonds, flaxseeds, pine nuts, pistachio nuts and walnuts are therefore all good for your joints. Walnuts, in particular, can help reduce inflammation as they contain the anti-inflammatory substances oleocanthal and omega-3 fatty acids. Flaxseeds and canola oil also contain omega-3 fatty acids.

Limit yourself to around 30g (one handful) of nuts or seeds a day as they are also high in calories.

Olives and olive oil

Olive oil contains oleocanthal and monounsaturated fatty acids, which are both anti-inflammatory, and antioxidants.

Try cooking with extra virgin olive oil as this is less refined and processed than regular olive oil and therefore contains more nutrients. As olive oil is damaged by the UV rays in sunlight, choose olive oil in dark bottles and do not store it by a window.

Use two to three tablespoons each day — this includes using it for cooking and as a dressing.

Whole grains

Whole grains are linked to reduced inflammation, while refined grains (eg white flour) are linked to increased inflammation.

Whole grains include barley, brown rice, buckwheat, bulgur, porridge oats and quinoa.

Try to eat around 180g each day. You can get around 30g of whole grain from one slice of whole grain bread, half a whole grain English muffin, 225g of porridge oats or 100g of brown rice.

Spices and herbs

Turmeric contains curcumin and chillies contain capsaicin — both of these are anti-inflammatory.

Other spices and herbs with anti-inflammatory properties include basil, cinnamon, garlic, ginger, rosemary and thyme.

Try adding these herbs and spices to flavour your foods and boost the anti-inflammatory effects of your diet.

Probiotics and prebiotics

Probiotics are foods or supplements containing live bacteria, which are beneficial for your body. Prebiotics are plant fibres that these beneficial bacteria feed off. By eating more beneficial bacteria or supporting the growth of existing beneficial bacteria in your gut, you can reduce inflammation in your body.

These bacteria have been shown to reduce levels of proteins that are raised during inflammation, such as CRP.

Prebiotic foods include bananas, berries, beans, leeks, legumes, oats, onions and peas.

Probiotic foods include probiotic yoghurts and fermented foods, such as kefir, kimchi, kombucha tea and sauerkraut.

Tea

Certain plants have anti-inflammatory properties. Drinking tea made from these plants may therefore help reduce your inflammation.

Try drinking green tea or teas made from holy basil, fennel, ginger, rose hip or turmeric.

Inflammatory foods to avoid

Processed foods

Highly processed foods tend to be inflammatory. Foods to avoid therefore include biscuits, crisps and other processed snacks — they often contain unhealthy fats that are linked to inflammation.

Foods with added sugar or salt

Sugar

There are different types of sugar; fructose, in particular, has been shown to cause inflammation of blood vessels and increase inflammatory substances in the body.

Foods and drinks containing added sugar will often contain fructose. Try to avoid these foods and drinks, which include biscuits, cakes, doughnuts, pastries, energy drinks and soft drinks. Fructose may be listed in the ingredients as glucose-fructose syrup or high fructose corn syrup (HFCS). 

Salt

High-salt foods can increase your blood pressure and may also increase the loss of calcium from your bones, making them weaker. 

Avoid eating high-salt foods such as canned meat, soups and vegetables, cured, smoked or salted meat, and ready-meals. 

If you have rheumatoid arthritis and are being treated with corticosteroids, it is even more important to follow a low-salt diet as corticosteroids can cause your body to retain more salt. 

Vegetable oils

Vegetable oils have high levels of omega-6 fatty acids. Your body needs a balance between omega-6 and omega-3 fatty acids. However, it is easy to have excessively high omega-6 fatty acid levels as vegetable oil is an ingredient in many processed foods and is often used for cooking. High omega-6 fatty acids levels are linked to inflammation.

Avoid cooking with vegetable oils, such as corn oil, sunflower oil and soybean oil. You can instead try cooking with coconut oil or olive oil and increasing omega-3 fatty acids in your meals eg by eating oily fish.

Trans fats

Trans fats increase cholesterol levels in your blood and therefore increase your risk of heart disease and stroke. Trans fats naturally occur at low levels in meat and dairy products. However, it is artificial trans fats, rather than natural trans fats, that have been shown to increase inflammation.

Artificial trans fats can be found in partially hydrogenated vegetable oil. In the UK, products containing hydrogenated vegetable oil must state this in their ingredients.

Processed and refined carbohydrates

Processed and refined carbohydrates have had almost all of their fibre removed. Fibre is an essential part of a healthy diet as it makes you feel full, helps control your blood sugar levels and feeds beneficial bacteria in your gut. In contrast, processed and refined carbohydrates are linked to an increase in inflammatory bacteria in the gut.

Foods and drinks to avoid that contain refined carbohydrates include biscuits, bread, cakes, certain cereals, pasta, pastries and soft drinks, as well as processed foods containing added sugar or flour.

Alcohol

Drinking a moderate amount of red wine may be good for your health as it contains resveratrol, which may be anti-inflammatory. However excessive alcohol increases levels of inflammatory proteins in your body such as CRP.

Try to reduce your alcohol intake, particularly if you have rheumatoid arthritis and are being treated with methotrexate as together they increase your risk of liver damage.

Nightshade vegetables

There is no conclusive evidence that nightshade vegetables, which include aubergines, peppers, potatoes and tomatoes, increase inflammation. However, some people have found removing nightshade vegetables from their diet has reduced flare-ups of inflammatory arthritis. You can try this for two weeks to see if your symptoms improve and if they do not you can return to eating them.

Summary

An anti-inflammatory diet is not a strict diet with absolute rules. It is instead a style of eating, which focuses on the overall benefits of eating a healthy, balanced diet. By reducing inflammatory foods, such as fried, processed, high-salt and high-sugar foods and increasing anti-inflammatory foods, such as colourful vegetables and fruits, dark, leafy greens, oily fish and beans in your diet, you can reduce the levels of inflammation in your body. Combining this with a healthy lifestyle and regular exercise can keep your joints healthier for longer.