At present, no medication is capable of curing osteoarthritis. However, it is possible to slow down the evolution of the disease and improve joint comfort. To a certain extent, diet can contribute to this. But there are many misconceptions about dairy products and gluten.
In osteoarthritis, the cartilage of the affected joint is gradually destroyed, resulting in stiffness and loss of mobility. Rheumatologists recommend taking anti-inflammatory drugs when the joint is too painful. This treatment is effective, but only has a temporary effect.
At present, the treatment of osteoarthritis is essentially based on lifestyle advice in order to provide lasting relief to patients. Physical activity, adapted to the physical capacities of each person, is one of the main recommendations.
Diet, on the other hand, has a more modest place due to a lack of scientific data.
"We have no evidence that an anti-inflammatory diet can play a role in osteoarthritis," observes Dr. Jean-Michel Lecerf, head of the Nutrition and Physical Activity Department at the Pasteur Institute in Lille.
Does losing weight reduce joint pain?
The only thing that is certain is that it is very important to maintain a normal weight to protect your joints. Losing even 4 to 5 kilos is enough to relieve osteoarthritis. This has been demonstrated in osteoarthritis of the knee in particular, but also in osteoarthritis of the hands. The effect is both mechanical (it is easy to understand in the knee because the joint has less weight to support), but it is also physiological. In overweight people, fatty tissue secretes mediators that increase sensitivity to pain, as well as pro-inflammatory molecules that only aggravate joint damage.
Should we favour the Mediterranean diet?
Some studies suggest that a diet following the principles of the Mediterranean diet reduces the risk of inflammatory rheumatism, such as rheumatoid arthritis. The mechanism would be both anti-inflammatory and antioxidant. However, this has not been demonstrated in osteoarthritis.
The Mediterranean diet is nevertheless widely recommended by doctors because it helps maintain good health and is protective of the cardiovascular system. In practice, menus should give a large place to whole grains, fruits and vegetables, fish and olive oil. On the other hand, meat, deli meats and ready-made meals should be reduced.
Omega-3s: how effective are they in treating osteoarthritis?
Omega-3s are polyunsaturated fatty acids found in fatty fish, but also in rapeseed oil and nuts.
Their nutritional value is recognized in cardiovascular prevention, against cerebral aging and depression. Their anti-inflammatory action could be interesting in osteoarthritis, "but we have no evidence of effectiveness on the clinical signs of the disease," said Dr. Lecerf. For the general population, the National Health Nutrition Program recommends eating fish twice a week, including a fatty fish (salmon, tuna, mackerel, herring, sardines, anchovies ...) for its contribution in omega-3.
Can we eat dairy products?
Milk, yogurt and cheese have a reputation for being pro-inflammatory. There is no proof of this, but when in doubt, some osteoarthritis patients prefer to avoid them. But this is a miscalculation.
"Some studies show rather a beneficial effect of dairy products, in particular in gonarthrosis (osteoarthritis of the knee, NDLR) with a lesser progression of the disease", underlines the doctor nutritionist.
For him, dairy products (rich in calcium and other nutrients) remain essential to the good health of bones, muscles and joints. The current recommendation is to consume two per day.
Do probiotics help reduce inflammation?
According to a popular hypothesis, an imbalance in the intestinal microbiota could promote inflammation in the body and thus aggravate the process of destruction of cartilage, characteristic of osteoarthritis. Hence the idea of offering patients probiotic food supplements, with the aim of restoring their intestinal flora. But how effective are they really?
Which probiotic strains should be recommended?
At this time, no study has provided reliable answers to these questions. However, Dr. Lecerf does not rule out the probiotic hypothesis. "The microbiota certainly plays an important role in health. It may have a role in inflammation. But we have no data on osteoarthritis," he explains. For him, the best probiotics remain yoghurts, which is in line with the recommendations on the consumption of dairy products.
Is the gluten-free diet useful in osteoarthritis?
Like milk, the gluten found in certain cereals (wheat, rye, etc.) is viewed with suspicion by some people with osteoarthritis. But there is no scientific argument that gluten in the diet aggravates joint pain. "Some people who are hypersensitive to gluten (without having celiac disease) complain of muscle symptoms. They may be improved when they stop eating gluten. But these symptoms are more like fibromyalgia. They are different from osteoarthritis", underlines Dr Lecerf.
The Seignalet diet recommends a diet without dairy products or gluten to relieve painful joints. But, to date, no scientific study has proven its effectiveness.
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