Monday, November 18, 2013

Weight Loss, Diet and Arthritis

I've been asked a lot about diet, arthritis and weight loss recently. The holiday season seems to make people simultaneously think about overindulgence and cutting back! There's no doubt that losing excess weight can help manage arthritis symptoms but it's also true that losing weight isn't always easy if you have arthritis. Joint pain may make many exercises difficult or impossible. The drugs used to treat arthritis, like steroids, can cause weight gain and increase appetite and, frankly, feeling in pain can drive even the most strong-willed arthritis sufferer to the cookie jar. 

So, in the face of all these difficulties, why should being a healthy weight matter? Being overweight or obese has an impact on both the likelihood of developing osteoarthritis and its progression: Lifetime risk of developing osteoarthritis increases with body mass index and the chance of osteoarthritis getting progressively worse is increased in overweight and obese patients. It’s thought that this mainly due to the increased pressure extra weight places on joints – one pound of body weight translates to four pounds of extra pressure on a knee joint. However, for people with all types of arthritis, there is also a link between being overweight and having increased levels of inflammatory chemicals circulating around the body (which are linked to the pain and destruction of joints).

Losing excess weight is consistently shown to help improve arthritis symptoms. It's not always easy but improving your diet can really help you feel better. If you want to lose weight, here are some strategies that might help:

1. Before you even start to contemplate changing your diet, write down everything you eat for a week. You might be surprised where some of your calories are coming from. Maybe it’s picking between meals or that packet of mints you ate without thinking in the car.

2. Focus on what you can add to your diet rather than what you need to forgo. Always include at least 2 portions of fruit or vegetables with each meal, pick high fibre products like wholewheat pasta, brown bread and porridge oats, make sure you are getting some lean protein in every meal (like a chicken breast fillet, beans, trimmed red meat, fish or tofu) and plenty of low fat dairy.

3. Watch what you drink. Alcohol, juices, smoothies, fizzy drinks and milky coffees (like your favourite latte) are rich in calories but rarely fill you up. It’s all too easy to drink the equivalent of a meal in a few minutes.

4. Stock your fridge and cupboards with healthy snacks. You don’t need to go hungry – try air-popped popcorn (recipe here), raw veg sticks, fruit and low fat cheese portions. Nuts and dried fruits may be healthy but are very energy dense so if you choose to snack on them, only have a small handful.

5. Ask for help. Depending on where you live, you may be able to get some support through your doctor. Many areas have some great weight management schemes. Online tools, diet clubs and forums also can provide valuable social support. If you can bear it, tell your friends and family that you are trying to make healthy changes and ask them to support you/not buy you chocolates.

For more tips, you can read my posts on what to feed your arthritis (or the principles of a healthy arthritis diet), eating well when you have an arthritis flare and some hints on how to stay healthy over the festive season. The NHS has a very handy 12 week weight loss plan and lots of advice here. Arthritis Research UK has some arthritis-specific weight loss and diet information here.