Diet & Arthritis

Videos & How-tos

There are certain arthritic conditions which are definitely partially treatable with diet, these include gout and coeliac disease, which are distinct entities. In these -diet is a factor.

In the case of gout, the cell nucleus is metabolically broken down, on cell death, from purine content to uric acid. Ultimately this is excreted by the kidney. The dietary source of purines is only approximately 4-5%, and the bodies own metabolism results in the other 95%. Diet however becomes a factor in acute and sub-acute phases of gout. A properly treated patient with gout can liberalize the diet once controlled.

Therefore with gout -diet should be controlled rigidly, especially in those times where there is an attack or risk of attacks or where there are tophi. I only start to liberalize the diet, when patients are stable on the drugs that control hyperuricaemia.
I am strict regarding alcohol, red meats, gravies and meat extracts, rich seafoods such as shellfish and lobster.
I do allow unrestricted ordinary fish, chicken and limited restricted fruit and unrestricted vegetables.

Egg whites – unlimited
Egg yolks – 2 per week
Alcohol is also to be avoided.

Diet and fad diets do NOT cure the other inflammatory arthritic conditions…such as rheumatoid arthritis and also there is no evidence that it cures osteoarthritis.

There are only one or two studies showing at most a marginal benefit –
just above placebo benefit but most studies show NO MAJOR RELATIONSHIP TO DIET.

My advice:

Moderation is the key.
Diet is only a marginal factor
Vegetarians are NOT immune from developing any type of arthritis…including Rheumatoid arthritis.
Excessive red meat I agree however should be discouraged.
However if you as an individual find a particular food irritant to your joints and arthritis-LEAVE that foodstuff OUT.
If you don’t find a particular food bothers you – enjoy it.

But remember all people are different and what is good for you may not be good for others, and Vice Versa.

It is my personal clinical experience that if a food “annoys” a patients joints – the patient knows.
It is a consistent finding…every time they take that particular foodstuff….they feel it in the next 12-36 hrs.

There are no effective blood or food allergy tests to decide effectively what someone can or cannot eat.
The sensitivity of these tests are too high, and specificity too low, for clinical practice.

Diet for Obesity

Of course being overweight doesn’t help the joints and in fact being overweight accelerates degenerative disease in joints plus increases the damage of inflammatory arthritis in weight-bearing joints.

Essentially you have to give up Carbohydrate.

The object is to get the energy from your body stores- so the diet I’ve designed makes this tolerable without suffering.

Plus it is sustainable long term.

Plus you are allowed 1 cheat month – during which you can eat whatever you want.

Monitor weight versus goal weight
Chart what you ate to see if their is a pattern where / when weight doesn’t drop.

Expect 4 kg down first 10 days then 100 – 200 gram drop per day thereafter.

Remember your body sees drop in intake as a “emergency” and thinks its starving. Therefore your metabolism drops and you will feel exhausted. Respond by doing MORE exercise.
Each day if you gain some weight rather than lose – CHANGE SOMETHING.. ie. more exercise for a day or 2 or even more dietary restriction.

Principles of the diet and health plan

No bread Rice Potatoes or Pasta.
No substitutes for bread Rice Potatoes or Pasta.
Unlimited white meat or fish
2 fruit maximal per day. No banana
Unlimited vegetables
Unlimited salads
Whatever salad dressing you want including mayo – make that salad appetizing and scrumptiously enjoyable
No sweets, chocolates or junk food
No potato chips / crisps
No sweetened fruit juices
No sugary drinks
Diet colas
Lots of water
Alcohol restrict to 2 spirit per week MAXIMUM
Beer is ideally excluded
2 egg with yolk a week
Unlimited egg white.
Unlimited vegetable soups in winter

Remember to exercise

The principle of exercise is to change the routine every 6 weeks
The body gets used to its constant exercise
If you run / walk – change your route every 6 weeks
If you cycle – change your route every 6 weeks
If you play golf – walk – alternate a pull trolley with a push trolley every 6 weeks
Swimming is always good exercise for arthritis
Exercise minimal – 20 mins 5-7 times a week
Remember you are allowed a day off a week

If you follow the plan – you will lose 3-6 kg per month

Breakfast Plan

All Bran or oat bran
Milk 2% or preferably skim
Non fat , non sweet yoghurt
Tea / Coffee / Rooibos – with Sweetener

Tea Midday

Tea / Coffee


Salad – unlimited with dressing if desired
Tuna / Salmon / fish / white meat – small with salad
Yoghurt non sweetened
Water / Tea/ Coffee with sweetener

Tea Afternoon

Tea / Coffee
Fruit – 1

Dinner / Supper

Low salt Vegetable soup unlimited especially in winter
Meat / Fish – as much as you want. Second helping allowed
Vegetables / stir fry vegetables – large helping
Salad – large helping plus any salad dressing
More salad or vegetables if desired
Water / Diet fruit juice

Night time snack

Yogurt small non fat
Water tea without sweetener. Avoid coffee

Hunger / snacking

Fish ie snoek / Mackerel / biltong
Vegetable Soup in winter