Osteoarthritis happens when the protective cartilage surrounding bones in joints is worn away. Since cartilage is the tissue that enables near frictionless movement osteoarthritis results in increased friction leading to irritation, inflammation of the joint, and pain. Eventually this wear can result in the bones rubbing directly against each other. While treatment options for the damage are limited, maintaining a healthy weight and reducing inflammation can slow the progression of the disease and reduce the resulting pain as well.

In this excerpt from the book The Green Pharmacy Guide to Healing Foods by James A. Duke, PHD and Bill Gottlieb, CHC the authors outline an osteoarthritis diet that can help with being overweight and inflammation.


Arthritic disease—which includes more than 100 different conditions—is the most common cause of disability in the United States. The most prevalent form is osteoarthritis. In fact, I have it myself. It’s an incurable condition that starts with minor aches and pains and eventually leads to chronic pain, stiffness, swelling, and limited range of motion, usually in the knees, hips, spine, hands, and feet. My own first line of defense is to carry Zyflamend, an herbal supplement manufactured by New Chapter, with me in case of flare-ups.

As the American population has grown older and heavier, the incidence of osteoarthritis has skyrocketed. An estimated 31 million Americans have osteoarthritis, according to the Arthritis Foundation—up from 21 million in 1995. That means about 1 in 8 Americans are coping with distress that can dramatically affect quality of life and at worst lead to expensive joint-replacement surgery.

Obesity-related osteoarthritis accounts for one-third of all cases—a nearly five-fold increase since 1971, which is partly due to a drastic increase in midlife obesity among baby boomers. About 39 percent of boomers were obese at midlife, compared to only 29 percent of their parents’ generation.

The financial toll of osteoarthritis and other musculoskeletal conditions—which include rheumatoid arthritis, fibromyalgia, carpal tunnel syndrome, gout, and back pain, among others—is an astounding $189 billion a year in lost wages and medical expenses. By the year 2040, it’s estimated that 78 million Americans will be affected by some form of arthritic disease.

For about 25 percent of us, the most common source of pain is our joints, according to a nationwide survey of 1,200 adults by researchers at Stanford University School of Medicine.

Desperate for relief, many osteoarthritis patients try to manage their symptoms with high daily doses of over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin and ibuprofen. Unfortunately, these can irritate the stomach lining and even cause severe gastrointestinal bleeding, which is difficult to manage and is often life threatening. A widely cited study showed that NSAID-associated bleeding caused 16,500 deaths in the United States in 1999, a toll higher than that from falls or poisonings.

Healing Foods for Osteoarthritis

To help prevent osteoarthritis—or manage lingering or lessening pain—there are a number of food remedies that may prove useful.


Refined, processed, and manufactured foods can intensify arthritis pain because they contain high amounts of inflammatory fats, carbohydrates, and additives. Processed foods such as cookies, crackers, and snacks, particularly those prepared with refined soybean oil, are loaded with pro-inflammatory omega-6 fatty acids. Hundreds of foods also contain high-fructose corn syrup, a quickly digested carbohydrate that disrupts metabolism and stimulates production of inflammatory substances.

Bottom line: Ditch the junk food.

People with arthritis should also try to reduce their consumption of animal protein—especially red meat and chicken— because it contains high amounts of an inflammatory amino acid, and to avoid carbohydrates with a high glycemic load, such as refined flour and sugar, which cause rapid spikes in blood sugar.

Chili peppers. Hot peppers contain aspirin-like compounds known as salicylates, as well as a resinous and pungent substance known as capsaicin that triggers the release of opiate-like substances known as endorphins. When applied topically, capsaicin temporarily depletes substance P, a chemical in nerves that transmits pain sensations. Without substance P, pain signals have no way to travel. Dozens of studies show that capsaicin can temporarily relieve many painful conditions, including osteoarthritis.

You can buy a commercial topical cream containing 0.025 to 0.075 percent capsaicin and apply it to your arthritic joints three or four times a day. Or you can do what people outside the United States often do: buy a chili pepper, mash it, and apply it directly to affected areas. You can also mix mashed hot pepper with a skin moisturizer. Either way, you’ll save money. A fresh pepper costs a few pennies, while a commercial capsaicin product such as Zostrix can cost up to $18.

No matter which method you choose, you may experience a burning sensation the first few times you use capsaicin, but it usually subsides with repeated use. Just be sure to thoroughly wash your hands after using it. Contact with your eyes, nose, or mouth may prove more painful than your arthritic joints.

Although capsaicin is best used topically, it may be helpful to add more peppers and pepper-derived hot sauces to your diet. Another option is taking a cayenne tincture (0.3 to one milliliter) three times per day. You also can make an infusion by stirring 1 ⁄2 to one teaspoon (2.5 to five grams) of cayenne powder into one cup of boiling water, letting it steep for 10 minutes, and taking one teaspoonful mixed with water three or four times daily.

I recently received a tip from a reader named Harriet Brennan, a retired nurse who had been taking the prescription NSAID diclofenac (Voltaren) for 13 years for her arthritis. She was able to dispense with the drug after trying a regimen that strikes me as a good herbal alternative to Celebrex. After removing the stems, Harriett blends 1 ⁄2 pound of chili peppers with two cups of apple cider vinegar, then lets the mixture marinate for three weeks and strains it through cheesecloth. Once a day, she adds 16 drops of this pungent brew to a 24-ounce glass of green tea with ginseng. She reports that her doctor actually requested her to make a batch for some friends! And if that wasn’t enough, the mixture may even have helped her lose more than 100 pounds. Capsaicin is thermogenic, which means it creates heat by burning more calories.

Ginger. Ginger contains high amounts of the enzyme zingibain, a powerful anti-inflammatory substance. According to some experts, it’s even more potent than the bromelain in pineapple or the papain in papaya. It also contains at least four natural COX-2 inhibitors and, unlike prescription COX-2 inhibitors such as Celebrex, is associated with no serious side effects.

It’s easy to get enough ginger in your diet to help reduce pain. You can take it as an herb in tea by steeping three or four slices in a cup of boiling water. If you prefer, you can get medicinal doses in tinctures or capsules. Andrew Weil, MD, founder of the Arizona Center for Integrative Medicine, recommends eating candied ginger with bits of antioxidant-rich dark chocolate. You can get medicinal doses by sprinkling 1 ⁄2 teaspoon of powdered ginger onto foods or by eating about an ounce (6 teaspoons) of fresh ginger every day.

In a study from researchers in India, ginger relieved pain as effectively as a standard NSAID (diclofenac)—and combining the ginger and the NSAID was more effective than either the ginger or the NSAID alone.

Pomegranate. The ancient Greeks used pomegranate to treat arthritis, and this exotic tropical fruit has been revered through the ages for its ability to treat a wide range of conditions. But when I wrote The Green Pharmacy in 1997, I recommended pomegranate for only one condition: diarrhea.

Since then, researchers have shown that this gorgeous fruit—which is loaded with antioxidants and anti-inflammatory compounds—ranks as a true superfood. Evidence is mounting that it can help conditions as diverse as heart disease, cancer, and osteoarthritis.

In a recent study published in the European Journal of Clinical Nutrition, researchers studied 55 people with rheumatoid arthritis, giving 30 a pomegranate extract and 25 a placebo. After eight weeks, the joints of those taking pomegranate were less swollen, tender and painful, and the people had less morning stiffness. They also had higher levels of an inflammation-fighting antioxidant, and lower ESR (erythrocyte sedimentation rate), a biomarker of inflammation.

In another recent study, published in the Journal of the Science of Food and Agriculture, 38 people with osteoarthritis drank pomegranate juice or a placebo. After six weeks, those drinking the juice had less stiffness and better everyday physical functioning, and lower levels of matrix metalloproteinases, enzymes that destroys cartilage.

And in a study on cartilage cells from scientists at Case Western Reserve University, pomegranate extract turned off the genetic activity that leads to the destruction of cartilage cells.

This is exciting research because pomegranate, unlike all of the drugs used to treat osteoarthritis, has virtually no side effects.

I recommend drinking one eight-ounce glass of 100 percent pomegranate juice a day. I’d also increase my consumption of other fruits and fruit juices rich in antioxidants and anti-inflammatory compounds, such as pineapple, papaya, and cherries. Intriguing research suggests that tangerines and cherries may help inhibit compounds associated with joint damage.

Tea. Tea contains at least seven different COX-2 inhibitors, including catechin, which helps reduce the inflammation associated with osteoarthritis and may even slow cartilage breakdown. It also seems to protect the bones. Women who routinely drink tea are significantly less likely than “tea-totalers” to develop osteoporosis. Compared to other varieties, green tea is especially rich in antioxidant compounds called phenols, which help protect the body from a multitude of disorders, including several cancers. For osteoarthritis, try drinking about five cups of tea a day.

Turmeric. This yellow curry spice is a rich source of curcumin, a strong antioxidant that protects against free radical damage. Curcumin contains natural pain-relieving COX-2-inhibitors, making it an attractive, side effect–free alternative to prescription COX-2 inhibitors such as Celebrex. It also reduces inflammation by reducing histamine levels and possibly stimulating the adrenal glands to produce more cortisone, the body’s natural painkiller.

There are now 20 clinical trials that show curcumin can help ease the pain and stiffness of osteoarthritis. In a recent study published in BMC Complementary and Alternative Medicine, people with osteoarthritis who took curcumin supplements for three months had less joint pain and better physical function. A study by Italian researchers showed that a combination of curcumin and glucosamine helped people with osteoarthritis walk farther, take fewer painkilling drugs, and feel better physically and emotionally. And in a study from Japan, curcumin eased knee pain and lowered the use of painkillers.

Curried Celery COX-2 Inhibitor

If you’re contemplating taking a prescription COX-2 inhibitor such as Celebrex for osteoarthritis or any other inflammatory condition, you may want to consider this side effect– free food “farmaceutical” that I developed. It contains more than a dozen natural COX-2 inhibitors and is good for what ails you.

To make this warm curried soup, place four to eight stalks of celery (loaded with apigenin) into a pot and add a bit of diced cabbage, cayenne, chives, garlic (optional), resveratrol-containing grape leaves or Japanese knotweed spears (optional), and onion (a good source of quercetin).

Then add water to cover, some spices—turmeric, basil, ginger, rosemary, sage, and/or thyme—and a generous amount of freshly ground black pepper (which contains piperine, a substance that makes turmeric more bioavailable), and bring to a boil.

For even more benefits, I’d chase this spicy dish with a cup of either green tea (which contains catechin and kaempferol) or chamomile tea (another good source of apigenin).

I prefer a whole foods approach whenever possible because as I’ve often said, I believe you get more healing power from whole foods than from individual components. I often add liberal amounts of curry to rice and other dishes and would consider adding other anti-inflammatory foods such as pineapple and papaya. Add a teaspoon of powdered turmeric to soups, stews, and other dishes. You can also can make tea with turmeric.

Grapefruit. I prefer the darker red variety of grapefruit, which is so tasty that I can consume almost an entire fruit for breakfast. (Talk about whole foods!) Grapefruit—especially the darker red variety—contains three COX-2 inhibitors and loads of powerful antioxidants, such as lycopene (the source of the red pigment), limonoids, and naringin. Grapefruit is also one of the best sources of vitamin C, an essential nutrient for people with osteoarthritis. One cup of grapefruit sections contains 88 milligrams of vitamin C, which is more than the recommended daily amount.

Oregano. The so-called pizza herb, a member of the mint family, contains dozens of anti-inflammatory and painkilling compounds. Among them are eight COX-2 inhibitors: apigenin, caffeic acid, eugenol, kaempferol, oleanolic acid, quercetin, ursolic acid, and rosmarinic acid. Of these, rosmarinic acid may be the most potent because it also has antibacterial and antiviral properties. Although many other mints—such as peppermint, rosemary, and biblical mint—may be useful for osteoarthritis, oregano stands out because it has the most antioxidant activity of any of the 100 different mints tested in scientific studies. I’d definitely add liberal amounts of this tasty herb to my pizza or any other food to help relieve the aches of osteoarthritis.

Pineapple. This exotic fruit is rich in a number of substances that can help people with conditions such as osteoarthritis. Foremost among them is bromelain, an enzyme that helps reduce swelling and inflammation in many painful inflammatory conditions. Bromelain can also flush out compounds associated with arthritic conditions and help you digest fibrin, another compound implicated in arthritis.

This luscious tropical fruit also contains high amounts of manganese and vitamin C, both of which are essential for the formation of collagen, the tough, fibrous protein that builds connective tissues such as bone, skin, and cartilage. You can get 100 percent of the Daily Value for manganese (2.3 milligrams) from just one cup of fresh pineapple chunks or pineapple juice. A cup of fresh chunks also contains 24 milligrams of vitamin C, which is 26 percent of the Daily Value.

If you have osteoarthritis, vitamin C is essential. A 10-year study of 149 people with knee osteoarthritis, published by researchers from Boston University, showed that those who consumed less than 150 milligrams of vitamin C per day tripled their rate of cartilage breakdown.

To get the maximum antioxidant punch from pineapple, try the “Gold” variety, which is imported from Costa Rica and contains four times as much vitamin C as other pineapples.

Unfortunately, research suggests that levels of bromelain in fresh pineapple and papain, a related enzyme in fresh papaya, may be too low to relieve a bad episode of osteoarthritis. While I would encourage enjoying these fruits—either whole or as juice—you’ll probably need to take supplements to get effective levels. Naturopaths suggest taking anywhere between 250 and 500 milligrams of bromelain three times per day.

From the Herbal Medicine Chest

For relief from the aches and pains of osteoarthritis, you may want to try one or both of these herbs.

Pycnogenol. This extract derived from the French maritime pine tree is a rich source of antioxidants and natural inflammation-fighting COX-2 inhibitors. In a recent study published in BMC Complementary and Alternative Medicine, researchers identified several cellular mechanisms by which pycnogenol protects painful joints: it downregulates the genes that lead to cartilage degeneration; it decreases levels of two matrix metalloproteinases; it reduces inflammatory immune compounds; and it reduces level of a protein that damages cartilage. And clinical studies testify to those effects. In a study published in Phytotherapy Research, 100 people with osteoarthritis took either pycnogenol or a placebo—after three months, those on the herb had far less pain, less stiffness, better physical functioning and used less pain medication. And in a study from Italian researchers, people with osteoarthritis who took pycnogenol decreased their use of pain medicine by 58 percent—while a placebo group decreased medicine by only one percent.

Stinging nettle (Urtica dioica). Nettle has a long tradition—especially in Germany—as a treatment for arthritis. That’s because it contains many active painkilling and anti-inflammatory compounds, such as caffeic acid, ferulic acid, and scopoletin. Nettle can be taken orally or applied to the skin. Since the late 1990s, studies have shown that this herb reduces levels of inflammatory substances made by the immune system, such as tumor necrosis factor-alpha and interleukin-1B, and may be useful in treating osteoarthritis.

In a study of 40 patients with arthritis, researchers studied the effects of either 50 milligrams of stewed nettle leaf combined with 50 milligrams of the commonly used arthritis drug diclofenac (Voltaren) or 200 milligrams of the drug alone. Because total joint scores improved equally in both groups, the researchers concluded that it might be possible to reduce the dose of arthritis drugs by 75 percent, reduce the risk of gastrointestinal bleeding, and protect against some of the newly discovered potential hazards of some COX-2 inhibitors such as (get this!) elevated levels of tumor necrosis factor-alpha and interleukin-1B!

For additional advice on proven natural remedies for common health conditions, purchase The Green Pharmacy from Bottomlineinc.com.

Related Articles