Diet and Arthritis

What is arthritis?

It is defined as a condition causing pain and inflammation of joints.  It can be caused by chronic overuse, or result from previous injury.  It can also be a result of auto-immune disease where the body’s immune system starts to attack its own proteins in the joint, resulting in damage and pain.

 ALSO READ : Turning the Tide – Dealing with the main lifestyle-related conditions in South Africa (Part 12)

How common is arthritis?

In the USA it is said to be the most common cause of disability.  According to the US Arthritis Foundation, it is estimated that 54 million Americans have doctor diagnosed arthritis (16% of the population), although there are probably many more that do not have a formal diagnosis and thus are not included in the statistics.

Information is scant about the incidence of arthritis in South Africa.  The Biokinetics Association of South Africa presented this startling statistic: A 2015 review of the prevalence of arthritis in Africa found that 2,5% of South Africans have been diagnosed with rheumatoid arthritis while 55,1% suffer from osteoarthritis. The incidence of osteoarthritis rises to over 82% in people over the age of 65.  That is incredible.  This must surely be one of the most prevalent health problems in South Africa!

What causes arthritis?

It all depends on what type of arthritis we are talking about.

Degenerative arthritis, also known as osteoarthritis, the most common, is caused by injuries to the joints, or damage from infections, or “over-use”.  However it is rare in traditional communities where people subsist off whole foods, and yet they work very hard physically to survive. (Br J Rheumatol 24:321, 1985).

Auto-immune arthritis, of which Rheumatoid arthritis is the most common is caused by the body’s immune system attacking its own proteins within the joint, resulting in inflammation and destruction of the joint, with associated deformities. 

Other types of inflammatory arthritis include psoriatic arthritis, lupus, and ankylosing spondylitis.  These debilitating and aggressive diseases are thankfully rare.

Here is a short video clip about what causes pain in arthritis:

Here is a more detailed explanation of the anatomy and physiology of joints and what happens with arthritis.  It is such a clear explanation of a very complex system:

When I study this video, I am just amazed at the complexity and amazing design in each joint.  To me it only reinforces my recognition and acknowledgement of the amazing capacity and wisdom of the Master Designer.

Here is a very generalised but simple overview of arthritis with a local perspective from the Western Cape Department of Health.

Why is there such an increasing incidence of arthritis?

There are a number of factors, but as with most changes in lifestyle as seen with Westernisation, it boils down to diet.

Obesity is a common consequence of a diet low in fibre, phytochemicals, anti-oxidants, an oversupply of refined carbohydrates and fats and reduced activity.  Obesity on its own causes excessive wear and tear of the joints, just like a chronically overloaded vehicle will result in damage to the springs, shock-absorbers, wheel bearings and tyres of a car.

A concept that has been around for many years, but is becoming increasingly “mainline” is that of a leaky gut.  This is where the single cell barrier between gut contents and the blood stream has been compromised, and large protein molecules, as well as bacteria and toxins are able to enter directly into the blood stream, setting up inflammation and antibody responses.  There are many factors that cause this, including:

• Environmental toxins (one that is particularly fingered these days is the herbicide Roundup (glyphosate) used to kill weeds in fields of GMO grains and even small amounts in our foods act as a toxin to our gut flora).
• Highly refined foods denuded of fibre, the nutritional substrate for our trillions of gut micro-organisms which help to keep our gut lining healthy
• Antibiotics – which do the same thing. This is why it is important to use probiotics when taking a course of antibiotics, and don’t use antibiotics unnecessarily for viral infections.
• There is increasing evidence that in some people dairy products and in fact all animal products may be the cause of damage to the gut microflora and either directly, or indirectly result in excess inflammation.
• Unfortunately some of the most common medications used for arthritis can aggravate leaky gut – things like anti-inflammatories and perhaps methotrexate.

For a most comprehensive article on arthritis, its causes and management, here is a long article with many references for those who would like to know more in depth:

Here is a dieticians perspective on a plant-based approach to arthritis.  It is difficult for traditionally trained health practitioners to be willing to accept the benefits of this approach without being scared of deficiencies.  These are mostly theoretical, except in the case of Vitamin B 12, which in fact most people may need as we get older.

Next week we will look at lifestyle related interventions to prevent and reverse many of the symptoms related to both degenerative and inflammatory joint disease.  Obviously it is impossible to correct badly deformed and damaged joints, but there is much that can be done to improve the quality of life, and perhaps delay the need for joint replacement surgery.

To a week ahead, with the prospect of helping those aching joints!

Dave Glass

Dr David Glass graduated from UCT in 1975. He spent the next 12 years working at a mission hospital in Lesotho, where much of his work involved health education and interventions to improve health, aside from the normal busy clinical work of an under-resourced mission hospital.

He returned to UCT in 1990 to specialise in obstetrics/gynaecology and then moved to the South Coast where he had the privilege of, amongst other things, ushering 7000 babies into the world. He no longer delivers babies but is still very clinically active in gynaecology.

An old passion, preventive health care, has now replaced the obstetrics side of his work. He is eager to share insights he has gathered over the years on how to prevent and reverse so many of the modern scourges of lifestyle – obesity, diabetes, ischaemic heart disease, high blood pressure, arthritis, common cancers, etc.

He is a family man, with a supportive wife, and two grown children, and four beautiful grandchildren. His hobbies include walking, cycling, vegetable gardening, bird-watching, travelling and writing. He is active in community health outreach and deeply involved in church activities. He enjoys teaching and sharing information.

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