What Foods Cause Osteoarthritis Flare-Ups And Which Should You Avoid?

Osteoarthritis (OA) is the most common type of arthritis, affecting over 32 million¹ people in the US. Up to 47% of women and 40% of men² may be diagnosed with osteoarthritis during their lifetime. The condition can lead to swelling, pain, and a reduced range of motion in your joints. It typically affects your hips, knees, hands, or spine, but it can occur in any joint. It is sometimes referred to as "wear and tear" arthritis or degenerative joint disease.

OA causes the cartilage in your joint to break down, affecting the underlying bone and increasing inflammation. These changes typically develop slowly and worsen over time. In some cases, OA can cause decreased function and disability, which can even prevent you from performing your day-to-day work or tasks.

If you have OA, it's important you make good choices about your diet to manage this condition. Knowing which types of food are linked with the development of OA can help you to maintain your quality of life as you get older.

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We make it easy for you to participate in a clinical trial for Osteoarthritis, and get access to the latest treatments not yet widely available - and be a part of finding a cure.

What foods cause OA flare-ups?

Research has shown that there is a link between nutrition and the development and progression of OA. A recent study has shown that following a Western diet high in sugar, fat, red meat, refined grains, and salt worsened OA and led to higher obesity rates³. On the other hand, following a diet high in vegetables, fruits, whole grains, fish, and legumes seemed to reduce the effects of OA.

The following five foods can cause increased inflammation that could, in turn, affect OA. It is recommended that if you have OA, you should limit these foods in your diet.

1. Salt

It is necessary to consume enough salt to maintain your body's fluid homeostasis, but consuming it in excess can increase swelling and inflammation⁴.

2. Sugar

Excess added sugar also increases inflammation in the body. Added sugar can be found in many processed foods, such as:

  • Sugar-sweetened beverages

  • Baked goods

  • Candy

  • Condiments (i.e., barbeque sauce)

Research has linked excessive sugar intake with a higher chance of developing obesity and low-grade chronic inflammation⁵ which negatively affects joint health.

3. Saturated fat and trans fats

A diet high in saturated fat has been shown to increase inflammation⁶ in the body. Foods that  contain significant amounts of saturated fat include:

  • Full-fat dairy

  • Red meat

  • Fast food

  • Butter

  • Coconut

  • Fried foods

Trans fat has also been strongly linked with systemic inflammation⁷ and increased bad cholesterol levels⁸. Some animal products also contain small amounts of naturally-occurring trans fatty acids. Trans fat can also be created artificially during food processing to add flavor and texture and increase the shelf life of food.

4. Omega-6 fatty acids

The two primary polyunsaturated fatty acids consumed are omega-6 and omega-3. Each type affects the body differently.

The typical American diet is low in omega-3 fatty acids and too high in omega-6 fatty acids. Consuming excessive amounts of omega-6 fatty acids is linked to increased inflammation and other health risks. This is because omega-6 fatty acids are pro-inflammatory⁹, whereas omega-3 fatty acids are anti-inflammatory. There is a recommended consumption ratio¹⁰ between the two types of polyunsaturated fatty acids.

Sources of omega-6 fatty acids include:

  • Sunflower oil

  • Corn

  • Soybeans

  • Safflower oil

  • Canola oil

  • Seeds

  • Poultry

  • Meat

  • Nuts

5. Refined carbs

Refined carbs are present in foods that have had their nutrients and fiber removed during processing, causing them to lose most of their nutritional value.  Refined carbs are referred to as simple carbs as they are digested and absorbed into your bloodstream easily, causing spikes in your blood sugar. They can increase AGEs production¹¹, stimulating inflammation.

Refined carbs are present in foods such as white rice and white flour. Foods containing refined carbs, such as baked goods, breakfast cereals, sweets, and snacks), are usually highly processed and have added salt, fat, and sugar.

What foods should you avoid if you have OA?

If you have OA, you may be able to decrease the severity of the inflammation by minimizing or avoiding certain food and drink, including the following:

1. Red and processed meats

Red and processed meats are associated with inflammation which could increase your symptoms of arthritis. Diet rich in red and processed meat tends to lead to high levels of inflammatory markers, such as:

  • C-reactive protein (CRP)

  • Interleukin-6 (IL-6)

  • Homocysteine

A study¹² involving 217 individuals with rheumatoid arthritis (RA) found that red meat worsened RA symptoms.

Another study¹³ involving 25,630 individuals showed that a high intake of red meat could increase the risk of inflammatory arthritis.

2. Added sugars

While it is important to limit your sugar intake for overall health, it is especially important if you have OA. The same study referred to above involving 217 individuals with RA noted that among 20 different foods, sugar-sweetened desserts and soda were most often reported to worsen RA symptoms¹². A similar effect is also suggested for OA.

Consuming soda or other sugary beverages may significantly increase your risk of developing arthritis. For instance, a study¹⁴ involving 1,209 adults between the ages of 20 to 30 found that those who drank fructose-sweetened beverages at least five times a week were three times more likely to develop arthritis than those who drank few to no fructose-sweetened beverages.

3. Gluten

Gluten is a group of proteins found in rye, wheat, triticale (a cross between rye and wheat), and barley. Research indicates that there may be an association between gluten and increased inflammation¹⁵, suggesting that you might be able to alleviate your symptoms of arthritis by going gluten-free.

4. Highly processed foods

Baked goods, breakfast cereals, fast food, and other heavily processed foods are usually high in added sugar, preservatives, refined grains, and other potentially inflammatory ingredients. These may all worsen symptoms of arthritis and should be avoided if you have OA.

Research shows that a Western diet rich in highly processed foods could increase your likelihood of developing RA¹⁶ by contributing to risk factors like obesity and inflammation. This could also be the case for OA.

5. Foods high in AGEs

Advanced glycation and end products (AGEs) are molecules made through reactions between protein or fat and sugar. AGEs can be formed through certain cooking methods, as well as naturally occurring in uncooked animal foods. They can also be produced by the body.

Foods rich in AGES are those with a high fat and protein concentration, including:

  • Grilled or pan-fried steak

  • Bacon

  • Fried or roasted chicken

  • Broiled hotdogs

  • Margarine

  • French fries

  • Mayonnaise

  • American cheese

Cooking methods that promote AGE production include:

  • Grilling

  • Roasting

  • Broiling

  • Searing

  • Frying

When AGEs build up in excess amounts in the body, it can lead to inflammation and oxidative stress¹⁷, which can worsen symptoms of arthritis.

6. MSG

Monosodium glutamate (MSG) is a food additive that works as a flavor enhancer. It is frequently used in soups, Chinese food, canned foods, and processed meats. Several studies have suggested a potential link between MSG and adverse health outcomes, such as weakness, headaches, and inflammation¹⁸.

Currently, there is inconclusive research into the effects of MSG, and the FDA considers it safe¹⁹. However, if you're dealing with a lot of inflammation, you may want to limit your MSG intake to see if it makes a difference to your inflammation.

7. Alcohol

Regular alcohol consumption is linked with systemic inflammation and can damage your body over time, particularly if you drink it heavily. The CDC states that moderate alcohol intake²⁰ is two drinks per day for men and one drink per day for women.

Depending on the type of alcoholic beverage you consume, it could also contain a high amount of sugar, such as cocktails. The combination of alcohol and sugar can increase its inflammatory effect.

8.  Dairy

Full-fat dairy products, including whole milk, cheese, butter, and cream, are linked with increased inflammation⁶ because of their high saturated fat content.

Along with having a high fat content, some dairy products, such as chocolate milk, sweetened yogurt, and ice cream, are also high in sugar which makes these dairy products more inflammatory.

9.  Nightshades

Nightshades are a group of vegetables that contain a compound called the solanine compound. While research has not confirmed whether they trigger arthritis pain, removing them from your diet may help to improve your symptoms, according to the Physicians Committee for Responsible Medicine²¹.

Nightshade vegetables include:

  • Chili peppers

  • Tomatoes

  • Potatoes

  • Bell peppers

  • Eggplant

The Arthritis Foundation²² recommends that if you suspect nightshades could be making your OA symptoms worse, you should omit them from your diet for two weeks. After this period, you can try reintroducing them one at a time to see if they have any adverse effects in order to isolate the trigger for your OA flare-ups.

The lowdown

If you have osteoarthritis, a healthy lifestyle and diet may improve your symptoms. Lifestyle factors like your body weight, activity level, and smoking status also contribute to the management of arthritis.

If you eat a typical Western diet high in sugar and fat, switching to a healthier diet may seem challenging and even overwhelming at first. It can be helpful to make gradual changes over time, or you may find an all-at-once approach is more effective. Figure out what motivates you more, and make sure to speak to your doctor.

As well as minimizing or avoiding foods that may increase inflammation, eating more foods that decrease inflammation can also contribute to positive joint health. Make sure to eat a healthy diet full of vegetables, fruits, and whole grains.

  1. Osteoarthritis (OA) | Centers for Disease Control and Prevention

  2. Arthritis (2021)

  3. Dietary patterns and progression of knee osteoarthritis: Data from the osteoarthritis initiative (2020)

  4. Dietary sodium, adiposity, and inflammation in healthy adolescents (2014)

  5. High intake of sugar and the balance between pro- and anti-inflammatory gut bacteria (2020)

  6. Inflammatory links between high fat diets and diseases (2018)

  7. trans Fatty acids and systemic inflammation in heart failure (2004)

  8. High systemic levels of low-density lipoprotein cholesterol: fuel to the flames in inflammatory osteoarthritis? (2016)

  9. Omega-6 fatty acids and inflammation (2018)

  10. The importance of the ratio of omega-6/omega-3 essential fatty acids (2002)

  11. Advanced glycation end-products: modifiable environmental factors profoundly mediate insulin resistance (2015)

  12. Diet and rheumatoid arthritis symptoms: Survey results from a rheumatoid arthritis registry (2018)

  13. Dietary risk factors for the development of inflammatory polyarthritis: evidence for a role of high level of red meat consumption (2004)

  14. Intake of high-fructose corn syrup sweetened soft drinks, fruit drinks and apple juice is associated with prevalent arthritis in US adults, aged 20–30 years (2016)

  15. The dietary intake of wheat and other cereal grains and their role in inflammation (2013)

  16. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis (2018)

  17. Dietary advanced glycation end products and their role in health and disease (2015)

  18. Extensive use of monosodium glutamate: A threat to public health? (2018)

  19. Questions and answers on monosodium glutamate (MSG) | U.S Food and Drug Administration

  20. Dietary guidelines for alcohol | Centers for Disease Control and Prevention

  21. Arthritis | Physicians Committee for Responsible Medicine

  22. Best vegetables for arthritis | Arthritis Foundation

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