Joint disease is a global health concern that can cause pain, disability, and decreased quality of life. It is also the leading cause of work morbidity. According to the Center for Disease Control and Prevention more than 54 million people in the United States have joint problems that account for 303 Billion $ in annual cost in medical spending and lost earnings.  And in Canada, there are 6 million people (one in five) who have joint problems. There are different types of joint diseases(arthritis) like osteoarthritis, rheumatoid arthritis, gout, lupus arthritis, etc. Arthritis mostly affects people over the age of 65 and women are more likely to have arthritis as compared to men.
Joints are made up of bones, cartilages, ligaments, and lubricating fluid. Joints are under continuous stress due to the weight of the body, movements, trauma, and ageing. Joints require many nutrients and vitamins to remain healthy and to repair the damaged tissue like calcium, phosphorus, proteins, zinc, vitamin C, vitamin D, and proteins. Collagen is also required to maintain joint health. There is no cure for joint disease and dietary and nutritional interventions remain paramount in healthy joints.
Joints require many nutrients to stay healthy; some of them are summarized below:
Calcium: There is about 1200 g of calcium in our body and 99% of which is present in bones and joints. Growth of bones is possible only if we are taking adequate intake of calcium and decreased intake will lead to resorption of bones and increased joint problems. Calcium is abundant in dairy products, green leafy vegetables, bread, and fortified flour.
Phosphorus: is also an essential component of our bones and essential for healthy joints. Food that is rich in phosphorus includes milk, meat fish, and poultry.
Vitamin D: is essential for the proper functioning of joints helps in calcium absorption and repair. Vitamin D deficiency results in weak bones and an increased incidence of joint diseases. 
Proteins provide substrates for bones and joint growth and improve the overall health of the joints.
Other Nutrients that are essential for joint health include vitamin C, vitamin E, zinc, and water. 
The first step in maintaining healthy joints is adequate nutrition. Certain points should be kept in mind while choosing optimal nutrition:
- Diet should provide all the essential nutrients that are essential for joints
- Diet should support ideal weight as overweight or underweight both are detrimental for joint health.
- Diet should include substances that reduce inflammation and boost the immune system.
- Anti-oxidants are also essential to prevent joint problems, so these should be added.
Although there is no magic diet for patients with arthritis increasing the intake of certain foods can help ease the problems of arthritis. These include 
- Fruits especially mangoes, cherries, strawberries, raspberries, avocado, watermelon, grapes, and pomegranate. 
- Vegetables that are good for joint health are broccoli, spinach, kale, sweet potato, carrot, squash, onion, garlic, and olives
- Fish contain omega-3 fatty acids that act as an anti-inflammatory. A polyunsaturated fatty acid is also found in fish oil that slows the development of arthritis.
- Grains: Refined grains are pro-inflammatory and can worsen the inflammation throughout the body. Whole grains are beneficial for inflammatory disorders. Examples of beneficial grains are brown rice, barley, millet, quinoa, rye, and oats.
- Nuts and Seeds are a good source of mono and polyunsaturated fats that are beneficial for certain types of arthritis. Walnut, peanuts, almonds, pistachios, and chia seeds provide a lot of benefits to a patient with arthritis.
- Spices also contain many potential benefits for joint health. Garlic, ginger, cinnamon, turmeric, and chilli have anti-oxidants and anti-inflammatory properties that are beneficial for patients with joint problems.
- Oils that offer anti-inflammatory benefits include olive oil, walnut oil, avocado oil, and soya bean oil.
- Beverages: Tea and coffee are rich in polyphenol compounds that have anti-inflammatory properties and the slow destruction of cartilage. Milk intake slows the progression of osteoarthritis. Orange, tomato, pineapple, and carrot juice contain vitamin C that is necessary for the health of the joints.
A patient with arthritis should minimize the consumption of foods that can increase pain, swelling, and inflammation. Weight gain and obesity are directly linked to joint problems, so cutting back foods that can increase weight is also helpful. We have compiled a list of foods that should be avoided by a patient with arthritis: 
- High caloric foods are worse for the health of joints as increase weight and exacerbate inflammation. Decrease intake of foods like fast food, red meat, full-fat yogurt, etc. can help in joint diseases.
- Nightshade Vegetables include eggplant, pepper, potato, and tomato. These contain a chemical called “Solanine” that exacerbates the pain and inflammation associated with arthritis.
- Mutton and Beef are associated with increased pain and inflammation and should be avoided in patients with arthritis.
- Food that is cooked at high temperatures contains Advanced glycation end products (AGE) that worsen arthritis. So should be cooked at low temperature or by moist heat.
- Alcohol and high purine foods like organ meat, herring, peas, and dried beans can increase the uric acid level and therefore should be used in a lesser amount.
- Butter is rich in fats and calories and therefore, can lead to excessive weight gain. It can increase pain and swelling due to the presence of high saturated fatty acid contents. It is best to avoid butter for people with arthritis.
Several supplements are used for pain relief and inflammation associated with arthritis. The supplements that have shown effectiveness in the clinical trials are :
- Fish Oil
- Methylsulfonylmethane (MSM)
- Vitamin A, D, E, and K if you have a deficiency.
Methylsulfonylmethane (MSM) is a very popular nutritional supplement that has reduce pain, and inflammation through its anti-inflammatory and antioxidant effects. It also has a positive effect on supporting the immune system during periods of stress. It provides the following important benefits for joints: 
- Reduce muscle soreness associated with exercise
- prevent cartilage destruction that is the underlying cause of osteoarthritis
- Improves range of motion and functioning capacity
- Reduce inflammation associated with arthritis.
According to the American Academy of Family Physicians, about one in four patients who take a prescription medicine also take a dietary supplement. It can be a vitamin, mineral, herb, botanical substance, or amino acid. However, careful consideration is required in some circumstances, where the intake of a certain supplement can cause more harm than good. So a supplement should always be taken in consultation with a doctor. A list of relative contraindications is summarized below: , 
|Obesity or BMI>30||Vitamin A and selenium present in the supplement can aggravate liver disease associated with obesity.
The risk of type-II diabetes is also increased.
|Pregnancy||Retinol-containing supplements should be avoided as it is associated with birth defects. Vitamin C and E is linked with the low birth weight of the babies|
|Gastritis or Peptic Ulcer Disease||Zinc, copper, potassium, and vitamin C cause increased irritation of the gastrointestinal system.|
|Cancer||Vitamin A and E have been linked with increased risk of cancer, and therefore should be avoided.
|Diarrhea and constipation||Iron should not be used in both conditions. Magnesium, vitamin C, and sorbitol-containing supplements can also worsen diarrhea.|
|Parkinson Disease||Manganese intake accumulates in the brain and causes resistance to the treatment.|
|Patients taking anticoagulants||Ginkgo Biloba and vitamin E have anti-platelets and anticoagulant properties and therefore can increase the risk of bleeding.|
If in doubt, It is important to consult with your treating doctor about supplements and dietary measures.
- Arthritis, Chronic Diseases Fact sheets, accessed on 29-08-2021, available at https://www.cdc.gov/chronicdisease/resources/publications/factsheets/arthritis.htm
- The truth about arthritis is available at https://arthritis.ca/about-arthritis/what-is-arthritis/the-truth-about-arthritis
- White-O’Connor, B., & Sobal, J. (1986). Nutrient intake and obesity in a multidisciplinary assessment of osteoarthritis. Clinical therapeutics, 9 Suppl B, 30–42.
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- M. Masud Parvez et al. Bioactive Food as Dietary Interventions for Arthritis and Related Inflammatory Diseases (Second Edition), Academic Press,2019, Pages 3-22, ISBN 9780128138205, https://doi.org/10.1016/B978-0-12-813820-5.00001-5.
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