Features July 2006 Issue

Food For Thought

To keep arthritis inflammation in check, green tea and mushrooms head the list — but fruit, fish, and veggies are also key.

It’s hard to read the food section of the newspaper, or walk down the grocery aisle without encountering a barrage of buzzwords. Certified organic … loaded with antioxidants … your best source of omega-3 … and on and on.

Though it all sounds good, it can sometimes be difficult to figure out which foods are rich sources of these key ingredients, and which are not. To help you develop a better sense of where to turn in the grocery aisle when looking for items that can help you keep arthritis inflammation in check and give you the level of antioxidants you need, we’ve reviewed a few common foods and beverages that should be part of your daily diet.

Coffee: Moderation is key
Most people start their day with a hot cup of coffee, and from an anti-oxidant perspective, there’s no reason to discourage this habit. Coffee beans are a rich source of polyphenols, particularly chlorogenic acid, and a cup of coffee can contain from 70mg to 350mg of this antioxidant.

In a recent study that compared more than 100 common food items, researchers at the American Chemical Society (ACS) found that Americans get more antioxidants from their daily coffee than from any other source.

“This is a surprising result, and a reflection of just how out of kilter the typical diet may be,” says Andrea Dunn, R.D., L.D., a dietitian at The Cleveland Clinic. “Coffee is fine in moderation, but you have to balance any anti-oxidant benefits against the side effects of stomach irritation, a faster heart rate, and higher blood pressure.

“You also have to guard against all those extra calories found in many specialty coffee drinks. It’s not uncommon for flavored coffee drinks to have several hundred extra calories, making any effort at weight control just that much more difficult.”

Tea: Preparation matters
Other common foods that are rated in the top five as dietary sources of antioxidants are black tea, bananas, dried beans, and corn. Both black and green teas are good sources of plant compounds known as flavonoids.

Of the various teas, green tea contains the most antioxidants per cup. This is because the leaves are used while still green, not allowing the flavonoids (catechins) within to oxidize and lose potency. Black teas, made from oxidized leaves, contain lesser amounts. Herbal teas—which use the flowers, leaves, and roots—contain a different set of flavonoids because they come from different plants than black and green teas. All flavonoids help by partially inhibiting the production of prostaglandins, which play a role in causing inflammation and pain.

Preparation, as well as source of the tea, matters. “In order to get the maximum benefit, make sure your tea is freshly brewed,” explains Dunn, “since flavonoids are not very stable and break down quickly.” So the next time you order tea at a restaurant, make sure you ask for a tea bag, since bottled, powdered. or decaffeinated teas have less of these compounds.

Mushrooms tops
Though many good sources of antioxidants are brightly hued (orange and yellow fruits and vegetables), mushrooms prove you don’t have to be colorful to be good. A recent ACS study showed that the common white button mushroom easily tops other foods (wheat germ, chicken livers) previously considered the richest source of the antioxidant ergothioneine.

“It doesn’t get much better than this,” says Dunn. “Besides being good for you, mushrooms are inexpensive, widely available, low in calories, and easy to cook with.

“Better yet, ergothioneine is unaffected by cooking, so mushrooms deliver their full benefit whether eaten cooked or raw.”

Color me healthy
Adding mushrooms to your plate, doesn’t mean leaving fruit in the cold. British researchers reporting in a recent issue of American Journal of Clinical Nutrition found that a modest increase in antioxidants from eating brightly colored (yellow and orange) fruits and vegetables—the equivalent to a glass of orange juice a day—was associated with a lower risk of inflammatory arthritis. Fruits particularly high in the helpful antioxidant beta crytoxanthin included yellow apples, cantaloupe, grapefruit, mangoes, oranges, peaches, pears, pineapples, tangerines, and watermelon. Vegetables high in these antioxidants include butternut squash, carrots, sweet corn, sweet potatoes, yellow squash, yellow peppers, and pumpkin.

Protective pomegranates
It’s well known that pomegranates contain antioxidants that help reduce inflammation, but what is just beginning to be understood is that this fleshy red fruit may also help slow the breakdown of cartilage. Researchers found in laboratory studies that an extract of this fruit seems to block an enzyme (interleukin-1b) that contributes to cartilage breakdown.

Though the study, reported in the Journal of Nutrition, is preliminary, it is well established that pomegranates can be found at most grocery stores. “I’m a big fan of pomegranates,” says Dunn. “I like to sprinkle the seeds on my salads.”

Spice is nice
Other studies suggest that diets which contain a modest amount of ginger or curry may prove helpful in easing the pain of osteoarthritis.

In a University of Miami study, 66 percent of those with knee OA who took ginger twice a day (255mg) felt better after six weeks, compared to 50 percent who took a placebo. Though such results suggest you might want to add a little ginger to your recipes, you need to guard against overuse.

“Just because a little is good, it doesn’t mean a lot is better,” says Dunn. Ginger is a known anti-coagulant, and can interfere with blood thinners as well as medications for high blood pressure, diabetes and heart disease. “Try using it only in a small amount at a meal, if you’re on a blood thinner or blood-pressure medication, and be sure to let your doctor know if you add it to your diet daily.”

Another spice with a positive profile is tumeric, a component of curry. Tumeric has long been used in Chinese medicine as an anti-inflammatory agent. Recent research reported in the journal Rheumatology has shown that curcumin, the active ingredient in tumeric, seems to inhibit several of the same enzymes that are also blocked by celecoxib (Celebrex) and other nonsteroidal anti-inflammatory drugs (NSAIDs). If supported by further studies, this finding could suggest a strategy that allows people to take lower and safer doses of these drugs.

Again, moderation is the watchword. “Curcumin may be helpful in small amounts,” says Dunn, “but it can intensify the effects of any blood thinners you’re taking. And it has been associated with causing contractions of the gall bladder—so if you have gallstones or related problems, it’s best to avoid it.”

Fishing for omega-3s
The reasons you should make fish a regular part of your diet keep getting more compelling. One recent study that examined the impact of fish on inflammation found that those who ate at least 10 ounces a week lowered their markers for inflammation by up to 33 percent, compared to those who ate no fish.

Though omega-3 fatty acids are an important reason why fish is good for you, scientists have only begun to figure out why. A research team has recently discovered a new class of fats (resolvins) made from omega-3 fatty acids that appears to block the migration of inflammatory cells to the inflammation site as well as to turn off other inflammatory cells.

If you’re not fond of fish, you could take fish oil. Start out with small doses, such as one pill a day, and increase as tolerated every few days. The biggest side effect of taking fish oil supplements? Burping up the fish smell. “Fish oil can act as a blood thinner,” says Dunn. “If you’re already on blood thinners, talk with your doctor before taking any supplement.”