Rheumatism dietary taboos

The first is to avoid foods that will clearly induce your own symptoms. The second is to specifically control foods with high purine, high fructose, photosensitivity, etc. that may aggravate inflammation based on your specific type of rheumatism and disease activity. The "all seafood should not be touched" and "all hairy foods should be avoided" posted online are purely generalizations, so don't believe them blindly.

Last week, I received a 32-year-old female patient with rheumatoid arthritis. I heard from relatives in her hometown that rheumatism should avoid all "hairy things". She has not touched fish, shrimp, beef and mutton for half a year, and even dared to eat half an egg a day. When she came for a follow-up examination, her erythrocyte sedimentation rate and C-reactive protein were two times higher than the normal value, and she was also found to have mild hypoalbuminemia. After asking, I found out that she didn't suffer from joint swelling and pain at all when she occasionally ate shrimp. It was entirely because she scared herself into not eating the food, which destroyed her immunity and aggravated her condition.

Why are there so many confusions about taboos for rheumatism in the market? Essentially, rheumatism is a collective term for hundreds of diseases. Gout, rheumatoid arthritis, systemic lupus erythematosus, Sjögren's syndrome, and ankylosing spondylitis are all included in this category. The pathogenesis is very different, and dietary taboos cannot be generalized.

Let’s talk about the most controversial high-purine foods. When many people hear about rheumatism, they say they should avoid seafood and animal offal. In fact, this requirement only applies to patients with gout, hyperuricemia and rheumatism. Even for this group of people, they are not completely off limits. During the remission period, they occasionally eat salmon and shrimp with medium purines. As long as there is no obvious spike in uric acid after eating and no discomfort in the joints, there is no need to strictly limit food. What’s interesting is that the concept of “fading things” in traditional Chinese medicine is not a one-size-fits-all standard. Different schools of traditional Chinese medicine have different views: some believe that patients with damp-heat arthralgia type (usually red, swollen and painful joints, yellow and thick tongue coating, bitter mouth and bad breath) should avoid spicy, high-fat, high-sugar, and strong foods. Patients with alcohol and cold-dampness syndrome (cold and painful joints, fear of wind, white and greasy tongue coating) can eat some warm foods such as pepper, mutton, and ginger, which can relieve discomfort. This set of syndrome differentiation and dietary taboos is actually consistent with the individualized dietary principles advocated by modern medicine.

Of course, this does not mean that all food taboos are universal. There is one type of food that no matter what kind of rheumatism you have, it is recommended to avoid it as much as possible - high-sugar foods that add a lot of fructose syrup, such as milk tea, bottled juice, carbonated drinks, and extremely sweet cream pastries. This is supported by clear research. A cohort study in the Annals of Rheumatology last year showed that rheumatoid patients who drank more than three cups of sugary milk tea per week had 27% higher disease activity than those who did not drink it. This is because fructose promotes the release of inflammatory factors in the body and increases blood uric acid, which is not good for any rheumatism disease. To be honest, I have seen many gout patients who abstain from beer and seafood. Even if they can’t help but drink iced Coke every day, the uric acid still cannot be reduced, and gout attacks occur more frequently than anyone else.

Let’s talk about the photosensitive foods that people often ask about. This requirement is actually only for patients with photoallergic symptoms, such as patients with systemic lupus erythematosus and dermatomyositis. If you are prone to rashes and joint pain after spending time in the sun, try not to go out in the sun after eating photosensitive foods such as celery, coriander, milkvetch, and figs, otherwise it will easily aggravate the rash. However, if you do not have photoallergy problems, or do not get exposed to the sun at all after eating, there is no need to eat them. I have an old patient who has suffered from lupus for 10 years. He loves to eat dumplings stuffed with coriander. He eats them every night and never goes out after eating them. He has never had any problems due to eating coriander in so many years.

Many people also ask whether soy products can be eaten? I always feel that soy products are high in purine and should be avoided. In fact, the absorption rate of plant purine is much lower than that of animal purine, and the impact on blood uric acid is minimal. Unless it is an acute attack of gout, it can be eaten normally. Moreover, the soy isoflavones in soy products also have certain anti-inflammatory effects, which are beneficial to patients with rheumatoid and lupus. I often recommend that my patients eat tofu and soy milk 2-3 times a week. It is much more reliable than eating those messy health products.

I have been in the Department of Rheumatology and Immunology for almost 10 years. I never prescribe long lists of taboos to patients. Instead, I ask them to keep a food diary for half a month, including what they ate on that day, and whether they have any joint pain, worsening rashes, or discomfort afterwards. After a long time of recording, they will know what to avoid, which is 10 times more useful than the cookie-cutter taboo lists on the Internet. After all, everyone's physique is very different. Others may be fine after eating it, but you may feel pain after eating it, and vice versa. There is no need to follow other people's recipes. After all, diet is only a means of auxiliary control, not a way to cure diseases. Don't focus on what you can and cannot eat every day, so that you dare not eat this or that. In the end, you will become malnourished and your immunity will drop, which will make it easier for the disease to recur, which is not worth the gain.