Tuesday, 26 June 2012

Arthritis-Friendly Recipe: Better-for-you Burgers

BBQ season is in full swing now and for many it's hard to imagine having one without burgers. Unfortunately they aren't always the healthiest option on the grill. They can be high in saturated fat and shop bought ones often have some fairly grim fillers lurking in them. But, it's easy to make your own healthier burgers that taste even better than the ready-made kind. If you have kids, get them involved by letting them help you make and shape these. Both the carrot or breadcrumbs act to lighten the mix and give the burgers that familiar texture but if you prefer things really meaty, just leave them out. You can also try mixing in different herbs and spices to suit your mood. To make shaping the burgers easy if you find it hard to roll them, just take a tablespoon full and put it on the baking pan, then flatten with a spatula. Serve the burgers with buns and toppings or sweet potato fries.

250g extra lean beef mince (5% fat)
2 tablespoon tomato puree
1 tsp smoked paprika (optional)
2 tsp French mustard
1 crushed clove garlic
Salt and black pepper to season.
EITHER 1 grated carrot or 2 tablespoons brown breadcrumbs

Serves 2 (easily doubled)

Mix all the ingredients together in a large bowl. Split the mixture into four and shape into burgers by rolling into a ball between your hands and then flattening. Put burgers on foil lined pan and grill on a medium-heat for about 4 minutes a side or until cooked how you like them!

Arthritis diet notes
Red meat is best eaten occasionally if you have arthritis as it has been linked to increased inflammation. However, if you choose lean cuts it is an excellent sources of iron which is particularly important if you have inflammatory arthritis as it can cause anaemia. Enjoy a good squirt of tomato sauce on these - it's rich in the antioxidant lycopene. 

 If you want more tips on eating healthily at BBQs and all summer long, have a look at this post.

Friday, 22 June 2012

Diet, Arthritis and Bone Health

We tend to spend a lot of time thinking about where our bones connect (our joints) but not so much time thinking about the health of our bones in general. Yet, arthritis can effect our bones in many ways, here are some of them:

Your disease - inflammatory arthritis can cause accelerated bone loss through a variety of mechanisms. Inflammatory chemicals trigger breakdown and resorption of bone which can lead to further joint damage and osteoporosis (another term for bone loss). Osteoporosis makes you more prone to fractures, particularly of the wrist or hip. Conversely, osteoarthritis is associated with higher bone density and excess bone growth in response to the joint damage. This excess bone growth can cause spurs and deformity around the joint, often increasing pain for sufferers.

Your drugs - whilst corticosteroids are wonderfully effective at reducing inflammation, patients on them at a high dose for a long period are more likely to suffer from osteoporosis. Some studies have also suggested that use of proton-pump inhibitor drugs (frequently prescribed if you take anti-inflammatory medication) can also increase the risk of hip fractures. However, there is still a lot of disagreement whether the research really does show a link and further studies are needed.

Your activity levels - weight bearing or resistance exercise is vital to help build bone mass. It can also strengthen muscles around joints in both inflammatory and osteoarthritis to help reduce pain, increase mobility and protect against frailty. It seems contradictory that using your joints more can help protect them but it really is true. To increase bone mass, walking, weight training, dancing and even gardening can all help. If you have osteoarthritis, you might find swimming, stretching, weight training and cycling more suitable to mobilise your joints without increasing the impact on them.

Your diet - what you eat can really make a difference to your bone health, no matter what kind of arthritis you have. Most people are familiar with the importance of calcium for their bones, but vitamin D and magnesium are also vitally important. I've written about calcium and vitamin D here and here. In terms of specific foods, soy protein has been shown to help prevent bone loss in women and oily fish (omega 3) have been found to normalise bone loss and excess production so are useful for all types of arthritis. Again, I've written about it here and there are loads of recipes to help you get plenty via this link.

Wednesday, 20 June 2012

Arthritis-Friendly Recipe: Quick Kedgeree

I'm slightly late the Jubilee party with this recipe. If you have never had kedgeree before it is a traditional brunch dish with smoked fish and curry spices. It sounds bonkers but it is very tasty, what could be more British?

2 fillets poached smoked haddock
450g cooked rice (about 150g dry weight)
1 cup frozen peas
1 small diced onion (try the ready chopped frozen kind if you slicing is tricky)
1 T mild curry paste
2 teaspoons turmeric
To serve:
Hard boiled eggs, halved (optional, it is traditional but I think this one tradition too far...)
2 T chopped parsley
Greek yogurt (optional, not traditional but I like it)

Serves 4

In a large frying pan, heat the curry paste and add the onion. Fry gently until the onion is translucent and soft - add a splash of water if the pan gets too dry. Add the frozen peas and turmeric. Heat, stirring constantly for another 3-4mins. Add the rice and cook for a further 2-3mins. Finally, gently flake in the fish. 

Serve sprinkled with parsley, eggs and yogurt (if using).

Veggie - If you don't eat fish, you can swap it for roasted aubergines, courgettes or just some cooked chickpeas. Throw a few flaked almonds of top and you have a lovely vegetarian meal. 
Extra omega 3 - swap the smoked haddock for some cooked salmon or trout (either smoked or plain).
Super speedy - buy ready cooked pilau rice, omit the onion and replace with a clove of crushed garlic and use pre-cooked chicken, fish or beans.

Arthritis diet notes
This is a good dish to add to anyone's anti-arthritis diet. The fish is a great source of lean protein, and if you choose to use salmon or trout you will add extra omega 3s and reduce the salt content (smoked haddock can be quite high in salt). Turmeric has anti-inflammatory effects that can help relieve joint pain. Have a read of this post for more information about arthritis and  turmeric.

Friday, 15 June 2012

Diet, Arthritis and IBS (and other digestive disorders)

A while ago I wrote about arthritis and tummy troubles in a post about the FODMAP plan. People with arthritis often struggle with digestive concerns and these can make it even harder to eat a healthy diet. In fact, there is some evidence to suggest that having arthritis makes you much more likely to have gastrointestinal problems - whether you have osteoarthritis or inflammatory arthritis. To try to help untangle some facts and fictions, I've put together a list of the most common conditions that affect people with arthritis alongside advice on treatment and diet. I'm definitely not a doctor so do make sure you tell yours if you are having any stomach symptoms. You can also find some general info about all of these conditions here.

IBS - irritable bowel syndrome encompasses all sorts of digestive concerns, from bloating and gas to diarrhoea and constipation. It's exact cause isn't understood and it affects different people in different ways. Some studies have suggested that genetic regulation of inflammatory factors may have a role, and the same pattern of genes has been found in some patients with inflammatory arthritis so there may be a link between the two conditions. However, there isn't any evidence that I could find to suggest that IBS is more common in people with these types of  arthritis. IBS is strongly associated with a type of arthritis known as fibromylagia.  Use of non-steroidal anti-inflammatory drugs (like aspirin or naproxen) has been found to be a risk factor for developing IBS by some researchers, but it is unclear whether this is due to the drugs causing IBS or whether people who take anti-inflammatories may have other conditions or symptoms that are perhaps related to IBS.

IBS is difficult to treat as it has many different causes. A dietician will be able to help you identify your possible triggers and adjust your diet to help. The FODMAP diet has shown great success in treating patients and you can read my post about it here (alongside a cracking chocolate chip cookie recipe). You may also want to see a doctor as there are many medications available to help relieve symptoms.

Coeliac disease - is an auto-immune disease where the body attacks the digestive system in response to exposure to gluten. Gluten is found in wheat, barley, rye and sufferers need to cut it out of their diets entirely. Coeliac disease is not the same as an intolerance or allergy. People with autoimmune, inflammatory arthritis are more likely than the general population to have coeliac disease, and likewise people with coeliac disease are more likely to develop arthritis.

The only treatment is to completely cut out gluten under medical supervision.Some patients are able to tolerate oats, but this varies from person to person. If you suspect you might be coeliac, you must see a doctor to help make the diagnosis before cutting out gluten for the tests to work properly. For more info see Coeliac UK's website and my gluten-free recipes.

Dyspepsia/heartburn/acid-reflux - the enemy of many of an arthritis sufferer, often as a side-effect of steroids, osteoarthritis treatments and anti-inflammatories. High dose NSAIDs have been found to increase the risk of dyspepsia by over 30%. It's important to see your doctor if you have any symptoms of dyspepsia, especially unintended weight-loss, vomiting, difficulty swallowing or blood in your stools.

Taking your arthritis medications with food will help avoid problems. Ginger can help relieve some of the discomfort or try eating probiotic yoghurt. Spicy, fatty and heavy meals can all make it worse.

IBD - inflammatory bowel disease is the term used to describe Crohn's and colitis. Both conditions are auto-immune in origin and cause inflammation in the gastro-intestinal tract. Symptoms include stomach pain, blood and mucus in stools, nausea and weight loss. Spondyloarthropathies (ankylosing spondylitis and psoriatic arthritis) are closely related to IBD, and some patients with IBD will develop arthritis. 

Patients with IBD need to be under the care of a gastroenterologist. A dietician can help with any diet plans. Reducing the amount of fibre you eat during a flare by eating well cooked, easily digestible foods can help. There is mixed evidence about the effectiveness of omega 3 fatty acids. When the condition is in remission it is important to eat a healthy, balanced diet and the arthritis-friendly recipes on this site can help you achieve this.

Wednesday, 13 June 2012

Healthy Houmous

Homemade houmous with pitta chips

Go to your fridge and take a look at the tub of houmous in there. Now, turn it over and read the ingredients. Chances are that it is filled with all sorts of things you didn't expect. Yuck, right? Don't worry it's ridiculously easy, cheap and quick to make your own healthy version - just follow the instructions below.

1 can of chickpeas drained (about 210g without the water)
2 tablespoons tahini (sesame paste)
2 tablespoons olive oil
2 tablespoons water (more or less depending on how sloppy you like it!)
1/2 peeled clove garlic
1/2 lemon juiced (or 1-2 tbls of white wine vinegar)
Salt to taste

Put all of the ingredients in a food processor and whizz together. Done.

Arthritis diet notes
Homemade hummus is rich in healthy fat with a better balance of omega 3 to omega 6 fatty acids than most shop-bought versions which tend to use cheaper vegetable oils rather than olive oil. Chickpeas are a good source of fibre, folate, protein and iron - all of which are important for healthy eating with any type of arthritis. Studies suggest that people with inflammatory arthritis (psoriatic arthritis, rheumatoid arthritis, ankylosing spondylitis etc) are often deficient in iron and folate so eating bean-based dips is a good way to top up.

Monday, 4 June 2012

Lemon and Garlic Cod

Lemon, garlic and cod go wonderfully together for an incredibly simple but delicious meal. This takes seconds to prepare and the foil parcels ensure you have beautifully moist, perfectly cooked fish. I often use frozen fish fillets - they are cheaper than fresh and just as good, as long as they are from a sustainable source. If you want to make this even quicker, put the fish fillets in a microwaveable dish, cover with cling-film and zap!

2 cod fillets (I used frozen but you can use fresh or another type of white fish)
2 tsp dried, ground garlic
4 tsp olive oil or melted butter
2 slices lemon
Freshly ground black pepper to taste

Serves 2

Place each fish fillet in on a large piece of foil. Pour half the oil or butter over each fillet and sprinkle with the garlic. Top with a slice of lemon and black pepper.

Fold foil up over each fillet loosely to make 2 parcels.

Pop on baking tray and cook for about 15mins (25 if your fish is frozen) or until fish flakes and is opaque in the centre. 

Arthritis diet notes:
White fish is a food source of lean protein and also contains some omega 3 fatty acids, although not as much as oily fish. Interestingly, some studies suggest that people who eat fish regularly are less likely to suffer from rheumatoid arthritis. We should all aim to eat 2 or 3 servings of fish a week, so this recipe will help you meet that target. Serve it with new potatoes and spinach for a super-healthy meal. You can find out more about fish oils and garlic in these posts:


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