Why is a Physio and not a Nutritional Therapist writing this?
A few months ago, I started writing a blog post about something that kept popping up in research—how what we eat impacts our joints. Around the same time, we connected with a brilliant Nutritional Therapist, Janine, who wrote an excellent guest post on gut health and its far-reaching effects. After attending one of her seminars, I was struck by how much this topic mattered.
As a Physio, I hesitated to dive into the gut-joint connection myself, thinking it was outside my scope. But after hearing from patients and colleagues that this perspective matters, I decided it was time to share my thoughts. So here it goes…
Can What We Eat Affect Arthritis?
Yes, scientists think that joint health and the Gut Microbiome are linked. Both what we eat, as well as what we do, can affect our gut microbiome, which in turn can affect our joints.
What’s a Microbiome?
It’s the collection of all bacteria, fungi and viruses that live in and on us. The gut microbiome is the part in the gut, large intestines and colon. There are thought to be over 5000 different types of bacteria alone in the microbiome.
Each persons microbiome is different, even in identical twins. It can be altered by hormone levels, illness, medication and what we eat and drink.
What Does the Gut Microbiome Do?
A healthy microbiome generates anti-inflammatory fatty acids.
What is Gut Dysbiosis?
This refers to an unhealthy gut microbiome. It’s when the levels and ratios of bacteria, fungi and viruses in our gut are impaired. The lining of the gut becomes more permeable or leaky and this seems to start an unhelpful chain of events. Ultimately this appears to lead to increase immune cell activation and seems to be linked to inflammatory joint conditions.
What Problems Has Gut Dysbiosis Been Linked to?
These range from colitis and Crohn’s Disease, to cardiovascular issues, Alzheimer’s, Parkinsons and depression.
It’s also associated with arthritic conditions, including Spondyloarthropathy, Rheumatoid arthritis, Psoriatic arthritis and Osteoarthritis. Joint health and the Gut Microbiome appear to be inextricably linked.
How Much Do We Know Exactly?
We’re at the really early stages of understanding the gut biome and its affect on joint health. It’s incredibly difficult to analyse gut microbiomes and whilst we know that they are altered in patients with arthritis, we don’t fully understand exactly how.
What Factors Seem to Help the Microbiome?
The great news is that exercise, relaxation and lowering stress, getting enough sleep and increasing your dietary fibre levels all seem to positively affect your gut microbiome.
What Factors Seem to Harm the Microbiome?
Alcohol, smoking, overuse of medications, anti-inflammatories, opioids, aspartame and consuming high levels of processed food, all seem to negatively affect the gut microbiome.
Might Prebiotics and Probiotics Help?
Pre biotics provide food for our gut microbiome. They’re resistant carbohydrates like barley, leeks, asparagus, leeks, onion, nuts, apples and sauerkraut). Pro biotics increase bacteria levels in the gut and are things like Yakult, Activia and if you’re feeling particularly flush, caviar!
There are some early animal studies done, which seem to show that consuming pre biotics can slow the rate of arthritis in injured joints.
Was Grandma Right and We Need More Roughage?
Basically yes. We need both soluble and insoluble fibre to help our digestion and gut microbiome. Doubling the average adults fibre levels in this country would be about right. Swapping out white pasta for wholegrain or buckwheat, swapping more processed cereals for muesli, porridge or bran flakes would help.
Making sure we getting nearer 8 than 5, fruit and vegetables per day, with as much variety as possible. Add some seeds and nuts into your diet, and avoid as much as possible highly processed foods.
In conclusion, many will take this information on and say, “yes well all that’s obvious. Eat better, exercise more and get the sleep and rest you need”. I guess like so much, its about balance. Like all health professionals, I’ll wait to see what new research comes out over the next few years.
What we do have to remember, is that even in osteoarthritis, it’s not just as simple as being all about wear and tear!
How do I Get Some Help With My Gut ?
I can’t repeat enough, that despite having a real interest in this area, it’s not my specialist area of expertise. My advice, would be consult someone who deals with these matters everyday. We’re incredibly lucky to have Janine on boartd at our Crawley clinic, and that would be a very good first point of call.
To read Janine’s guest blog, and to book an appointment click here.
All our Physiotherapists are highly qualified, experienced, with a variety of post graduate specialisations. If you or anyone you know would like to have a physiotherapy assessment with the team at Dorking , Leatherhead or Crawley , contact us here.
Blog post written by Sam Bowden, Head2Toe Physiotherapist and Director at Head2Toe Dorking, Leatherhead, & Crawley Clinics.
The role of the microbiome in rheumatoid arthritis: a review, Tsetseri et al, Rheumatology Advances in Practice, Volume 7, Issue 2, 2023
Intestinal barrier dysfunction plays an integral role in arthritis pathology and can be targeted to ameliorate disease, Matei et al, Med (N Y). 2021 Jul 9; 2(7): 864–883
