Seafood - smart food for arthritis?

May is National Arthritis Month, and if you’re battling arthritis pain, now might be a good time to catch up on news from several recent studies: Fish oil, also known as omega-3 fatty oil, seems to reduce inflammation and pain, particularly for those with rheumatoid arthritis.

“Omega3-fatty oils may improve inflammation,” says John Hardin, MD, professor of medicine at the Albert Einstein College of Medicine and chief scientific officer for the Arthritis Foundation. “Omega-3 fatty acids stabilize cell membranes in a way that could make a less hospitable environment for inflammation, resulting in less joint pain and less stiffness.”

Reeling in the benefits
In order to take advantage of omega-3’s inflammation-reducing properties, you’d have to consume 3 to 6 grams of fish daily (that’s a serving each day), and that’s probably too much for most people to eat in a week, says registered dietitian (RD) Lona Sandon, a spokeswoman for the American Dietetic Association who specializes in arthritis. Also, recent news about high levels of mercury in certain fish does raise issues about how much fish it’s safe to consume.

But if you eat three servings of fatty fish per week, says Sandon, you will probably have no adverse effects from mercury and you may notice a modest decrease in stiffness and swelling. Try cold-water fish such as salmon, light tuna, or cod. If you are pregnant or preparing meals for young children, cut back on or avoid albacore white tuna, tuna sushi, king mackerel, and swordfish, which contain high mercury levels.

Getting a line on supplements
Studies that found a connection between pain relief and fish oil looked at people taking fish oil in capsule form. Because different fish have various amounts of the oil in their own bodies, “the only way to control your intake of omega-3s is by taking capsules,” says William L. Smith, PhD, professor of biological chemistry at the University of Michigan Medical School.

Supplements deliver a large, consistent dose of oil dailyadds Vonda Wright, MD, orthopedic surgeon at the University of Pittsburgh Medical Center’s Center for Sports Medicine. Even so, she says, people with arthritis will need to take the supplements for two or three months before they’re likely to notice results.
After using the supplements for a while, some patients can scale back on their nonsteroidal anti-inflammatory medication, while others notice that the fish oil supplements leave them feeling less stiff in the morning and that the duration of the stiffness is shortened.

Beware of ‘fishy’ side effects
Fish oil supplements are hardly a magic bullet, however. Though good scientific studies point to their success, not everyone is convinced. “Fish oil does have some modest effect, but I don’t think it’s very potent for most people,” says Daniel Solomon, MD, chief of clinical sciences in the division of rheumatology at Brigham and Women’s Hospital and associate professor of medicine at Harvard Medical School. “And they can be an annoyance as far as side effects are concerned.”

At the megadoses recommended, fish oil capsules can cause flatulence and gassiness that results in “fish burps,” says Sandon. Some people also report stomach distress and oily stools.

There are ways to reduce those side effects, though. Sandon says refrigerating the capsules reduces the repeating fish taste, as does buying capsules that are labeled odorless. “Enteric-coated” capsules are helpful because they don’t break open until they reach the small intestine, cutting down on the amount of oil that backs up into your esophagus, causing you to belch.

Ask your doctor
Consult with your doctor before beginning any course of supplements. Sandon notes that fish oil capsules can interact with blood thinners, aspirin, and blood pressure medication. If you get the go-ahead, look for capsules that have docosahexaenoic and eicosapentaenoic acid (DHA/EPA), two forms of fish oil that are most easily absorbed by the body. Supplements containing alpha-linolenic acid (ALA) may get their omega-3s from plants, and that type of ALA is not as easily absorbed and converted to the DHA/EPA forms that are most helpful. As supplements do not need to be approved by the Food and Drug Administration prior to marketing, there can be great variety in what’s sold to consumers. Look on the package for the United States Pharmacoepia seal, which offers some assurance that the manufacturer has met quality standards