Your SlideShare is downloading. ×
Arthritic Nutrition
Upcoming SlideShare
Loading in...5

Thanks for flagging this SlideShare!

Oops! An error has occurred.

Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Arthritic Nutrition


Published on

No Downloads
Total Views
On Slideshare
From Embeds
Number of Embeds
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

No notes for slide
  • Transcript

    • 1. Arthritic Nutrition Presented by Stacy Ison University of Indianapolis Senior Athletic Training Student May 2007
    • 2. Overview
      • Arthritis Basics
      • Nutrition Basics
      • Arthritic Nutrition
    • 3. What is Arthritis?
      • Inflammation and pain in the joints
      • The degeneration and inflammation of joints can cause joint stiffness, pain, swelling, deformity, and eventually disability
      • Also refers to joint damage, such as destruction of cartilage
    • 4. Types of Arthritis
      • Rheumatoid Arthritis
      • Juvenile Arthritis
      • Gout
      • Fibromyalgia
      • Osteoarthritis (OA)
        • Most common form, affecting 21 million adults, according to the CDC
        • Characterized by degeneration of cartilage and the underlying bone within a joint as well as bony overgrowth
        • The joints most commonly affected are the knees & hips; Spine, ankles, and old fractures sites also affected
    • 5. Risk Factors
      • The exact cause is unknown
      • Age
        • More likely to develop as you age
      • Weight
        • Excess weight increases the likelihood
      • Sex
        • Women are more likely to develop
      • Medical History
        • Joint injury or acute trauma
      • Genetics
        • Specific gene found in some people
      • Lifestyle
    • 6. Arthritis Statistics
      • According to the CDC:
        • 46 million adults in the U.S. have some form of arthritis
        • By 2030, 67 million of Americans are projected to have arthritis
        • People who are overweight or obese report more doctor-diagnosed arthritis
        • Among adults with knee osteoarthritis, engaging in moderate activity at least 3 times per week can reduce the risk of arthritis-related disability by 47%
        • In 2003, there were 418,000 total knee replacements performed due to arthritis
        • In INDIANA
          • 29% of adults with arthritis, with 14% between the ages of 18-44
          • 71% of adults with arthritis who are overweight or obese
          • 18% of adults with arthritis who are physically inactive
    • 7. Arthritis and Athletics
      • The term arthritis typically stirs up images of elderly and inactive people, but a number of younger, athletic adults are suffering
      • Injuries are common in athletics, but an injury that goes untreated or does not heal properly is the one that causes the degenerative process to begin
      • Repetitive low-grade impact may also be enough to start the arthritic process
    • 8. Arthritis and Athletics
      • CDC notes that those who suffer joint injuries, such as ACL, meniscus, or rotator cuff, are SIX times more likely to develop OA
      • Participants in sports with a high degree of torsional loading and levels of impact are more likely to develop OA if they suffer sports-related injuries that do not heal completely
      • Football players appear to have an increased incidence of degenerative changes, with 30% with a history of knee injury showing evidence of OA 10-30 years after competing
    • 9. How does this affect you?
      • Even though exercise is believed to be beneficial for arthritis because it increases the circulation of fluid that surrounds the joint… rigorous, high-impact, high-stress athletic activities may cause a greater risk for arthritis!
      • Those athletes are typically the kinds that you see here!
      • Think about many clients you have that are at risk for arthritis due to previous injury or their athletic activity… Or you may already have clients with arthritis
    • 10.  
    • 11. Nutrition
      • 3 Main Goals
        • Prepare for performance/training
        • Maintain the level of performance/training
        • Aid in recovery from performance/training
      • Based on a variety of factors
        • Age
        • Size
        • Physical Condition
        • Type of Exercise/Athlete
      • Nutrition is a science, but finding the right nutritional balance for each person is an art!
        • What is good for one person is not always good for another
    • 12. Nutrition
      • If you drink enough water and eat a balanced diet, your body can:
        • Make energy efficiently
        • Fuel top performance
        • Gain more power, strength, and endurance
      • 6 Nutrients to Health
        • Carbohydrates
        • Fat
        • Protein
        • Vitamins
        • Minerals
        • Water
    • 14. Carbohydrates
      • Most important source of fuel
        • Made of Sugars, Starches, and Fiber
        • Found in pastas, breads, cereals, rice, fruits, and vegetables
        • Top Choices: Bran Cereals, Oat Bran, Whole Grain/Dark breads, Whole Grain Crackers
      • In general, whole grains have more nutritional value than products made from refined flour
      • For an active population, carbohydrates should provide about 60-70% of daily calories
    • 15. Why are Carbohydrates important?
      • The body converts sugars and starches from carbs to energy (glucose) and stores it in the liver and muscle tissues (glycogen)
        • This gives endurance and power for high-intensity, short-duration activities
      • If the body runs out of carb fuel during activity, it will burn protein for energy
        • This results in a decrease of performance level
      • To prevent depleting carbohydrate fuel:
        • Eat carbs for at least several days before exercise/competition, so muscle begin glycogen-loaded
        • Eat more carbs during exercise/competition lasting more than 1 hour to replenish energy and delay fatigue
    • 16. Fats
      • Small amounts of fat are needed for certain critical functions and as an alternative energy source to glucose
      • Too much is associated with heart disease and other major health problems
      • Saturated Fats vs. Unsaturated Fats
        • Triglycerides (primary form)
        • Phospholipids
        • Trans Fat
          • Like Saturated fat; Man-Made
        • Cholesterol
          • LDL: “BAD” fat
            • Clogs arteries
          • HDL: “GOOD” fat
            • Produced by body
            • Cleans arteries
            • Increased by exercise
      • For an active population, fats should be limited to no more than 25%
    • 17. Why are Fats Important?
      • Fat is an energy source and reserve
      • Fat protects vital organs and provides thermal insulation
      • Fat is a vitamin carrier and hunger depressor
      • The way the body uses fat for energy depends on the situation
        • With rest or exercise at low intensity, it is the primary fuel source
        • With increased intensity, the body uses more carbohydrates for fuel rather than fat
        • If the body uses up its glycogen supply and you continue to exercise, your body will burn fat for energy, decreasing exercise intensity
    • 18. Protein
      • Provides the body with power to build new tissues and fluids
        • Found in meats, fish, poultry, eggs, beans, nuts, dairy products
        • Top Choices: Lean beef, turkey, fish, peanut butter
      • Digested into amino acids, which are rebuilt into the protein in the muscle and other tissues
        • 9 essential amino acids: Consumed through diet; body cannot synthesize
        • 13 non-essential amino acids: Body can synthesize from other material
      • For an active population, proteins should provide about 15-20% of daily calories
    • 19. Why are Proteins important?
      • The body can not store protein, so it is burned for energy OR converts it to fat
      • The amount needed by an athlete depends on many factors
        • Level of Fitness: Active people need more
        • Exercise Type, Intensity, & Duration: Endurance athletes burn protein for fuel
        • Total Calories: The body burns more protein if enough calories are not consumed to maintain body weight
        • Carbohydrate Intake
    • 20. How Do I Know If I’m Getting the Ideal Percentages?
      • If you kept track of total calories, total carbohydrate intake, total protein intake, and total fat intake for the day, how would you know if you were consuming the recommended percentages?
      • Must know that:
        • 1 gram carbohydrate = 4 kcals
        • 1 gram protein = 4 kcals
        • 1 gram fat = 9 kcals
      • EXAMPLE
        • Sally ate 1600 total calories, 250 g carbohydrate, 100 g protein, and 40 g fat for the day
        • 250g carbs x 4 kcals = 1000 ÷ 1600 = 62.5%
        • 100g protein x 4 kcals = 400 ÷ 1600 = 25.0%
        • 40g fat x 9 kcals = 360 ÷ 1600 = 22.5%
    • 21. Caloric Balance
      • Caloric Balance = # of calories consumed - # calories expended
      • Calorie Consumption (previous slide)
      • Caloric Expenditure
        • Basal metabolism: Minimal amount of energy required to sustain body’s vital functions
        • Work metabolism: Physical activities in 24 hour period
        • Excretion
    • 22. Vitamins & Minerals
      • VITAMINS
        • 4 Fat Soluble: A, D, E, K
          • Stored in the Body
        • 9 Water Soluble: C, B1, B2, B6, B12, Niacin, Folacin, Biotin
          • Not stored in the Body
        • Antioxidants
          • May prevent premature aging, certain cancers, heart disease
          • Include Vitamin A, Vitamin E, and beta-carotene
      • MINERALS
        • Function to maintain bone strength, muscle contraction, and hormone synthesis
        • 3 Major: Calcium, Phosphorus, Magnesium
        • 9 Trace: Including Iron, Zinc, Copper
    • 23. Hydration
      • Water is the most critical factor
      • Because the body does not make or store water, you must replace what you lose through sweat and urine
      • Being thirsty is not a reliable way to tell if you need water – you are already dehydrated by then!
      • Don’t begin to feel thirsty until you have already lost 2% of your body weight
      • Urine should be colorless; dark urine indicates dehydration
    • 24. Hydration Tips
      • Drink at least 8 cups each day; often athletes need more
      • Drink before, during, and after activity to maintain hydration and avoid overheating
      • Drink small amounts of water frequently, not large amounts less often
      • Drink cooler beverages to cool your core body temperature and reduce sweating
      • Drink 2-3 cups of water for every pound lost after exercise
      • Sports drinks are beneficial for longer events, but may work best to be diluted with 50% water
    • 25. Nutrition & Arthritis
      • Most of us have probably heard all of the more common (and sometimes extreme) ways to treat and prevent arthritis
        • Lifestyle changes including regular exercise, stretching, aerobic activity, and weight management
        • Pharmacologic treatments including NSAIDs, COX-2 inhibitors, and glucocorticoids
        • Supplements and Herbs
      • How does simple nutrition play a role?
    • 26. Arthritic Nutrition 101
      • How does Food Affect Arthritis?
        • Arthritis is a disease of inflammation
        • Logical and effective treatment should consist of anything that fights inflammation
        • Specific foods you eat can either make inflammation in the body worse or can reduce the amount of inflammation produced by the body
    • 27. Arthritic Nutrition 101
      • What Foods Should be Avoided?
        • Saturated Fats
          • Fats found in and from animal products and some oils
          • Avoid fatty beef or pork, poultry skin, ice cream, butter, whole or 2% milk, regular cheese, bacon
          • Opt for low-fat or no-fat dairy products, lean cuts of beef or pork, and skinless chicken or turkey
        • Trans Fats
          • Man-made to give baked goods longer shelf-life
          • Mix of vegetable oil and added hydrogen molecules that turn solid
        • Simple and Refined Carbohydrates
          • Set up a state of inflammation in the body which causes an increase in cytokines and other pro-inflammatory compounds
          • Sugary foods, white flour baked goods, white rice, bread
    • 28. Arthritic Nutrition 101
      • What Foods Should be Included?
        • Omega-3 Fatty Acids
          • Work to decrease inflammation in the body by suppressing the production of cytokines and enzymes that erode the cartilage
          • Many studies support fish oil to reduce symptoms of rheumatoid arthritis
          • Salmon, herring, mackerel, sardines, anchovies, trout, oysters, omega-3 fortified eggs, flaxseed, walnuts, seaweed, and soybeans
        • Extra Virgin Olive Oil
          • Protects body against inflammation because it contains polyphenols (an antioxidant)
          • Substitute olive oil when cooking rather than using vegetable oil or butter
    • 29. Arthritic Nutrition 101
      • What Foods Should be Included?
        • Antioxidants
          • Protect the body from the effects of free radicals, which are cell-damaging molecules produced by inflammation
          • Research has demonstrated certain antioxidants may help prevent arthritis, slow its progression, and relieve pain
          • The best include Vitamin C, Selenium, Carotenes, and Bioflavonoids
            • Guava, peppers, oranges, grapefruit, broccoli, brazil nuts, tuna, crab, shrimp, whole grains, sweet potatoes, carrots, kale, squash, and many more!
    • 30. Arthritic Nutrition 101
      • What Foods Should be Included?
        • Vitamin D
          • Critical for joint health
          • May reduce risk of arthritis
          • For those already with arthritis, a deficiency may cause a worsening disability overtime
          • Basic daily requirement: 400 IU until age 70, 600 IU over 70
          • Wild salmon, mackerel, sardines, milk (skim, 1%, low-fat), soy milk, egg yolks, and mushrooms
        • Spices
          • Ginger
            • Shown to lessen pain of osteoarthritis if taken in highly purified form.
            • Contains chemicals that work similar to anti-inflammatory meds
          • Turmeric (curcumin)
            • A mustard-yellow spice with its main ingredient being yellow curry
            • Said to suppress inflammatory body chemicals and work similar to an anti-inflammatory med
    • 31. Arthritic Nutrition 101
      • Should Supplements be Considered?
        • Multivitamins
          • Provides 100% DV of Vitamin D, Vitamin C, Selenium, and Vitamin A
          • Beware of mega-dose varieties: Excess Vitamin C can make certain cases of arthritis worse
        • Fish Oil
          • Studies have shown doses from 1.2 grams to 3.2 grams for excellent relief in conjunction with an omega-3 rich diet
        • Glucosamine + Chondroitin
          • Nutrients naturally found in and around cartilage cells
          • Thought to strengthen and stimulate growth of cartilage
          • Recommend 15 mg glucosamine and 1200 mg chondroitin daily
        • SAMe
          • Possibly as effective as NSAIDs
          • Recommend 1200 mg daily
          • Beware of side effects: insomnia, rash, GI problems
        • GLA
          • Found in evening primrose oil, borage oil, and black current oil
          • Thought to reduce pain, joint tenderness, and morning stiffness by suppressing certain inflammatory substances
          • Recommend 1-2 grams daily
    • 32. Arthritic Nutrition: 1Day Meal Plan
      • Breakfast
        • Vanilla Pumpkin Breakfast Pudding
          • 1 cup nonfat, vanilla yogurt mixed with ½ cup canned pumpkin puree and topped with 2 TBS chopped walnuts
      • Lunch
        • The Ache-Less Salad
          • 3 cups leafy greens topped with 4 ounces of either salmon, crab, shrimp, tilapia, turkey breast, or grilled chicken. Mix with ½ cup chopped tomato, ¼ cup chopped red onion, ¼ cup sliced mushrooms, 1 sliced red bell pepper, 2 chopped beats, ½ cup chopped carrots, ¼ cup corn. Toss with 1-2 teaspoons olive oil and unlimited balsamic vinegar
      • Afternoon Snack
        • Ginger Spiced Pumpkin Muffin
        • Includes whole-wheat flour, cinnamon, ginger, skim milk, pumpkin, canola oil, and more
        • For full recipe, visit
      • Dinner
        • Chicken Curry and Cauliflower with Brown Rice
        • Includes curry powder, garlic, ginger, boneless chicken breast, onion, chickpeas, fat-free yogurt, and more
        • For full recipe, visit
      • PM Snack
        • One cup of fresh berries
    • 33.  
    • 34. Questions or Comments?
    • 35. THANK YOU!
    • 36. Resources
      • Clark, Nancy. Nancy Clark’s Sports Nutrition Guidebook: Eating to Fuel Your Active Lifestyle. Leisure Press; Brookline, MA. 1990.