Sugar, inflammation, and achy knees

Having a whole lotta sugar takes its toll on the body. It has been linked with weight gain, type 2 diabetes, heart disease, dental caries, liver disease, accelerated ageing, and the list goes on!

But could too much of the sweet stuff be contributing to our body’s creaks and pains?

Let’s see!

Joint pain and inflammation

Inflammation is a term we hear a lot with respect to health. We are told that anti-inflammatory foods are great for us, and things that cause inflammation tend to cause trouble.

This is true to an extent.

An inflammatory response is a normal part of the human defence system. The swelling, redness, pain and heat experienced when we cut our thumb is a reflection of the influx of chemical warriors coming to save the day, kick starting the healing process. We need inflammation to heal wounds, clear debris, and fight pathogens, to stand strong in the face of adversity!

But when inflammation is present long-term, all those warriors, such as cytokines, can get a little carried away, and begin to damage parts of our body that are otherwise quite healthy.

Including our joints, which can present as arthritis.

Oh my achy knees!

Common forms of arthritis include gout, ankylosing spondylitis, rheumatoid arthritis (RA) and osteoarthritis (OA), with fibromyalgia a related condition.

RA is an autoimmune condition, where the body’s immune system mistakenly attacks its own tissues thinking it as some pathogenic terrorist! Whilst there may be genetic predisposition, triggers are unknown. What we do know is inflammation is rife and damaging to the joints,² and as with many autoimmune conditions, diet may have a large role to play in its presentation.

OA is not an autoimmune condition like its rheumatoid cousin. It is less aggressive and more gradual in onset, but features excessive inflammation just the same. OA can present in knees, hips, back, hand, elbow or perhaps a combination of these sites, and its cause can be unknown, or be due to misalignment, mechanical stress, or follow an injury. It is also more likely to creep in during older age.⁵

Inflammation is evident in OA following weakening of cartilage, leading to much cellular debris to be collected by our immune system, and further production of pro-inflammatory cytokines such as interleukin-1 and tumour necrosis factor-alpha. However, these guys then partake in further joint destruction and get in the way of extracellular matrix protein biosynthesis – meaning a gradual degradation of joint function. ⁵

Inflammation ain’t only about diet – but it’s a big factor

We have had a look at diet’s relationship to inflammation. Stress, being overweight, and medication also each contribute to presence of inflammation – and on-going it can be damaging.³

It seems when it comes to the swelling and aches in the joints, pro-inflammatory and processed foods have a lot to answer for.

In past, surveys of patients with arthritis have found that the foods believed to worsen symptoms include red meat, salt, sugar, dairy, fats, caffeine, and even nightshade plants like tomatoes and eggplant. ⁸ It has also been found that a diet high in plant foods improves symptoms.⁷ Of course there is speculation that belief over physiological action is at play when it comes to the impact of certain foods on symptoms – but if you feel better, you are onto a good thing, right?

Excess sugar intake specifically can contribute and exacerbate arthritic conditions and an inflammatory state, through:

1. Contributing to obesity, which puts more pressure on joint;
2. Excess fructose contributing to increased uric acid levels in the blood and therefore chances of a gout attack;
3. Dramatic spikes in blood sugar from a large intake of highly refined carbohydrates (such as white bread, soft drink, or doughnuts), therefore increasing levels of inflammatory cytokines.⁴

Reduce your inflammatory load

Whilst we cannot claim a cure-all-aches-and-pains-with-diet solution here, the impact of food choice on health is profound. People are unique with their own unique set of circumstances, and working out what heals or harms you is a personal journey, and one we would recommend you undertake with a trusted healthcare practitioner.

What we will say, though, is reducing exposure to factors that increase the inflammatory load can only help.

Therefore, reduce intake of highly refined and processed foods, and replace these with a variety of whole foods. This means foods that closely resemble their original form, and should include an array of wonderful colours, from black beans, to purple blueberries, orange carrots to yellow turmeric.

Finally, boosting intake of foods packed with anti-inflammatory goodies can help, including omega-3 rich oily fish, chia and flaxseed, as well as curcumin in turmeric, and ginergol in ginger, all of which have been found to assist alleviate joint pain.^1;6

You are what you eat! So eat well, and live better!

By Angela Johnson (BHSc Nut. Med.)

References

1. Bartels, E, Folmer, V, Bliddal, H, Altman, R, Juhl, C, Tarp, S, Zhang, W, & Christensen, R 2015, ‘Review: Efficacy and safety of ginger in osteoarthritis patients: a meta-analysis of randomized placebo-controlled trials’, Osteoarthritis and Cartilage, vol. 23, pp. 13-21.
2. Better Health Channel 2016, ‘Rheumatoid arthritis’, The State Government of Victoria, viewed 21 June 2016, <https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/rheumatoid-arthritis>.
3. Bosma-den Boer, MM, van Wetten, M, & Pruimboom, L 2012, ‘Chronic inflammatory diseases are stimulated by current lifestyle: how diet, stress levels and medication prevent our body from recovering’, Nutrition & Metabolism, vol. 9, no. 1, p. 32.
4. Harvard Health Publications 2007, What you eat can fuel or cool inflammation, a key driver of heart disease, diabetes, and other chronic conditions, The Family Health Guide, Harvard Medical School, viewed 21 June 2016, <http://www.health.harvard.edu/family_health_guide/what-you-eat-can-fuel-or-cool-inflammation-a-key-driver-of-heart-disease-diabetes-and-other-chronic-conditions>
5. Hechtman, L 2012, Clinical Naturopathic Medicine, Churchill Livingstone, Chatswood, N.S.W
6. Kuptniratsaikul, V, Dajpratham, P, Taechaarpornkul, W, Buntragulpoontawee, M, Lukkanapichonchut, P, Chootip, C, Saengsuwan, J, Tantayakom, K, & Laongpech, S 2014, ‘Efficacy and safety of Curcuma domestica extracts compared with ibuprofen in patients with knee osteoarthritis: a multicenter study’, Clinical Interventions in Aging, p. 451.
7. Muller H, de Toledo FW & Resch KL 2001, ‘Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review’ Scandinavian Journal of Rheumatology, 30, no. 1, pp. 1-10.
8. Physicians Committee for Responsible Medicine n.d., Foods and Arthritis, viewed 21 June 2016, <http://www.pcrm.org/health/health-topics/foods-and-arthritis>