Louise Chang, MD
Despite the claims you may see or read sometimes, there is no magic arthritis diet. No single food or special eating plan can slow arthritis or reduce pain. A well-balanced diet is important for your overall health and energy level, of course. But when it comes to managing osteoarthritis, the single most important thing you can do is to maintain a healthy weight.
If you’ve dieted before, you already know that’s not easy. But arthritis sufferers have an added reason to try to drop even a few pounds. Excess weight puts added stress on joints, particularly knees, causing pain and worsening arthritis damage.
“Being just 10 pounds overweight increases the force on your knees by 30 to 40 pounds with every step you take,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. Small wonder, then, that being obese is linked to a four- to five-fold increase in the risk of developing osteoarthritis.
If you’ve tried and failed to lose weight before, don’t be discouraged. You don’t have to lose a lot to have an impact on arthritis. “Almost any weight loss can have beneficial effects, especially in reducing pain,” says Fontaine. And though losing weight and keeping it off isn’t easy, some people do succeed. By learning how these losers succeeded, researchers have identified six key winning strategies.
Many people set themselves up for failure by pegging their goals too high. “If you begin with unreasonable goals, you’re going to be disappointed, and for too many people, that spells the end,” says nutrition and exercise counselor Ruth Ann Carpenter, RD, author of Healthy Eating Every Day (Human Kinetics).
If you’re overweight or obese, start out with a goal of lowering your weight by 5%. (That’s just 10 pounds for someone who weighs 200 pounds.) Once you reach your first goal, set another goal of losing another 5%. Setting doable goals is especially important when you have the challenge of arthritis, since you may be limited in the amount of physical activity you can do.
No single weight loss plan has ever been shown to work for everyone. Some people succeed by carefully counting calories. Others lose weight and keep it off by eliminating a few high-calorie foods from their diets, such as sugared beverages or high-fat desserts. Among participants in the National Weight Control Registry, which tracks people who have successfully lost an average of 66 pounds and kept the weight off for at least five years, just over half used a formal program, such as Weight Watchers of Jenny Craig. The others successfully lost weight on their own.
“There is no one-size-fits-all approach,” says Rena Wing, PhD, professor of psychiatry and human behavior at Brown University, who helped create the Registry. Indeed, many successful losers try several approaches before they find the one that works best for them. If you’ve tried and failed, think about what worked and what didn’t for you. Consider the kinds of lasting changes you’re most likely to be able to make. Choosing the approach you’re most comfortable with is the key to making healthy changes you can live with.
Restaurant meals are often loaded with fat, salt, and calories. When the Center for Science in the Public Interest analyzed entrees from leading nationwide restaurant chains, the results were shocking. Some entrees contained almost as many calories as most of us should get in an entire day. If you go out for lunch or dinner, divide oversized portions in half before you start the meal and take home the rest.
Better still; get in the habit of cooking and eating at home. Most of the National Weight Loss Registry participants who have kept weight off do a lot of cooking at home. It’s easy to understand why. “When you cook at home, you control exactly what and how much you eat,” says Carpenter.
Cutting back on the calories you eat is half of the weight loss equation. The other half is expending calories through physical activity. “Studies show that exercise is particularly important for keeping weight off,” says Kimberly Topp, PhD, professor and chair of the department of physical therapy and rehabilitation services at the University of California, San Francisco.
Exercise poses challenges for people with arthritis, of course. Bad knees, especially, can make many activities painful. “Anything that puts strain on joints, like running, can worsen arthritis,” says Topp. “Still, there are many activities that even people with osteoarthritis of the knees can do.” Among them: swimming, water aerobics, walking, and light resistance exercises. “In the end, the only kind of exercise that’s bad for people with arthritis is no exercise,” says chronic disease specialist Kate Lorig, RN, DrPH, professor emeritus at Stanford University School of Medicine and author of The Arthritis Helpbook.
Enrolling in a weight loss program helps some people lose weight. But even if you don’t want to sign on for an organized program, it’s worth putting together your own informal support group.
“Many studies show that social support is a crucial factor for success in any kind of lifestyle change, including dieting and physical activity,” says Fontaine. Chances are you have friends and colleagues who would like to join you in losing a few pounds. Talk to them about setting a goal together and encouraging each other.
To stay motivated, it’s important to reward yourself along the way. Treat yourself to something special when you hit your short-term goals. And be aware of the less concrete rewards that you’re getting by losing weight. Notice the way you feel. Monitor pain levels in your knees. Chances are you’ll begin to feel less pain over time. For many people with arthritis, that’s reward enough.
SOURCES:Kevin Fontaine, PhD.Rena Wing, PhD, professor of psychiatry and human behavior at Brown University.Ruth Ann Carpenter, RD, author of Healthy Eating Every Day (Human Kinetics).Kimberly Topp, PhD, professor and chair of the department of physical therapy and rehabilitation services at the University of California, San Francisco.Weight Control Information Network, National Institutes of Health.Klem, M. American Journal of Clinical Nutrition, August 1997; vol 66: pp 239-46.National Weight Control Registry.Center for Science in the Public Interest.Lorig and Fries, The Arthritis Helpbook, sixth edition, Da Capo Press, 2005.Kate Lorig, RN, DrPH, professor emeritus, Stanford University School of Medicine, co-author of The Arthritis HelpBook.
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