Joint-Venture - Natural approaches to the pain of Arthritis
The Borneo Post - Sunday, 21 October, 2001

By the time we're in our forties, most of us will have begun to experience deterioration in at least one of our joints. By the time we're 70, some form of joint complaint will have become almost universal.

Three joint conditions, all forms of arthritis, are particularly prevalent, gout, osteoarthritis and rheumatoid arthritis. Sadly, there is no real cures for any of these, and many of the drugs often used to relieve their symptoms are riot only expensive, but can have side-effects that include dizziness, headaches and digestive problems. There's growing evidence, too, that some form of the drug treatments for arthritis can lead to further joint damage in the longer term.

Gout - The Rich Man's Disease
Some foods we eat contain substances called purines. The body also produces purines naturally and they play a role in normal human physiology. As they are utilised in the body though, they break down and the end product of this process is uric acid. Uric acid is not highly soluble, so when there is too much of it in bodily fluids, it forms solid crystals. These crystals can end up in different parts of the body, from joints and tendons to the kidneys and other tissue, often causing damage, pain and inflammation.

One condition caused by excess uric acid is gout, which has long been known as `the rich man's disease' because it often strikes those with a taste for wine and expensive meals. This nickname makes the role of diet in gout very clear and almost all cases of gout can be relieved by adjustments in the way we eat and, especially, drink.

Gout Symptoms
When someone suffers their first gout attack, the usual scenario is something like this: he's a man, over 30. Suddenly, without any real warning, he will experience intense, excruciating pain in one big toe. Other times, it may be a different joint that suffers. In any case, the pain can be so severe that the slightest weight on the joint (even bedclothes resting on the toe), or the slightest vibration, can be almost intolerable.

Out With Gout!
It is now widely understood that dietary adjustments can eliminate gout in almost all cases, by keeping uric acid levels within the normal range.

It you have gout, one thing you shouldn't do is trying to dull the pain with alcohol! Alcohol is a major contributor to gout - not only does it increase uric acid production in the body, it also impairs the body's ability to excrete uric acid. Many gout attacks occur after an episode of alcohol consumption, and for many sufferers, more care with alcohol can by itself prevent gout.

You could also avoid foods that are high in purine, the precursor to uric acid - see the insert table.

If you have gout, try to avoid these high-purine foods.
Anchovies Lamb Sardines
Beef Mutton Trout
Codfish Peas Venison
Gravies Salmon Some beans
Kidneys Tribe Chicken
Lobsters Veal Herring
Rabbit Bacon Liver
Spinach Cauliflower Oatmeal
Turkey Duck Pork
Asparagus Ham Shellfish
Brains Lentils Tuna
Crab Mushrooms Yeast
Halibut Perch  

Carbohydrates - sugar and white flour are examples - should be kept to a minimum, because they increase the body's production of uric acid. The same goes for saturated fats - typically animal fats - which inhibit uric acid excretion.

Fluid intake (filtered water is best!) should be kept high. It helps dilute uric in the body and promotes its elimination. There are also herbs that can help; celery and juniper are believed to aid in the elimination of excess uric acid.

Osteoarthritis is also known as degenerative joint disease, and that alternative: name sums up the nature of the disorder. Joints contain a cushioning substance known as cartilage, which protects the ends of bones. In osteoarthritis, the cartilage in a joint is damaged, and begins to harden. Continued use of the damaged joint leads to further deterioration and a cycle of worsening joint health is underway.

Medical treatment for osteoarthritis usually comes in the form of non-steroidal anti inflammatory drugs, or NSAIDs. These include aspirin and ibuprofen, which can suppress the inflammation associated with osteoarthritis. Unfortunately, most NSAIDs have problematic side-effects ranging from headaches to stomach ulcers.

Prostaglandins and Inflammation
Inflammation is normally a useful bodily function, a natural healing response to disease. Rheumatoid arthritis, though, is a case of inflammation gone awry. And because we don't know what causes rheumatoid arthritis, the best we can hope to do is temper the inflammation and the joint damage it can cause.

Fatty acids form part of everyone's diet. They are also produced naturally in the body and play a part in so many physiological processes that it would be impossible to list them. One of the creation of prostaglandins, hormone-like molecules that help both to promote and to moderate inflammation.

Just how much inflammation prostaglandins promote depends, in part, on the foods our body uses to create them. Substituting dietary fats from animal sources, such as meat and dairy products, with oils from fish and vegetarian sources, can help the body produce prostaglandins that are less inflammatory.

It's now known that consuming omega-3 fatty acids - found in the oil deep sea fish like mackerel, salmon, herring and cod - can help produce an overall reduction in inflammatory activity. Omega­6 fatty acids, like those found in evening primrose oil, are a vegetarian pathway to a similarly moderated level of inflammation.

Unfortunately, these steps aren't likely to eliminate rheumatoid arthritis. However, by reducing the severity of inflammation, attention to fatty acid intake can help to minimmise the impact of this debilitating disease.