Diet Does Play a Role in the Development of Some Forms of Arthritis

Robert Shmerling, M.D.

Harvard Health Letters

Q: Does diet play a role in the development of arthritis?

A: Many people assume that diet has a lot to do with the development of arthritis. Based on our current understanding, this notion is largely myth.

However, there are some links between diet and arthritis. For example, getting enough milk and vitamin C is associated with a somewhat lower risk of gout. Gout is a disorder characterized by too much uric acid in the blood and tissues. Crystals of uric acid are deposited in the joints, where they cause a type of arthritis called gouty arthritis.

The risk of developing gout appears to be increased among people who drink alcohol and eat a diet high in meat, seafood, high-fructose corn syrup (as in sweetened soft drinks) and purines (a form of protein found in sardines, liver and other organ meats). However, the vast majority of people who choose these foods and drinks never develop gout. And for those who already have gout, drug treatments are usually more effective and reliable than changing what they eat and drink.

Another condition in which diet may affect arthritis risk is celiac disease. This is an immune reaction to gluten in the diet. Gluten is a component of wheat and other grains. By eliminating gluten from the diet (by avoiding many bread products, cereals and a host of other common foods), the condition can be controlled and the arthritis improved.

There's no clear connection between diet and the two most common forms of arthritis, osteoarthritis and rheumatoid arthritis. Removing certain types of foods or adding others to treat arthritis have met with inconclusive or disappointing results.

Perhaps the most important connection between diet and arthritis is the well-known link between obesity and osteoarthritis. The best way to reduce your risk of developing osteoarthritis is to maintain a healthy weight and avoid a diet that contributes to obesity. Recent studies suggest that obese people with osteoarthritis have less pain if they lose weight. (However, genetics have an impact on osteoarthritis risk. Changes in diet alone do not reliably reduce arthritis symptoms.)

We may someday figure out that diet matters much more than we realize now. But, at the current time, diet plays little or no role in the development of most joint diseases.

(Robert H. Shmerling, M.D. is associate physician at Beth Israel Deaconess Medical Center, Boston, Mass., and associate professor at Harvard Medical School. He has been a practicing rheumatologist for over 20 years.)

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