This month I thought I would write about two conditions that make their presence felt as the winter chills set in, that is, arthritis and gout.
Arthritis is a major health challenge for New Zealand, as it affects the productivity and quality of life for many of us. Did you know that half of all New Zealand women aged over 65 years of age have arthritis, as do a third of New Zealand men over 65 years. That is a lot of us!
There are many different types of arthritis, affecting both young and old. The most common types are osteoarthritis, gout and rheumatoid arthritis.
Osteoarthritis results from degradation of the joint due to wear and tear over time. Osteoarthritis may also be seen in younger people playing a lot of sport. Higher body weight also contributes significantly to the severity of osteoarthritis.
Gout is a form of arthritis in which high blood uric acid levels lead to urate crystals forming in joints/tissues (which is painful). Eating lots of meat and shellfish, drinking more alcohol and carrying extra weight can aggravate gout.
Rheumatoid arthritis is essentially a disease of inflammation, involving an inflamed synovial membrane, cartilage damage and bone breakdown. Long-term inflammation is also a factor in many other health conditions, including heart disease, gut problems, asthma, type 2 diabetes, brain cognitive function and depression. Luckily, following healthy eating guidelines to include more nutritious food choices will not only reduce inflammation, but is also likely to help you to drop excess body fat, which should improve your symptoms!
The first line of defence to help manage arthritis and gout is to ensure that you are doing regular exercises that you can tolerate (see a physiotherapist for good advice) and keeping a healthy body weight; or if not, making progress towards that. In terms of your diet, critiquing your snack and beverage choices is a great first place to start, as you can easily introduce more nutritious food at those opportunities. The accompanying table makes some suggestions that you can try.
Many of the foods recommended in healthy eating guidelines, in particular vegetables, fish and fruit contain anti-inflammatory nutrients. Tea is one of them, others include omega-3 fatty acids, curcumin (found in turmeric), ginger, antioxidants (found in tea, nuts, vegetable oils, and the rainbow of colours from fruit and vegetables).
People with gout have to be careful how much meat and seafood they eat, as these foods are high in purines, which can increase blood uric acid levels.
Thus, people with gout are recommended to add non-meat protein and healthy fat sources such as legumes (lentils, beans and chickpeas), nuts and seeds, and vegetables and fruits to their diet. Minimising alcohol intake will also help manage gout, and help you to cut kilojoules from your diet. Beer is more likely to cause gout attacks than other alcohol types.
To help manage your symptoms, ensure that you limit your intake to less than two standard drinks of alcohol on any one occasion. Drink plenty of water instead: this is even more important if you are prone to kidney stones.
For those with rheumatoid arthritis, omega-3 fatty acids look promising to help manage pain and morning stiffness. Indeed, the use of fish oil supplements with a combined total of 3g of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) have been demonstrated to reduce reliance on non-steroidal anti-inflammatory medications.
Excellent dietary sources of omega-3 fatty acids include fresh and canned salmon, tuna, herring, mackerel, sardines, blue cod, warehou, southern blue whiting and rainbow trout; squid and rock lobster; and shellfish including mussels, oysters, scallops, pipi, and mussels.
These forms of arthritis have a hereditary component also. If your parents or immediate family members have arthritis, make regular exercise and a healthy diet a priority now, so that you can keep your body working well for you. This is so valuable not only for each of us as individuals, but for New Zealand society as a whole as our median population age gets older.
If we invest time in ourselves now, we can certainly age gracefully.
Dr Kirsty Fairbairn is a health, wellness and sports dietitian at Invigorate Nutrition (www.invigoratenutrition.com), based at Eclipse Health, Wellness and Performance, Hanover St, Dunedin.
