A rheumatology and immunology professor has shared the ‘best’ kind of anti-inflammatory diet to follow which, according to research, ‘reverses symptoms in eight weeks’. Speaking to ZOE Health co-founder Jonathan Wolf on a new episode of his podcast show, Dr Tamiko Katsumoto MD explained how diets high in inflammatory foods, such as processed foods, increase your risk of getting arthritis.
The chronic health condition now affects one in five people, she says. It causes pain and stiffness and can impact any joint, but it is most common in the hands, knees, hips, feet, and lower back. Although smoking was once the number one cause of chronic disease, today, it’s poor nutrition Dr Katsumoto warns. And she says inflammation is a huge part of the story as too much of it in your body can trigger various health problems.
Dr Katsumoto is a Clinical Associate Professor in the Division of Immunology and Rheumatology at Stanford University. She specialises in how plant-rich diets improve individual health and has been investigating the impact of diet on the immune-system.
Speaking to Jonathan about the science behind arthritis, she shared a diet that can reduce inflammation, improve mobility, and “shield you from the threat of this disease.” The health expert also discussed the differences between osteoarthritis, wear and tear, and rheumatoid arthritis.
Osteoarthritis (OA) is a degenerative disease that worsens over time, often resulting in chronic pain. Rheumatoid arthritis (RA) is an autoimmune disease that causes the body’s immune system to attack healthy tissue in the joints.
It is important to note that arthritis does not have a cure. However, some treatments, including diet, lifestyle changes and medicine, can help slow it down and manage symptoms – and reduce the risk of developing arthritis. As too much inflammation in the body can trigger the health condition, lowering inflammation is vital.
In a study titled ‘ A multidisciplinary lifestyle program for rheumatoid arthritis: the ‘Plants for Joints’ randomised controlled trial ‘, researchers said: “Reversing and preventing adverse lifestyle factors could potentially reduce the incidence and burden of RA, as well as alleviate its comorbidities.”
Dr Katsumoto says modern-day diets exacerbate the issue, but making more healthy choices could reduce your risk of the disease. The bone, joint and muscle doctor also highlights the most beneficial foods, lifestyle changes and supplements for joint health.
When asked by Jonathan if “full-blown arthritis” is inevitable if you’re starting to feel symptoms, the Stanford professor replied: “Not necessarily.” He then asked: “Could you reverse arthritis with the right foods?” To which the doctor said: “Yes”.
Sharing what she believes to be the biggest myth about arthritis, Dr Katsumoto said: “I think the biggest myth is that there’s nothing you can do to change your arthritis course. I think there are actually a lot of things that we are all capable of doing through diet, lifestyle, etc, that can make a difference.”
Study that ‘slowed arthritis inflammation in eight weeks’:
Telling viewers about “positive news that it is possible”, Jonathan said: “Within eight weeks of changing your diet, [you can have] have a profound impact on your arthritis because it’s having this profound impact on inflammation.”
Addressing Dr Katsumoto, he added: “You’re saying if you are living with arthritis and you were to make that sort of change in your diet, you think it can really change not only your symptoms but even potentially get you to a point where you say, ‘I don’t even need to take all the medication I’m taking today’.
“I understand that you’re also really interested in food as playing an important protective role. And that in particular [you’re] excited about a breakthrough new clinical trial that the team was telling me about actually earlier this week, which I think is called plants for joints. Could you tell me about that?”
The professor revealed: “This was a very exciting trial. I’m a huge fan of randomised controlled trials. I think this is our highest level of evidence. This is a group, our Dutch colleagues, they actually did two studies in parallel. They did one in rheumatoid arthritis and they did one in osteoarthritis.
“To clarify, it was a metabolic-associated osteoarthritis. So patients that tended to have metabolic syndrome were maybe overweight. So those patients with OA.” Jonathan replied: “So randomised controlled trials are basically the gold standard of scientific testing?”
Dr Katsumoto said: “Yes, they are helpful in that they minimise any confounding bias in terms of the fact that people are put into two different groups, there’s an equal chance of whatever intervention working or not, and comparing to a placebo provides a robust comparator.
“Basically what they did was they put them through a lifestyle intervention, and this is absolutely really thrilling to me because I’m a huge fan of the American College of Lifestyle Medicine. Just to quickly provide their six pillars of lifestyle medicine; diet is number one, in addition; exercise, stress reduction, social connections, sleep, and then finally avoidance of risky substances. So those are the six pillars of lifestyle medicine.
“Essentially what this randomised controlled trial did was put these patients through either the active arm. They called it the plants for joints arm that underwent these six lifestyle interventions versus the placebo, which was essentially the standard of care. They ran them through this program for 16 weeks and what they found at the end of the study and even at eight weeks at the midpoint, they saw dramatic improvements in the patient’s joint disease.”
She added: “So for the rheumatoid arthritis patient, the endpoint they looked at is called DAS28. This is a disease activity score based on 28 different joints. So you measure swollen and tender joints. You measure the CRP inflammatory marker. You measure how the patient is feeling.
“Based on that endpoint, which is a very robust endpoint, there was a very statistically highly significant difference in terms of the RA patients that underwent this lifestyle program. They looked more deeply to see what was the most likely thing driving this difference, and it was most likely diet. Of course, you can’t separate out, it was a full holistic intervention of multiple different domains.
Bottom line, Dr Katsumoto says she thinks diet “played a huge role” in the remarkable results – especially anti-inflammatory foods. The American College of Rheumatology (ACR) recommends the Mediterranean diet (MD) as an anti-inflammatory eating pattern for people with arthritis.
What is the best diet for anti-inflammatory foods?
Naming the best anti-inflammatory diet to reduce your risk of arthritis, she praised the Blue Zone diet. This diet is based on the type of food and lifestyle choices of people who live the longest in the world. The diet focuses heavily on plant-based foods, fish, grains, seeds, nuts, pulses, beans and lentils. It cuts out a lot of dairy and meat products.
Speaking about the ‘best’ vegetables to eat to beat inflammation, the Stanford professor said: “Cruciferous vegetables. These are things like broccoli, and kale, and cauliflower, and these really kind of the deep leafy greens… And they’re so important. I really think food is medicine. And these are incredibly important in terms of helping our liver detoxify.
“We’re living in a very polluted world. I think that these are super helpful foods that can help us clear our body of a lot of these toxins, these endocrine disruptors, which we haven’t talked about. But there’s a lot of these things that we need to be thinking about that are super helpful for my patients.”
As for meat, researchers say people who live the longest often reduce their meat intake significantly. Dr Katsumoto said animal products should be eaten in moderation, adding: “If you look at the blue zones, they say that the majority of blue zones end up eating meat less than five times a month. So really that comes down to maybe once a week. Meat should be considered a treat.”
She continued: “Another food type that I love a lot are things like chia seeds and flax seeds. I think chia seeds are the perfect food. They’re high in fibre, high in omega-3, and high in protein. They’ve just got so many great components that I add them to my smoothies. I just try to incorporate them wherever I can. I get a big bottle of them and add them wherever I can.”
As for fish, she says oily types are great for reducing inflammation. She explained: “So we know omega-3 fatty acids are incredibly anti-inflammatory. That being said, I also encourage my patients to not go too heavy on fish, to eat the smaller fish, so not so much the tuna and the swordfish, you know, things that are much larger and can end up bio accumulating things like heavy metals and toxins.
“Try to go for the wild-caught instead of the farmed… I tend to also recommend my patients to check out the Monterey Bay Aquarium’s resource called seafoodwatch.org. Seafood Watch has a lot of examples where what’s sustainably caught and which ones are thought to be healthier. We have to be thinking about pollutants. Our oceans are not the cleanest, so we have to be thinking about that as well.”
What is the ‘best’ plate of anti-inflammatory food?
Sharing what the ideal plate of food looks like, she said: “So half of the plate focuses on high-quality vegetables and some fruits. Then, a quarter of the plate is proteins, preferably plant proteins or lean proteins, but things like beans and lentils. I’m a big fan of tofu.”
Another food the doctor recommends is refined grains, which she says should take up the remaining quarter of the plate. “So, whole wheat and whole things like quinoa. And some of these ancient grains are really good, like farro and bulgur and millet.”
What is inflammation and arthritis?
Inflammation is the body’s way of reacting to injury or infection, resulting in symptoms like swelling, redness, and discomfort. When this reaction happens in the joints because the immune system is overly active, it can result in a condition known as inflammatory arthritis. In this case, the body erroneously targets its own joint tissues, leading to pain and damage.
The National Institute of Environmental Health Sciences says: “Acute inflammation combats infection and stimulates tissue repair and regeneration. When it fails to improve quickly, it can turn chronic and lead to disease. Inflammation resolution failure is increasingly recognised as leading to cancer development.”
Examples of how inflammation can lead to disease includes cancer, as inflammation can damage DNA and lead to cell proliferation, which can increase the risk of cancer. As for arthritis, when the immune system mistakenly attacks the body’s own cells or tissues, it can cause rheumatoid arthritis and lupus.
The NHS says: “Arthritis is a common condition that causes pain and inflammation in a joint. In the UK, millions of people have arthritis or other, similar conditions that affect the joints. Arthritis affects people of all ages, including children.”
Symptoms:
- Pain, swelling, and stiffness in joints
- Redness and inflammation of joints
- Limited movement
- Tiredness and fever
Causes:
- Ageing
- Injuries that damage a joint
- Certain health conditions
- Genetic factors
- Environmental factors, such as infection with certain viruses and bacteria
Arthritis doesn’t have a cure, but there are various treatments available that can help manage the condition and slow its progression. Options include medications, physical therapy, surgical procedures, and adjustments to your lifestyle.
The NHS says: “Osteoarthritis treatments include lifestyle changes, medicines and surgery. Treatment for rheumatoid arthritis aims to slow the condition’s progress and minimise joint inflammation. This helps prevent joint damage. Treatments include medicine, physiotherapy and surgery.”
Many individuals with arthritis lead vibrant, fulfilling lives. By educating yourself about the disease and finding ways to manage the symptoms, you can maintain an active lifestyle.
If you have concerns about your bone, muscle or joints, speak to a doctor. The best ways to stay healthy and reduce your risk of chronic diseases include exercising regularly, limiting alcohol, quitting smoking, maintaining a healthy weight, ditching processed foods, eating a balanced diet, getting enough sleep and drinking plenty of water.