Tips For Avoiding/Managing Rheumatoid Arthritis

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Avoiding/Managing Rheumatoid Arthritis

Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.

Inflammatory vs Non-Inflammatory Arthritis

Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

You may be wondering: how does one get non-inflammatory inflammation of the joints?

The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause. So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can, but it’s not as absolutely critical a deal as it is for “inflammatory” forms of arthritis.

We’ll tackle the beast that is osteoarthritis another day, however.

Today we’re going to focus on…

Rheumatoid Arthritis

This is the most common of the autoimmune forms of arthritis. Some quick facts:

  • It affects a little under 1% of the global population, but the older we get, the more likely it becomes
  • Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
  • However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
  • It is 2–4 times more common in women than in men
  • Approximately one third of people stop work within two years of its onset, and this increases thereafter.

Well, that sounds gloomy.

Indeed it’s not fun. There’s a lot of stiffness and aching of joints (often with swelling too), loss of joint function can be common, and then there are knock-on effects like fatigue, weakness, and loss of appetite.

Beyond that it’s an autoimmune disorder, its cause is not known, and there is no known cure.

Is there any good news?

If you don’t have rheumatoid arthritis at the present time, you can reduce your risk factors in several ways:

  • Having an anti-inflammatory diet. Get plenty of fiber, greens, and berries. Fatty fish is great too, as are oily nuts. On the other side of things, high consumption of salt, sugar, alcohol, and red meat are associated with a greater risk of developing rheumatoid arthritis.
  • Not smoking. Smoking is bad for pretty much everything, including your chances of developing rheumatoid arthritis.
  • Not being obese. This one may be more a matter of correlation than causation, because of the dietary factors (if one eats an anti-inflammatory diet, obesity is less likely), but the association is there.

There are other risk factors that are harder to control, such as genetics, age, sex, and having a mother who smoked.

See: Genetic and environmental risk factors for rheumatoid arthritis

What if I already have rheumatoid arthritis?

If you already have rheumatoid arthritis, it becomes a matter of symptom management.

First, reduce inflammation any (reasonable) way you can. We did a main feature on this before, so we’ll just drop that again here:

Keep Inflammation At Bay

Next, consider the available medications. Your doctor may or may not have discussed all of the options with you, so be aware that there are more things available than just pain relief. To talk about them all would require a whole main feature, so instead, here’s a really well-compiled list, along with explanations about each of them, up to date as of this year:

Rheumatoid Arthritis Medication List (And What They Do, And How)

Finally, consider other lifestyle adjustments to manage your symptoms. These include:

  • Exercise—gently, though! You do not want to provoke a flare-up, but you do want to maintain your mobility as best you can. There’s a use-it-or-lose-it factor here. Swimming and yoga are great options, as is tai chi. You may want to avoid exercises that involve repetitive impacts to your joints, like running.
  • Rest—while keeping mobility going. Get good sleep at night (this is important), but don’t make your bed your new home, or your mobility will quickly deteriorate.
  • Hot & cold—both can help, and alternating them can reduce inflammation and stiffness by improving your body’s ability to respond appropriately to these stimuli rather than getting stuck in an inappropriate-response state of inflammation.
  • Mobility aids—if it helps, it helps. Maybe you only need something during a flare-up, but when that’s the case, you want to be as gentle on your body as possible while keeping moving, so if crutches, handrails etc help, then by all means get them and use them.
  • Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility. Only you can decide where to draw the line when it comes to that trade-off.

You can also check out our previous article:

Managing Chronic Pain (Realistically!)

Take good care of yourself!

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  • Anti-Inflammatory Khichri & Tadka

    10almonds is reader-supported. We may, at no cost to you, receive a portion of sales if you purchase a product through a link in this article.

    This is halfway between a daal and a risotto; it’s delicious and it’s full of protein, fiber, heathy fats, and flavors. And those flavors? Mostly from health-giving phytochemicals of one kind of another.

    You will need

    For the khichri:

    • 1 oz chana dal
    • 1 oz red lentils
    • 1 oz brown lentils
    • 1 oz quinoa
    • 4 oz wholegrain basmati rice
    • 1 tbsp chia seeds
    • 1 tsp ground turmeric
    • ½ tsp MSG or 1 tsp low-sodium salt

    For the tadka:

    • 2 tbsp avocado oil (or other oil suitable for high temperatures—so, not olive oil on this occasion!)
    • ¼ bulb garlic, thinly sliced
    • 1 fresh red chili (adjust per heat preferences)
    • 1 fresh green chili (adjust per heat preferences)
    • 1 tsp cumin seeds
    • 6 curry leaves
    • 12 twists of freshly ground black pepper

    To serve:

    • Optional: flatbreads or poppadoms
    • Optional: lemon wedges or lime wedges
    • Optional: chopped cilantro or parsley

    Method

    (we suggest you read everything at least once before doing anything)

    1) Simmer the khichri ingredients in 5 cups of water, stirring occasionally if necessary, until it has a risotto-like consistency; this will probably take about 30–40 minutes. This time can be greatly reduced by using a pressure cooker, but obviously you won’t be able to check or stir, so do that only if you know what you’re doing cooking those grains and pseudograins in there, and what settings/timings to use for your specific device.

    2) Make the tadka when the khichri is nearly ready, by heating the 2 tbsp of avocado oil in a skillet until very hot but not smoking, Add the rest of the ingredients from the tadka section, and cook until the garlic is nice and golden.

    3) Pour the tadka over the khichri to serve, with any of the optional accompaniments we mentioned.

    Enjoy!

    Want to learn more?

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    Take care!

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  • How Not to Die – by Dr. Michael Greger

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    Dr. Greger (of “Dr. Greger’s Daily Dozen” fame) outlines for us in cold hard facts and stats what’s most likely to be our cause of death. While this is not a cheery premise for a book, he then sets out to work back from there—what could have prevented those specific things?

    Some of the advice is what you might expect: eat green things and whole grains, skip the bacon. Other advice is less well-known: get a daily dose of curcumin/turmeric, take it with black pepper. Works wonders. If you want to add in daily exercises, just lifting the book could be a start; weighing in at 678 pages, it’s an information-dense tome that’s more likely to be sifted through than read cover-to-cover.

    If you’re a more cynical sort, you might note that since the book doesn’t confer immortality, but does help us avoid statistically likely causes of death, logically it significantly increases our chances of dying in a statistically unlikely way. (Ha! Your mental exercise for today will be decoding that sentence )

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    How to get enough protein from a salad, without adding meat? Cashews and chickpeas have you more than covered! Along with the leafy greens and an impressive array of minor ingredients full of healthy phytochemicals, this one’s good for your muscles, bones, skin, immune health, and more.

    You will need

    • 1½ cups raw cashews (if allergic, omit; the chickpeas and coconut will still carry the dish for protein and healthy fats)
    • 2 cans (2x 14oz) chickpeas, drained
    • 1½ lbs baby spinach leaves
    • 2 large onions, finely chopped
    • 3 oz goji berries
    • ½ bulb garlic, finely chopped
    • 2 tbsp dessicated coconut
    • 1 tbsp dried cumin
    • 1 tbsp nutritional yeast
    • 2 tsp chili flakes
    • 1 tsp black pepper, coarse ground
    • ½ tsp MSG, or 1 tsp low-sodium salt
    • Extra virgin olive oil, for cooking

    Method

    (we suggest you read everything at least once before doing anything)

    1) Heat a little oil in a pan; add the onions and cook for about 3 minutes.

    2) Add the garlic and cook for a further 2 minutes.

    3) Add the spinach, and cook until it wilts.

    4) Add the remaining ingredients except the coconut, and cook for another three minutes.

    5) Heat another pan (dry); add the coconut and toast for 1–2 minutes, until lightly golden. Add it to the main pan.

    6) Serve hot as a main, or an attention-grabbing side:

    Enjoy!

    Want to learn more?

    For those interested in some of the science of what we have going on today:

    Take care!

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    Our Verdict

    When comparing pomegranate to cherries, we picked the pomegranate.

    Why?

    In terms of macros, pomegranate is slightly higher in carbs, and/but 4x higher in fiber. That’s already a good start for pomegranates. Lest we be accused of cherry-picking, though, we’ll mention that pomegranate is also slightly higher in protein and fat, for what it’s worth—which is not a lot. As with most fruits, the protein and fat numbers are low importance next to the carb:fiber ratio.

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  • Are You A Calorie-Burning Machine?

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    Burn, Calorie, Burn

    In Tuesday’s newsletter, we asked you whether you count calories, and got the above-depicted, below-described set of answers:

    • About 56% said “I am somewhat mindful of calories but keep only a rough tally”
    • About 32% said “I do not count calories / I don’t think it’s important for my health”
    • About 13% said “I rigorously check and record the calories of everything I consume”

    So what does the science say, about the merits of all these positions?

    A food’s calorie count is a good measure of how much energy we will, upon consuming the food, have to use or store: True or False?

    False, broadly. It can be, at best, a rough guideline. Do you know what a calorie actually is, by the way? Most people don’t.

    One thing to know before we get to that: there’s “cal” vs “kcal”. The latter is generally used when it comes to foodstuffs, and it’s what we’ll be meaning whenever we say “calorie” here. 1cal is 1/1000th of a kcal, that’s all.

    Now, for what a calorie actually is:

    A calorie is the amount of energy needed to raise the temperature of 1 liter of water by 1℃

    Question: so, how to we measure how much food is needed to do that?

    Answer: by using a bomb calorimeter! Which is the exciting name for the apparatus used to literally burn food and capture the heat produced to indeed raise the temperature of 1 liter of water by 1℃.

    If you’re having trouble imagining such equipment, here it is:

    Bomb Calorimeter: Definition, Construction, & Operation (with diagram and FAQs)

    The unfortunate implication of the above information

    A kilogram of sawdust contains about a 1000 kcal, give or take what wood was used and various other conditions.

    However, that does not mean you can usefully eat the sawdust. In other words:

    Calorie count tells us only how good something is at raising the temperature of water if physically burned.

    Now do you see why oils and sugars have such comparably high calorie counts?

    And while we may talk about “burning calories” as a metaphor, we do not, in fact, have a little wood stove inside us burning the food we eat.

    A calorie is a calorie: True or False?

    Definitely False! Building on from the above… We will get very little energy from sawdust; it’s not just that we can’t use it; we can’t store it either; it’ll mostly pass through as fiber.

    (however, please do not use sawdust to get your daily dose of fiber either, as it is not safe for human consumption and may give you diseases, depending on what is lurking in it)

    But let’s look at oil and sugar, two very high-calorie categories of food, because they’re really easy to physically burn and they give off a good flame.

    A bomb calorimeter may treat them quite equally, but to our body, they are metabolically very different indeed.

    For a start, most sugars will get absorbed and processed much more quickly than most oils, and that can overwhelm the liver (responsible for glycogen management), and lead to non-alcoholic fatty liver disease, diabetes, and more. Metabolic syndrome in general, and if you keep it up too much and you may find it’s now a lottery between dying of NAFLD, diabetes, or heart disease (it’ll usually be the heart disease that kills).

    See also:

    Meanwhile, we know all about the different kinds of nutritional profiles that oils can have, and some can promote having high energy without putting on fat, while others can strain the heart. Not even “a fat is a fat”, so “a calorie is a calorie” doesn’t get much mileage outside of a bomb calorimeter!

    See also:

    A calorie-controlled / calorie-restricted diet is an effective weight loss strategy: True or False?

    True, usually! Surprise!

    • On the one hand: calories are a wildly imprecise way to reckon the value of food, and using them as a guide to health can be dangerously misleading
    • On the other hand: the very activity of calorie-counting itself promotes mindful eating, which is very good for the health

    There is a strong difference between the mind of somebody who is carefully logging their pre-bedtime piece of chocolate and reflecting on its nutritional value, vs someone who isn’t sure whether this is their second or third glass of wine, nor how much the glass contained.

    So if you want to get most of the benefits of a calorie-controlled diet without counting calories, you may try taking a “mindful eating” approach to diet.

    However! If you want to do this for weight loss, be aware, that you will have to practice it all the time, not just for one meal here and there.

    You can read more on how to do “mindful eating” here:

    Dr. Rupy Aujla: The Kitchen Doctor | Mindful Eating & Interoception

    Take care!

    Don’t Forget…

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