Inflammation And Insulin Resistance
So, how can inflammation lead to high blood sugar? The answer has to do with insulin.
Insulin is a hormone that helps a persons cells absorb sugar from the blood so it can be used for energy. If the cells are unable to use insulin effectively, a condition known as insulin resistance, excess sugar can start to build up in the blood. Eventually, the person may develop type 2 diabetes.
Remember that RA can cause widespread inflammation throughout the body. This inflammation, in turn, may increase the bodys risk of developing insulin resistance.
Researchers are still studying exactly how inflammation contributes to insulin resistance. Two likely culprits are tumor necrosis factor and interleukin-6 , proteins that are involved in joint inflammation. Theres evidence that both TNF and IL-6 may interfere with insulins ability to work properly.
Lower Your Risk Of Type 2 Diabetes
While scientists are unsure about the exact connection between RA and type 2 diabetes, evidence points to a correlation between the two.
The Arthritis Foundation notes that when someone has RA, their body often releases too much tumor necrosis factor . In small doses, TNF can help the body fight off infection and heal wounds. However, too much TNF can cause inflammation, joint damage, and cell damage. It can also make the body more resistant to insulin, which can lead to diabetes.
What does this have to do with sugar? Type 2 diabetes occurs when the pancreas doesnt make enough insulin and the bodys cells dont respond properly to insulin. This causes a buildup of sugar in the blood and high blood sugar levels.
If your diet has too many added sugars, you are at a greater risk for type 2 diabetes especially if you are overweight or living with obesity, have an unhealthy diet, or do not live an active lifestyle. Corticosteroids, a common RA treatment, can also raise blood sugar and alter sugar metabolism. Joint pain, inflammation, and other RA symptoms can make those with RA less active and at higher risk for complications like diabetes.
How Does Sugar Contribute To Arthritis Risk
As you eatsugar over time, you can increase your risk of developing various types of arthritis. First, sugar triggers the production of cytokine molecules, which promote the bodys defensive inflammatory response, and this low-grade chronic inflammation can lead to arthritis-related problems. Second, high sugar consumption can lead to weight gain and obesity, and this additional weight can create and exacerbate joint problems of all kinds. So, between the inflammation and the weight gain, sugar contributes to two major risk factors for osteoarthritis.
Additionally, the chemical breakdown of sugar in the body leads to byproducts that can increase the risk of gout. When mouth bacteria are triggered by the starches in sugar, they can enter the bloodstream and create infections and problems in the joints. Sugar can also throw your gut microbiome out of whack, messing up the balance of bacteria in your body, which can also increase inflammation in the body and lead to arthritis.
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Sugar Intake Promotes Weight Gain And Obesity Which Can Worsen Arthritis
Obesity is common among arthritis sufferers and forms a risk factor for the development of arthritis.
Losing weight is one of the therapy goals in arthritis. Added sugar intake is very well associated with obesity and weight gain.
Added sugar makes you crave for food that is deficient in nutrients and high in carbs making your body nutritionally deficit and gain more weight.
According to a study published in The American Journal of Clinical Nutrition, added sugars in beverages are the most highly consumed, which is responsible for obesity and weight gain.
Research states that the added sugar can make you obese by increase body fat, muscle fat and liver fat. Therefore, sugar intake can be harmful in arthritis patients by increasing pain and inflammation in the body.
What does this mean?Obesity is a risk factor and reason for worsening arthritis symptoms. Added sugar is prominent in increasing weight and obesity which can lead to more damage to your body and complicate arthritis management.
How Sugar Interacts With Rheumatoid Arthritis
People with RA have been found to have proteins in their body called anti-citrullinated protein antibodies . These proteins can cause the inflammation that triggers RA, and experts believe that sugar can tell the body to make ACPA, which will make symptoms worse.
Sugar has also been found to affect the gut microbiome, which is the balance of good and bad bacteria in the digestive tract. People with RA have been found to have gut microbiomes that are out of balance, and sugar can encourage the growth of bad bacteria that can alter the gut. The result of off-kilter gut bacteria is inflammation, which can lead to RA symptoms.
Multiple studies have found that by simply removing sugar from a diet, patients have lost weight and found a reduction in RA symptoms. Avram Goldberg, MD, suggests, If you do find that sugary foods seem to make your RA symptoms worse, then you should keep them to an absolute minimum.
One of the easiest ways to cut out a large portion of sugar from a diet is to avoid sugary drinks. Many people dont realize how much sugar is hiding in a simple beverage, but they are the biggest contributors of sugar in the American Diet. One study found that women who consumed one sugar-sweetened soda a day were about 60% more likely to get RA than women who drank less than one a month.
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Choose Good Carbs And Avoid Bad Carbs
Good carbs contain a lot of fiber, which is absorbed slowly into the blood stream. This provides the body with energy, but without spiking glucose and insulin levels. Good carbs are found in foods such as whole grains, vegetables, fruits, and beans. And while some fruits like apples and pears have seemingly high sugar levels, they are love on the glycemic index, which means they keep blood sugar levels steady while preventing feelings of hunger.
Bad carbs, along with triggering your inflammation response, are absorbed quickly into the blood, which tends to spike blood sugar and insulin levels. Bad carbs are found in foods such as white bread, white rice, sugary beverages, and sweets.
There is room for some tasty treats in your life, as long as you eat them in moderation while focusing on eating mostly healthy, nutritious foods.
Reasons To Avoid Sugar If You Have Rheumatoid Arthritis
Some people with rheumatoid arthritis choose to limit or eliminate certain foods from their diets to reduce inflammation. One ingredient that your health care provider may recommend you avoid when living with inflammatory arthritis is sugar. From aggravating RA symptoms and inflammation to increasing your risk for other complications or health issues, too much sugar or sugar substitutes can make life with RA even more difficult.
Here are three reasons why you should consider limiting your sugar intake as part of your RA care plan. As always, ask your rheumatologist or a health care provider for medical advice before making dietary changes. They can advise you on the best way to do so or refer you to a specialist, such as a registered dietitian, for further guidance.
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Inflammatory Arthritis And Type 2 Diabetes
Experts dont know for sure how inflammatory arthritis such as RA and PsA are connected with diabetes, but research suggests certain factors may drive an association, including:
Inflammation: Both rheumatoid arthritis, psoriatic arthritis, and type 2 diabetes are characterized by inflammation, says Jessica Starr, MD, an endocrinologist at Hospital for Special Surgery in New York City. There are studies that have shown that having RA increases your risk for developing type 2 diabetes and having type 2 diabetes increases your risk for developing RA, says Dr. Starr. A common mediator for this may be inflammation, but the data isnt completely clear.
What researchers do know is that having more inflammation such as that occurs in rheumatoid arthritis, psoriatic arthritis, and other kinds of inflammatory arthritis promotes insulin resistance, and could promote type 2 diabetes, says John Davis, III, MD, a clinical rheumatologist at the Mayo Clinic in Rochester, Minnesota. Some of the same inflammatory markers that are high in people with inflammatory arthritis are also seen in people with diabetes.
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Joint Pain With Diabetes
Diabetes does not cause arthritis, but if you have diabetes, you are more likely to develop arthritis. The ends of the bones are padded with cartilage, a gel made from collagen, protein and water. Cartilage allows bones to move on each other without being damaged. Joint cartilage can be damaged by injuries or by wear and tear with hard use. Having diabetes can potentially speed up the damage to joint surfaces. Extra glucose can sometimes stick to joint surfaces, which limits their movement.
This interferes with movement and leads to wear and tear injury. High glucose levels can thicken and degrade the collagen, which is a problem because tendons and ligaments are made from collagen.
Reduced flexibility of the joints can lead to stiffness, and you can have a greater risk for physical injury. People with joint damage may reduce their physical activity due to discomfort or pain. Reduced activity promotes heart disease and insulin resistance.
Here are ways to prevent and treat joint problems and to keep active:
- Stretching: Keeping muscles and tendons relaxed and aligned so they will move as needed.
- Aerobic exercises: Walking or swimming can improve knee and hip function. Water exercise classes are good for people with painful joints because the water carries some of the weight.
- Quit Smoking: Smoking causes stress on connective tissues, which will lead to joint pain.
- Rest joints: When your joints hurt, rest to allow them to heal properly.
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Potentially Relevant Pathophysiological Mechanisms
Looking at the effects of glucose, there is evidence for a specific role of glucose on oxidative markers, which can, in turn, lead to increases in biomarkers of chronic inflammation. High dietary glycemic index has been linked to increased inflammatory responses by means of recurrent hyperglycemic responses in the early postprandial phase, as well as elevated levels of free fatty acids in the late postprandial phase, both of which are considered to result in an overproduction of free radicals and releases of proinflammatory cytokines, which may, in turn, induce inflammation and vascular damage . Fructose has a low glycemic index , and there is evidence that suggests that consumption of foods with a lower dietary GL/GI is associated with anti-inflammatory effects. Accordingly, ingestion of fructose may contribute to a reduction of chronic inflammation, due to the avoidance of glycemic spikes . This may be one potential explanation for the absence of consistent signals or harm in response to fructose intake.
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Eating To Reduce Pain
At the weekend we ran one of our Healing Foods workshops, and I discussed food that helps pain management.
In my clinic I often work with clients who experience pain on a regular basis. This may be in relation to arthritis, headaches, period pain or aches and pains from training in the gym. There is so much we can do to help manage pain purely by diet. Here is some information about how pain occurs and my top tips for eating to keep it at bay.
WHERE THERE IS PAIN THERE IS INFLAMMATION
The underlying cause for inflammation may be due to a number of factors. Some common areas for consideration are:
Hormones: Some hormones are connected with the inflammatory response .
Fats: The amount and type of fat in the diet is directly linked with inflammation, especially the essential fatty acids omega 3 and omega 6 .
Digestion: Our digestive system also has the power to mess about with inflammation in the body. If the digestive system is struggling then localized damage may occur in the gut leading to inflammation and food sensitivities .
EATING TO REDUCE INFLAMMATION
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Foods That Contain High Contents Of Advanced Glycation End Products
AGEs are molecules that are made from sugar and fats or protein reactions. They are existent in uncooked animal foods and they also result from particular cooking methods and high cooking temperatures. Some of the richest AGE food sources include fried, grilled, roasted, seared, and/or broiled high protein and fat animal foods- bacon, steak, hot dogs etc.
AGEs can accumulate in the body, especially as you age. Osteoarthritis is associated with growing older and it is pretty obvious why these foods should be avoided. As a matter of fact, those with arthritis have been shown to have high AGE levels. If AGEs accumulate within joints and bones, one may develop or experience a progression of osteoarthritis. American cheese, French fries, mayonnaise, and margarine are also rich in AGEs. With a high accumulation of AGEs in the body, inflammation and oxidative stress result. AGE formation and oxidative stress are akin to disease progression for those with arthritis. You can replace AGE-rich foods with whole foods and vegetables to reduce the load in the body.
Artificial Sweetener & Joint Pain
If you have arthritis, youre well aware of the pain, inflammation and swelling it causes in your joints. Pain-reducing medication is the primary method of treating arthritis. In addition, making changes to your diet to avoid inflammatory foods in favor of foods that reduce inflammation may help ease your symptoms. In some people with arthritis, artificial sweeteners may be a culprit that requires avoiding. No reports exist of artificial sweeteners causing joint pain in healthy individuals.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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How Does Sugar Affect Chronic Pain
Consuming sugar causes our bodies to release insulin and stress hormones. These chemicals, in turn, can trigger inflammation, which is one of the most common causes of chronic pain.
Inflammation occurs when the body sends white blood cells to an area of injury or infection. The white blood cells then go to work protecting and healing the affected area. This sudden influx of cells to a single place causes swelling, redness, and tenderness.
Sometimes this swelling may pinch or aggravate nerves, which can cause pain. Inflammation is a very natural response to bodily harm, but it can become chronic if it continues even in the absence of injury. Excess sugar consumption can promote chronic inflammation.
The parts of our bodies where we have the least amount of blood circulation are at greatest risk of inflammation. That is why the joints and back are common chronic pain points and can be the most dramatically impacted by sugar consumption.
Research points to refined sugars as posing the greatest risk of causing inflammation. Refined sugar is the type you find in sweets like baked goods, candy, and ice cream.
In The Kitchen With Arthritis: Foods To Avoid
The goal of an anti-inflammatory diet for arthritis is to reduce inflammation and the joint degeneration and pain it causes.What Are Anti-Inflammatory Foods?
You can influence inflammation by eating anti-inflammatory foods, such as leafy greens and colorful vegetables, and avoiding these 7 inflammatory foods:
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Vegetable Oils And Dressings
You might think that oil from corn, sunflowers, and peanuts would be healthy. But these oils are high in Omega 6 fatty acids. While your body needs some Omega 6, too much leads to inflammation. Avoid most mayonnaise and bottled salad dressings, as well as vegetable oils such as safflower, sunflower, soy, and grape seed.
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Be Careful With Sugar
Its important to note that some sugar substitutes can be just as harmful as sugar for inflammation. Products that are marketed as sugar-free often contain aspartame an artificial sweetener that may worsen RA symptoms like inflammation.
Low-fat foods can also be misleading. These foods usually contain fewer calories but more sugar than full-fat versions. Food manufacturers will often add sugar to low-fat foods to add flavor.
Trans fats, which are common in processed foods, also trigger inflammation and should be avoided. Read nutrition labels and opt for full-fat foods to help you stay away from unnecessary sugars. Adding nutritious foods that contain vitamins and antioxidants to your diet will potentially help your RA, strengthen your immune system, and improve your overall health and wellness.
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Sugar And Refined Flour
Your blood sugar levels can surge after youve eaten simple carbohydrates that are easily broken down by the body. Such foods include sugary snacks and drinks, white-flour bread and pasta, and white rice. A spike in your blood sugar prompts the body to produce pro-inflammatory chemicals called cytokines, which can worsen your RA symptoms if the inflammation affects your joints. These foods can also cause you to put on the pounds, stressing your joints. There is no real replacement for these foods, but you can try gluten-free alternatives, which can be helpful, says Domingues.
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How Can My Diet Affect My Condition
Eating a balanced diet and having a healthy lifestyle such as regular physical activity, not smoking, not drinking excessive amounts of alcohol can have a huge impact on arthritis and our health in general.
Although there are no diets or supplements that will cure your arthritis, some people do find that their condition is affected by what they eat, how much they weigh and their physical activity levels.
There are many types of arthritis, and there are differences between people, so what works for one person may not work for another.
When it comes to what we eat, the two things that can have the biggest impact on arthritis are:
- Your weight being overweight can increase the strain on your joints, so keeping to a healthy weight can help. Being overweight can also increase your risk of developing certain conditions, such as rheumatoid arthritis or gout.
- Eating a balanced diet eating a diet with all the vitamins and minerals you need is important for everyone, but for people with arthritis it could help reduce the side effects of some drugs and protect you from conditions affecting the heart and blood, which can be a complication of some forms of arthritis.
Changing your diet probably wont have as great an impact on your arthritis as medical treatments, and its not recommended that you stop any of your treatments.
You should always speak to a healthcare professional before you make any major changes to your diet and lifestyle.
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