Losing weight and joint pain

Aches and pains are typically connected with ageing, particularly in the joints.  You assume it will never happen to you, until one day you wake up with a sharp aching or burn in your joints when you get out of bed or go up the stairs.  Arthritis is one of the most frequent causes of joint pain in Australia, affecting four million people.  You might be surprised to learn that there are over 100 different forms of arthritis. Most people are familiar with osteoarthritis and rheumatoid arthritis, but it also includes ankylosing spondylitis, gout, lupus, scleroderma, psoriatic arthritis, hemochromatosis, and 92 other conditions.


There are several causes of arthritis, some of which are beyond your control, such as genetics, gender, and age, but others are, such as smoking, repetitive traumas, body weight, a work that requires repetitive bending or crouching, and some infections.  


The impact of weight gain on joint health

Excess weight can contribute to joint pain in a number of ways. To begin, there is a 4kg load on weight bearing joints such as the knees for every kg of body weight. There is a lot of wear and tear on the Cartlidge and bone in these areas over time. The relative pressure on your joints increases when you walk upstairs or a hill.   Weight has a compounding impact, which is why even a minor weight loss of a few kgs can make such a large difference in joint discomfort and mobility. So instead of trying to drop 20kg to feel better, start with simply 2-3kg to notice a change.


Inflammation is the second way that extra weight might contribute to joint pain. Excess fat deposits in the body result in an increase in circulating inflammatory cells known as cytokines. As a result, inflammation can begin to build up in our joints long before we notice any pain because we often gain weight as we age, this is something to keep an eye on in order to reduce the long-term risk of developing arthritis.


Diet strategies for joint pain relief

So, what can you do if you already have joint discomfort and inflammation? The first step (before considering weight loss) is to ensure you are eating a varied diet of largely unprocessed foods. This will improve your consumption of foods that have anti-inflammatory properties in the body. These foods contain phytonutrients (mostly found in plant foods), which assist to clean up some of the trash from inflammation known as "free radicals." An overabundance of free radicals in the body causes cell instability and might lead to further inflammation. 


Inflammation is a normal and important aspect of our immune system that aids in the fight against harmful germs and viruses as well as the repair of damage. However, without a clean-up system provided by phytonutrients, inflammation might escalate.  Plan foods are the best source of phytonutrients. Aim for at least 30 different plant items every week in your diet. Make a checklist and challenge your buddies to complete it.


Then, aim for small, progressive weight loss.  Begin with a 2kg goal and see how you feel, then try for another 2kg. You will gradually notice small improvements in your discomfort and mobility. Request assistance from your doctor by referring you to an accredited practising dietitian for individualised medical nutrition therapy and an exercise physiologist/physio for assistance in improving your mobility and activity.


A dietitian can assess the nutritional quality of your entire diet, giving special attention to the foods and nutrients that research has shown can enhance your arthritis-related health.  For example, people with rheumatoid arthritis are at a higher risk of developing heart disease, and switching from saturated to unsaturated fats in your diet and cooking may affect your cholesterol, pain, and inflammation.


Omega-3 is a type of unsaturated fat that is a necessary ingredient (we can't make it in the body from other nutrients, so we have to eat it) that can reduce inflammation as well as joint discomfort and stiffness.  To achieve your body's needs, you'd need to eat two meals (about 140g each) of oily fish per week. Omega-3-rich foods include salmon (both canned and fresh), sardines, calamari, and trout, to name a few. There are some plant versions of omega-3, however they have a poorer anti-inflammatory impact. If you don't consume fish, using a daily fish-oil supplement with about 450mg of EPA and DHA may help with pain.


Saturated fats, which are mostly found in animal meals, as well as coconut oils, should be avoided. Omega-6 fats are another option to consider because, despite being an unsaturated fat, in high doses, they can be pro-inflammatory in the body and potentially worsen symptoms. These fats are typically found in processed meals.


The takeaway tips:

Things to work towards if you are experiencing pain and inflammation in your joints:

  • Eat a wide variety (30+) of plant foods each week
  • Aim for a small and gradual weight loss if you are carrying excess weight
  • Improve the balance of fats in your diet (see below)
  • Speak to your GP about a referral to an accredited practising dietitian if you would like personalised advice about food choices, portion sizes and recipes to suit your needs


Key tips to achieve a helpful balance of fats in your diet are:

  • Choose lean meats
  • Limit coconut oils and creams
  • Choose low fat processed foods or limit them all-together
  • Include a very small (30g or closed handful) of unsalted nuts (and choose a variety of types)
  • Include oily fish a couple of times a week or trial a daily omega-3 supplement.

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July 06, 2023