How I’m Beating Arthritis with Food-And-Lifestyle-Medicine (1)
There’s NO doubt about it – I’m beating arthritis with food-and-lifestyle medicine. Today, I took a break from writing, recipe testing and filming for my upcoming book to walk, painlessly, through a local park on this glorious early Spring day. As I looked up and noticed the new blossom flowering against the clear blue sky, I felt tangible renewal. I felt hope. I sensed a future without pain. All at once, I was struck by a profound thought:
“I am BEATING arthritis with food-and- lifestyle medicine!”
And it felt good. It felt SO good that I want to share how I’m healing my arthritis (I have psoriatic arthritis) with food-and-lifestyle medicine. As you read further, please, please bear in mind anyone who may also benefit and share this with them.
I take a ‘food-and-lifestyle-as-medicine’ approach, putting myself (a whole person) at the centre of the complex and interconnected web that is my whole life. Although for me, food is our first and our BEST medicine and the key to a healthy mind and body, food is by no means our only medicine; no amount of perfect-for-you, nutritious healing foods will mend a broken lifestyle and the impact of a toxic environment.
A whole life is a BIG topic!
In this post, I’ll focus on how I pieced together the medical and research evidence on arthritis and psoriasis that convinced me I could heal-with-food.
In the next post, I’ll share my own ‘healing-with-food prescription’ and how traditional foods are essential to this prescription.
In the final post, I’ll share the lifestyle changes that are helping me in beating arthritis. Changes like restoring restful sleep; reducing stress; taking regular breaks in nature to move my body; and fostering inner and outer connectedness.
If I’ve learned one thing, it’s that true health is a journey, not a destination. So, let me share with you that journey…
Left unchecked all forms of arthritis will, literally, cripple your life. It disfigures joints – hands, neck, shoulders, spine, hips, knees, feet – and restricts movement and mobility. Arthritis is inflammatory, degenerative and chronically painful. It provokes depression. And it doesn’t stop there – it’s progressive. It started in my hands.
Many types of arthritis are long-term conditions, where the disease can’t be cured. And indeed, conventional approaches to treatment offer a glum future – increasingly strong, anti-inflammatory medication (painkillers, non-steroidal anti-inflammatories (NSAIDs), steroid injections, disease-modifying anti-rheumatic drugs (DMARDs), ‘biological immunosuppressant drugs (commonly methotrexate, used for chemotherapy) and/or surgery.
In the short term, these drugs can help people ‘get their lives back’ – but they’re not a long-term solution.
“They shouldn’t be the end of treatment, but a bridge to cool off inflammation while we treat the root cause of the disease.” (Dr Mark Hyman).
The thing is, each option comes with a host of frightening side-effects. Ultimately, the pre-occupation of conventional medicine in treating arthritis is a question of balancing the progression of disease, with the impact of side effects of medications and/or of surgeries. (1)
MY EXPERIENCE: The first signs of arthritis showed up in my mid-twenties (explained as ‘wear and tear’). Slowly my hands, knees and toes joint were all affected. Initially, my rheumatologist diagnosed primary degenerative and subsequently, inflammatory arthritis.
I’ve had prescribed and/or endured all of the above treatments. Thankfully, it was the prospect of the long term consequences of drug ‘therapy’ and undergoing yet more surgery that pushed me down the road to recovery.
Arthritis is not just ‘wear & tear’
A study by investigators at the Stanford University School of Medicine has shown that the development of osteoarthritis is, in great part, driven by low-grade inflammatory processes. This is at odds with the prevailing view attributing the condition to a lifetime of ‘wear and tear’ on long-suffering joints. (2)
The study’s senior author William Robinson, MD, PhD explains the implications of these findings:
“It’s a paradigm change … people in the field predominantly view osteoarthritis as a matter of simple wear and tear, like tires gradually wearing out on a car … it also is commonly associated with blow-outs, such as a tear in the meniscus — a cartilage-rich, crescent-shaped pad that serves as a shock-absorber in joints — or some other traumatic damage to a joint.
“Recent findings suggest that low-grade complement activation [inflammation] contributes to the development of degenerative diseases, including Alzheimer’s disease and macular degeneration. Our results suggest that osteoarthritis can be added to this list of diseases.
“Right now we don’t have anything to offer osteoarthritis patients to treat their underlying disease. It would be incredible, for the one-third of humans over 60 who have it, to find a way to slow it down.”
MY EXPERIENCE: Food-and-lifestyle medicine is not only slowing down the underlying disease process of arthritis – inflammation and autoimmunity – but it’s reversing it!
Arthritis is an autoimmune condition…
And it’s one of a growing multitude which can affect just about every part of our body!
In respect of arthritis, our joints are lined with cartilage that lubricates them and absorbs physical impacts to enable us to move freely and comfortably. Most of the cartilage in joints consists of collagen, a protein critical to keeping joints mobile and mucous membranes, skin, hair and nails healthy
Conventional wisdom has it that oesteoarthritis is a consequence of an inevitable process of “wear- and-tear” on joints as we age. Rheumatoid arthritis, on the other hand, has always been recognised as an inflammatory autoimmune disease that arises when the body mistakenly attacks its own tissues, in this case the joint linings and cartilage. (3)
However, scientists at the University of Nebraska have shown that osteoarthritis and rheumatoid arthritis both involve the structural degradation and gradual destruction of cartilage in ageing (and in not so ageing!) joints. They found and that both arise from pro-inflammatory, immune factors. In osteoarthritis and in rheumatoid arthritis, the chief cause of autoimmune response is exposed collagen and the ensuing attack by sensitised killer T-cells. (3)
A new paradigm – ‘functional’ medicine…
Functional Medicine is an emerging 21st century approach of ‘systems’ medicine. It seeks to treat the cause, not merely the symptoms of disease, asking not only WHAT disease do we have, but WHY are we sick?
Dr Mark Hyman, the Medical Director at Cleveland Clinic’s Center for Functional Medicine, is a trail-blazing physician in this field and has this to say:
“Autoimmune conditions are connected by one central biochemical process: A runaway immune response also known as systemic inflammation that results in your body attacking its own tissues. Your body is fighting something — an infection, a toxin, an allergen, a food or the stress response — and somehow it redirects its hostile attack on your joints, your brain, your thyroid, your gut, your skin, or sometimes your whole body.” (4)
As we have seen above, conventional treatments for arthritis focus on pain control, symptom and immune system suppression, and disease ‘modification’. Is there any role for ‘dietary modification’? My Consultant Rheumatologist (a senior and well respected figure in his field) argued vehemently that there was NOT!
However… the University of Nebraska research team (in the study above) found that chicken soup prevented the mobilisation of immune system cells to sites of inflammation. After further analysis, they discovered that it was not the vegetables in the soup, but a soluble component of the chicken broth itself that exerted this anti-inflammatory activity; the researchers concluded that it was likely that the collagen from chicken bones in the broth had a beneficial anti-inflammatory effect. (3)
Indeed, bone broth (made from chicken or beef bones) has long been held as a curative by Traditional Chinese Medicine and by the ‘ancient science of life’ Ayurveda in India. Many cultures across the globe have their own versions of healing chicken soup (think ‘Jewish penicillin‘) and science is now showing us how bone broths heal by breaking down collagen into gelatin (a jelly-like substance) making it bio-available (easily digested and absorbed) to our body.
Gelatin, besides being good for hair, nails, skeletal and connective tissue, helps our digestion by lining the mucous membranes of the digestive tract, protecting and sealing them against damage from food or drinks (I’ll explain the importance of this below). And if that wasn’t enough – bone broth increases the nutritional value of other foods that eaten with it.
It’s frustrating that few conventional physicians (remember my rheumatologist?) will entertain the prospect that food-and-lifestyle-is-medicine. Dr Mark Hyman is equally frustrated:
“I recently participated in a group discussion with a conventional doctor, a rheumatologist, and patient with an autoimmune disease, and one of my patients. When my patient described how he cured his autoimmune disease by finding and eliminating the causes of inflammation in his diet and environment, it was dismissed as a “spontaneous remission.” In the face of a paradigm-shattering medical case, these doctors were hardly curious and quickly dismissive, describing what was shared as anecdotal.”
However, thanks to the efforts and courage of leading-edge physicians and practitioners, who are prepared to put their ‘heads above the parapet’ we are seeing how science is confirming what our ancestors always knew: we are what we eat, digest and absorb and our bodies are designed to heal-with-food.
MY EXPERIENCE: Five years ago, after struggling with skin issues around my hair-line, scalp and behind and in my ears, a dermatologist confirmed I’d developed three different conditions: psoriasis, eczema and seborrheic dermatitis. I left the consultation with a fist full of prescriptions for various lotions and creams – but no response to my question “Is there anything I can do about my diet to help myself?”
Now, my rheumatologist gave me a new diagnosis – psoriatic arthritis – and with it, the prospect of methotrexate.
Psoriasis, psoriatic arthritis (PsA) and chronic inflammation
In 2014, member States of the World Health Organisation (WHO) recognised psoriasis as a common but serious noncommunicable (NCD) with no clear cause or cure. In 2016, the WHO published a Global Report on Psoriasis (5)
“Psoriasis has an unpredictable course of symptoms, a number of external triggers and significant co-morbidities, including arthritis, cardiovascular diseases, metabolic syndrome, inflammatory bowel disease and depression.”
Psoriasis can develop at any age, but research indicates that there seem to be two peaks for the disease – between 16 and 22 and between 57 and 60 years of age. Psoriasis a chronic skin condition, thought to be caused by a combination of genetic predisposition, a compromised immune system, and the environment (environmental and pharmaceutical toxins and stress).
It can be localised to one or two areas (e.g. scalp or elbows – mine appeared here) or can appear all over the body, forming raised, red, scaly plaques that can itch, crack and bleed. The disease is painful and can cause disfigurement and disability – in about 20% of cases, it’s so severe that no creams and ointments can control it.
One of the critical features of psoriasis is chronic inflammation and, as the WHO report highlights, numerous studies have and continue to report the coexistence of psoriasis and other serious diseases. (5)
“Psoriasis is a common, chronic, noncommunicable skin disease, with no clear cause or cure. The negative impact of this condition on people’s lives can be immense. Psoriasis affects people of all ages, and in all countries. The reported prevalence of psoriasis in countries ranges between 0.09% and 11.43%, making psoriasis a serious global problem with at least 100 million individuals affected worldwide. Psoriasis has an unpredictable course of symptoms, a number of external triggers and significant co-morbidities.”
In 2009, the WHO recorded UK, 7. 25 million in the UK. In most developed countries, prevalence of psoriasis is between 1.5 and 5% – in the United States there are about 7 million people with psoriasis, including about 3 million who have never been diagnosed. Around 10% of sufferers develop arthritis with this skin condition: among those with extensive, severe skin disease, incidence of arthritis can be three or four times more common. In most instances, the skin condition appears before the arthritis.(6)
MY EXPERIENCE: It was arthritis that showed up appeared first and psoriasis came afterwards – along with eczema and dermatitis. Thankfully my research, diet and lifestyle changes have enabled me to throw away the prescriptions, has prevented these conditions from progressing. Instead, I’m turning BACK the clock!
While it’s encouraging that the WHO recognises that “the negative impact of this condition on people’s lives can be immense” it admits that “treatment of psoriasis is still based on controlling the symptoms.“
In its 44 page report, the WHO acknowledges the potentially serious consequences of psoriasis and emphasises the need for multidisciplinary team working, individually adapted treatment and the access to medications… (5)
“Health-care professionals and health systems must strive to provide patients with comprehensive care from multidisciplinary teams of specialists, including dermatologists, rheumatologists, psychologists, psychiatrists, paediatricians, cardiologists and others. Clinicians must inform patients about the possible consequences of the disease and collaborate with them to identify barriers to adherence and help address these barriers to achieve optimal management.
“Patients suffering from psoriasis should have access to comprehensive, individually adapted treatment. At a minimum, public and private facilities should provide the drugs included on the WHO Model List of Essential Medicines, including systemic therapies. Universal health coverage schemes should cover the costs of these treatments. For newer biological therapies, more needs to be done to reduce the price of these medicines, if they are to present a sustainable and affordable treatment option for patients with psoriasis. The development of biosimilars may help in this regard. Governments should take cost-effectiveness of treatment options into account when developing national guidelines.”
But, despite a plethora of science which links autoimmune disorders to a compromised and dysbiotic intestinal tract, processed foods (as well as to medications, environmental and household/personal care toxins, stress) there is not ONE single mention, reference, or acknowledgement of the impact of food and nutrition on this chronic, inflammatory, autoimmune condition!
MY EXPERIENCE: It was learning about the relationship between our western diet of processed and ‘fake’ foods ⇒ dysfunctional digestion ⇒ a damaged and dysbiotic digestive tract ⇒ compromised immune system and finally ⇒ full-blown autoimmune disease, that started my healing process.
Autoimmune diseases and the gut
It’s interesting that autoimmune disorders occur almost exclusively in developed countries. People in poor nations without modern amenities like running water, flush toilets, washing machines, and sterile backyards don’t get these diseases. (3) (4)
“If you grew up on a farm with lots of animals, you are also less likely to have any of these inflammatory disorders. Playing in the dirt, being dirty, and being exposed to bugs and infections trains your immune system to recognize what is foreign and what is “you.” (Dr Mark Hyman).
Dirt, germs and bacteria, it seems, are good for us! Mouth to anus, our digestive tract is a hollow tube which, in an important sense, is ‘outside’ our body. Along with our food, this hollow tube is the main route through pathogenic bacteria can enter our body.
However Nature has a cunning plan: she has made sure that around 60% of our immune system is found is in our gut – on the other side of the tube! Known as our ‘second brain’, the integrity of our gut (our enteric nervous system, the ENS) plays a huge part in determining our health and in disease processes. This second brain, our ‘gut’ nervous system, comes from the same embryonic tissue as our central (brain-brain) nervous system and is actually connected to it, via the autonomic nervous system.
The Enteric (Gut) Nervous System…
The ENS acts completely independently and does a number important jobs, keeping everything moving in the right direction from the top down, by coordinating the contraction of muscle cells; triggering the gut hormones and enzymes to be released from cells to promote digestion; helping to keep the blood flowing so when we absorb our food it can get to where it needs to go.
Crucially, it controls the immune and inflammatory cells in the gut. Are you getting the picture?
If immune and inflammatory responses and autoimmune diseases (like arthritis and psoriasis) are controlled by our gut, then wouldn’t the status of our gut health be a KEY factor in determining disease and healing? However, our western diet and lifestyle has seen to it that our digestive health AND our lifestyle is far from good.
The food we eat and how we live impacts directly and indirectly on the integrity of our gut. Our gut lining is like a fine cheese cloth designed to allow the tiny molecules from fully digested foods to pass through into our blood stream. Inflammation (from processed foods, toxins, stress and dysfunctional lifestyles) displaces the balance of our beneficial gut flora, letting opportunistic and pathogentic bacteria and yeasts to proliferate, increasing inflammation and provoking gut permeability. Now, instead of keeping illegal substances (undigested ‘macro’ molecules, pathogens and other substances) at bay, it allows them to pass through it into the blood stream – setting us up for trouble.
The ancient life-science of Ayurveda holds that proper digestion and elimination are the key to health and healing and Hippocrates, the father of modern medicine, held that all diseases begin in the gut; modern science is proving them right!
MY EXPERIENCE: In my training as a GAPs Practitioner (Gut & Psychology/Physiology Syndrome) with Dr Natasha Campbell McBride, I learned about the central role that our gut microbiome plays in every aspect of our physical and mental health.
I learned how industrial food processing changes the nature of the food we eat, such that our body just can’t recognise it. I learned how the ‘ingredients’ in processed foods, alcohol, drugs, food toxins, pharmaceutical medications, antibiotics, contraceptive pills, agricultural chemicals, environmental and emotional stress ALL impact on our digestion. I learned how this compromises our immune system, provokes chronic immune responses and sets up the vicious cycle which ultimately leads to full-blown autoimmune (and other chronic and degenerative) disease.
Autoimmune disease & hypothyroid
But there’s another player on the field in this autoimmune game – one that some would argue is the KEY player. This player determines not only the effectiveness of our digestion, but crucially, the strength of our metabolism (how effectively our cells can produce the energy we need to run every organ and body system).
If our metabolism is slow, the strength and efficiency of our digestion and elimination is impaired nutrients struggle to reach the cells… slowing down metabolism even further and further weakening digestion and elimination. Into this ‘chicken and egg’ cycle, enters the key player: THYROID HORMONE!
Every cell in our body is impacted by thyroid hormone – it’s like a ‘master switch’ that turns on the genes that keep every cell running ‘hot’. If your thyroid slows down, every other organ and system in your body slows down, including our brain, heart, gut, and muscles. Keep this up, and the trouble starts…
Hypothyroidism – particularly sub-clinical hypothyroidism – is now a very common condition, but it’s hugely under-diagnosed due unreliable testing methods. In hypothyroidism our overall metabolic ‘gas pedal’ slows down, because the master gland that controls it, our thyroid gland, is not functioning at full speed to keep cells running hot.
Symptoms caused by low thyroid function include:
– feeling cold when everyone else is warm, cold hands & feet, low basal temperature, slow pulse
– difficulty in sleeping, lack of energy, tired-all-the-time
– brain fog, low mood, & depression
– weight gain and inability to lose weight
– slow transition & constipation
– brittle hair, hair loss, loss of outer third of eyebrows
– dry, flaky skin and nails… and more!
Indeed the impact of thyroid hormone is so ubiquitous in the body that almost any symptom may be associated with thyroid dysfunction.
The gluten connection…
Many toxins – and even common ‘healthy’ foods – in our daily environment impact negatively on thyroid function – for example chlorine and fluoride (think water and toothpaste) binds thyroid receptor sites depleting thyroid hormone. Goitrogenic (cruciferous) foods and food sensitivities. Gluten sensitivity (with or without Coeliac disease) impacts on thyroid function.
In this excellent video, Dr Tom O’Bryan explains autoimmunity in relation to the impact of gluten on thyroid function and our gut health:
Hypothyroid and psoriatic arthritis…
Even as far back as 2006, studies were showing a significantly higher prevalence of thyroid autoimmunity findings in men and women with PsA and of subclinical hypothyroidism in women with PsA, than in the general population. The authors advised that thyroid function and anti-body test and a thyroid ultrasound should be performed as part of a clinical evaluation, particularly in women with PsA.
Putting together the pieces of the ‘jigsaw’
It’s a glum picture, right?
Fake and processed foods, ‘toxic’ lifestyle (stress, poor sleep, medications, antibiotics, contraceptives, environmental and household/personal care products), slow metabolism, thyroid dysfunction, slow digestion, slow elimination, inflammation, leaky gut, dysbiotic gut flora, compromised immune function, autoimmune disease.
But it was through discovering the relationship between all the pieces of the jigsaw and learning that our food is our first and our BEST medicine, that started me on my journey of healing-with-food.
IN THE NEXT POST, I’ll share what I have learned about ‘healing diets’ and how foods I have incorporated into my diet are helping me to heal from two, so called, incurable autoimmune conditions.
In the meantime, if what you’ve read here has raised issues for you, or someone you have shared with, please feel free to contact me for a chat.
There’ll be no strings, just a friendly, caring and listening ear ♥