With the winter holidays approaching, sweet treats begin to appear in abundance. For those living with arthritis, excessive sugar consumption is known to increase inflammation in the body, and with inflammation comes arthritis flare-ups.
How does sugar cause inflammation?
Inflammation is part of the body’s natural healing process, which takes place in order to combat foreign substances or repair tissue that is injured. But if inflammatory cells (like white blood cells) linger, they can develop into an out-of-control fire, resulting in chronic inflammation and health ramifications.
Studies show that consuming excess sugar can produce more inflammatory proteins called cytokines. If you have arthritis, you already have high levels of cytokines, so producing more of these proteins can worsen your symptoms. Excess sugar also causes advanced glycation end products (AGEs) to form in the blood, which are detrimental compounds that increase inflammation.
Should you abstain from sugar if you have arthritis?
Sugar consumption is known to trigger arthritis symptoms, but it affects each person differently. Depending on the circumstances, sugar can be important for blood sugar stability and support individuals who are active. Its impact also depends on individual needs and type of arthritis.
“If you are an active individual and working out for 45 minutes or more at moderate to high intensity, sugar intake can be a useful tool to help ensure blood sugar stability and sparing of muscle glycogen,” says Lalitha Taylor, registered dietitian and CEO/Founder of Taylor Nutrition, who lives with rheumatoid arthritis. “This is where working with a registered dietitian can help determine what that looks like for individuals in terms of nutrient timing and amount of sugar (or carbohydrates).”
It is important to watch your sugar intake if you have rheumatoid arthritis, which often affects the joints in the knees, wrists and hands, creates chronic pain in the body, and can cause damage to the joint tissue, lungs, heart and eyes. One study found that 24 per cent of the participants with rheumatoid arthritis reported that foods affected their symptoms, with desserts and sugary sodas being the most common culprits.
Those with
osteoarthritis, the most common type of arthritis, also need to be cautious. Osteoarthritis usually affects the knees, hips, or spine, and over time, the tissues in the joints start to break down, causing pain and affecting one’s activity level. Researchers found that sugar consumption increased
inflammation and weight gain, negatively impacting knee joints and increasing osteoarthritis.
If you live with
gout, an inflammatory arthritic condition, sugar poses an added risk. When you consume sugar, your body breaks down fructose, releasing purines that lead to high uric acid levels. This can form a type of crystal that builds up in the joints, tissues and fluids in the body, causing
painful gout flare-ups.
Beware of added sugar.
While some treats are clearly full of sugar, others have naturally occurring sugars - like fruits, vegetables and dairy. It’s important to watch out for added sugar in a wide range of foods, especially processed foods. Sugar can show up in unexpected places—in soups, condiments, yogurts and peanut butter.
“Reducing added sugars can be a powerful step for managing arthritis symptoms,” says Taylor. “While it may not be realistic for people to completely eliminate processed sugar or all desserts, it’s best to consume sugar in moderation to avoid exacerbating inflammation.”
Opting for naturally sweet foods, like fruit in moderation, or choosing low-glycemic foods can help with the management of inflammation and support joint health by minimizing insulin spikes and inducing a slow increase in glucose levels.
Be sure to read nutrition labels and keep your added sugar intake to less than 5 per cent of your total daily calories. When reading a label, watch for corn syrup, fruit juice concentrate, fructose, glucose, sucrose – or any ingredients that end in “ose.”
In addition to table sugar and added sugar, it’s best to limit refined carbohydrates, such as white rice, white potatoes and white flour products like bread and crackers, which have a high glycemic index and add to the production of AGE products.
“You can employ strategies to have sugar in moderation without increasing inflammation,” says Taylor. “For example, you can lower the glycemic index of these higher sugar foods by pairing them with a meal that contains protein, fibre and healthy fat. And if you want to indulge in some of these higher sugar foods on occasion—have them at the end of a meal.”
Is it safe to eat fruit?
Fruit contains fructose, a naturally occurring sugar – and generally, the sweeter the fruit, the more fructose it contains. Yet, fruit is a good source of fibre, nutrients and antioxidants. Also, there are many anti-inflammatory fruits. In fact, cherries may help reduce gout symptoms and blueberries have been reported to help rheumatoid arthritis symptoms.
Rather than eliminating fruit, watch your portion size and lean toward fruits that are lower in sugar, such as cantaloupe, berries, kiwis, peaches, papaya and plums. Just be sure to limit fruit juice – one glass may contain more than a full day’s recommended allowance of sugar.
Are artificial sweeteners an option?
Generally, sugar alternatives such as aspartame, sucralose, acesulfame potassium (ace-K) and cyclamate are safe for healthy adults, but it’s best to use them sparingly rather than multiple times a day. Your tastebuds may get used to artificial sweeteners in foods and drinks, leading you to reach for more processed foods rather than whole foods, such as vegetables, grains and legumes.
Studies have shown that while regular consumption of sugar-sweetened soda is associated with an increased risk of rheumatoid arthritis, there was no significant association between diet soda consumption and the risk of arthritis.
It’s important to note that certain artificial sweeteners remain controversial, and their safety is still being investigated. For example, aspartame has been known to provoke an inflammatory response in some individuals who are particularly sensitive.
Consider natural sugar alternatives.
There are a number of natural sweeteners that are less harmful than refined sugar and may even have health benefits:
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Both honey and maple syrup contain minerals and antioxidants but are somewhat high in sugar, so should be consumed in moderation.
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Agave and coconut sugar are both lower on the glycemic index than sugar. Agave is sweeter than sugar, so you can use less of it. Coconut sugar contains minerals including iron, zinc, calcium and potassium.
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Monk fruit sweetener contains zero calories. During processing, fructose and glucose are eliminated from the sweetener. It is sweeter than sugar and is an antioxidant with anti-inflammatory properties.
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Xylitol is extracted from corn or birch wood and contains 40 per cent fewer calories than sugar. It doesn’t contain fructose so it won’t increase your glucose or insulin levels – and it may even improve bone and dental health.
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Stevia is a plant-based sweetener that contains zero calories, contains nutrients and is associated with lower blood sugar levels.
Overall, to help manage your arthritis symptoms, focus on eating a nutritious, balanced diet. Reducing your sugar intake, particularly processed foods with added sugar, can reduce your symptoms and help you live an active and more comfortable life.