Health YES OR NO Health advice can be complicated! Read on for straightforward diet and exercise advice that can really make a difference to your arthritis symptoms Words: Georgina Wintersgill W eve all done it. You go online to find the answer to what you thought was a simple question. An hour later, youve visited a dozen websites, your heads swimming with information, and youre still not sure of the answer! Here, we address some of the most frequently asked questions about diet and exercise for people with arthritis. Do I need to watch my sugar intake? YES Its one of lifes little pleasures, but too much sugar is bad for your waistline and your arthritis. Excess weight puts pressure on your joints, making pain and stiffness worse. Sugar may also increase inflammation in the body. In 2018, American researchers found that giving mice a high-sugar diet led to increased joint inflammation, even without obesity. If you take sugar in tea or coffee, or add it to cereal, gradually reduce it until you can stop it altogether. Cut down on biscuits, cakes, sweets and chocolate. Make sensible swaps: choose unsweetened breakfast cereals rather than frosted ones; add fruit to fat-free plain yogurt rather than buying flavoured yogurt; replace fizzy drinks with fruit juice mixed with sparkling water. Cutting down on sugar should have the added advantage of improving your overall diet. Dr Sarah Schenker, a dietitian and author of the British Dietetic Associations food fact sheet on arthritis, says: When you cut back on added sugar, you have to cut down on a lot of processed foods, so youre more likely to think about other, healthier things you can eat. Should I eat oily fish? YES* Oily fish including salmon, sardines, pilchards, trout, mackerel, and herring are the best source of omega-3 fats, which are important for overall health. Omega-3s are thought to have an anti-inflammatory effect and can lower cholesterol, helping to reduce the risk of heart attack. And, in 2018, University of Surrey researchers concluded that taking one-and-a-half standard capsules of fish oil a day reduced pain in people with osteoarthritis. The NHS recommends eating at least one portion of oily fish a week. Dr Schenker says: Mackerel is one of the richest sources of omega-3. Smoked mackerel is a really easy lunchtime option because it doesnt need cooking. Tinned sardines or pilchards are also really rich sources. *If you dont like fish, consider taking a daily omega-3 supplement. Fish oil supplements are the best source as they contain the three most important omega-3s EPA, DHA and ALA. If you dont eat fish for ethical reasons, algal oil is a good vegan source as it contains EPA and DHA. You can get ALA in your diet from leafy green vegetables, walnuts, seeds (including linseed/flaxseed, pumpkin, and chia) and some vegetable oils (including rapeseed, linseed/flaxseed, and walnut). Can I exercise with arthritis? YES When youre in pain, exercise may be the last thing you feel like doing. But regular exercise, of the right type and at the right level, can increase your range of movement, increase muscle strength, and reduce pain and stiffness. Dr Fiona Chikusu, a GP and clinical adviser to Versus Arthritis, says: We encourage people with arthritis to exercise, as there are many benefits. Weightbearing exercises are particularly good for osteoarthritis. The Versus Arthritis website has some good exercises that you can do from home, even from your chair. Take a look at our Lets Move movement programme at versusarthritis.org. Alternatively, your GP can give you some exercises to suit your needs. You can also access physiotherapy via your GP. Keeping active is very important, too not just for arthritis, but for a healthy lifestyle. Walking, cycling, swimming and yoga are all good options. Check out the exercise section on the Versus Arthritis website for more ideas. Should I stop exercising if Im in pain? IT DEPENDS Its normal to feel some stiffness or discomfort when starting a new exercise programme. But it should settle down. Dr Chikusu says: Your muscles may be stiff the next day. Thats expected and happens to anyone when they start a new exercise programme. Its just your muscles reacting in response to the exercise and it should settle down within a week. If it doesnt, seek medical advice. The exercise youve tried may not be suitable. She adds: Before you start a new exercise programme, check with your GP that its safe for you to do so. Starting a new exercise programme should be a gradual process. For some people, even 10 minutes is enough to start with. Slowly build up when youre ready. If youre exercising and the pain becomes severe, stop. Always stop if you have any kind of severe pain, says Dr Chikusu. You shouldnt be thinking, No pain, no gain thats wrong. Stop and get advice from your GP or physiotherapist. Should I consider a vitamin D supplement? YES Vitamin D helps the body maintain calcium and phosphate levels to keep bones, teeth and muscles healthy. It may also have anti-inflammatory effects and a role in maintaining the health of the immune system. Take a look at our feature for more information on vitamin D.