Tuesday, 22 October 2013

Time to Hibernate? All About Pain,Tiredness and Diet in Arthritis

Autumn is slowly turning into winter and with the darker nights I get an urge to hibernate.Some of this is just my response to cold, wet evenings and some of it is the effects of feeling exhausted by arthritis. Before we get into the ins and outs of what to do when you feel exhausted, I want to explain what I mean by 'fatigue' or 'tiredness' when you suffer from the pain of arthritis. Sometimes, those of us with arthritis feel ordinarily tired: exhausted, cranky and like we could do with an extra 6 hours in bed. However, when your arthritis is flaring the fatigue is nothing like that 'ordinary tired' feeling. It feels like someone has simply taken your battery out (a friend once said it was like being the opposite of the Duracell bunny!). Sleep doesn't particularly help and you tend to feel like you are wandering around with lead for limbs and borscht for brains.

Why does this happen? Well, arthritis pain is both physically demanding and mentally exhausting. The inflammation that causes pain taxes your body - systemic inflammation over time can lead to anaemia and cachexia (loss of lean body mass), both of which increase feelings of fatigue. Medications that help tackle inflammation, like anti-inflammatories or disease modifying drugs, can also cause side effects which increase fatigue. Anyone who has had a 'methotrexate hangover' will recognise well the feeling of being utterly wiped out by a medication. Diet can help to some extent with this kind of arthritis fatigue. Eating plenty of omega 3 rich foods can help reduce inflammation and you can also support your body by making sure you are getting enough B vitamins and iron through eating plenty of wholegrains, leafy greens and even lean red meat.

Pain can make it difficult to sleep which leads to even more fatigue. Arthritis can stop you getting comfortable at night or wake you in the early hours of the morning. Some people with arthritis call this , fittingly, 'painsomnia'. Luckily  you can help tackle some of the causes of insomnia through diet. Try not to eat anything heavy, spicy or tough on the digestive system in the 3 hours before bedtime. Instead try a light snack to help balance your blood sugar that is rich in calcium, magnesium and the amino acid, tryptophan. A bowl of milky porridge (oatmeal) or a chicken sandwich on wholemeal bread both provide the right mix of sleep-encouraging nutrients.

Finally, being tired and in pain makes shopping,cooking and eating healthily a challenge. It can be very tempting to reach for something instant or ready made when you are totally exhausted. However, people with all kinds of arthritis have been shown to be more likely to be deficient in vitamins C, E, folic acid and calcium than people without the condition, probably due to the difficulties preparing food you are shattered. Shortages of these nutrients can exacerbate fatigue and make it harder to bounce back from pain. A well-balanced healthy diet can help you cope - try stocking the freezer up with pre-prepared home made meals, frozen veg and fish and even healthier ready meals (see here for tips) so you have a stash of easy, healthy options when you feel a flare coming on.

And, if all this sounds too much like hard work and you just want to get into bed or slump on the sofa - go for it. Sometimes you need to listen to what your tiredness is telling you.

Monday, 7 October 2013

Arthritis Friendly Recipe: Trick or Treat Pumpkin Muffins

With Halloween just around the corner, here is a great, arthritis-friendly healthy pumpkin muffin recipe. I'm not a huge fan of halloween but I am a big fan of these gently spiced, gingery muffins. Using pumpkin purée eliminates the need to hack up a large pumpkin which can be pretty difficult if you have arthritis but by all means use some cooked pumpkin if you have it. The muffins make a great afternoon snack or a fun, healthy thing to serve to trick-or-treaters. See the recipe variation for my rather wicked adult-version (a bit like Russian Roulette with a muffin).

Ingredients:

1 can pumpkin purée (454 grams)
2 medium eggs
200g gluten-free or plain flour
50g ground almonds
50g rolled oats
100g light brown soft sugar
1 tablespoon treacle or molasses
1tsp ground ginger
1tsp cinnamon
1tsp baking powder
50g chopped glace ginger or 1tsp fresh grated ginger (optional)

Makes 12


Using an electric whisk or stand mixer, beat the eggs and sugar together for 3 minutes or until pale and fluffy. Add the pumpkin purée and treacle and briefly mix again. Tip in all the other ingredients and fold them into the wet mixture until just combined.

Fill each muffin case two-thirds full. Bake at 180C/375F for 25 minutes of until a knife inserted into the centre of the muffin comes out clean.


Variation:

For an adults-only Halloween treat, fill 3 muffin cases half full before adding a sprinkle of chilli flakes into the centre or each case. Top with another spoonful of muffin mix to cover the chilli flakes. Fill the other 9 cases as usual. Serve as a 'Trick or Treat' (although actually I really like the warmth of the chilli ones!).

Arthritis diet notes:
Pumpkin is an excellent source of vitamins A, C and fibre. The ginger in this recipe adds an anti-inflammatory kick whilst the ground almonds boost the vitamin E and healthy monounsaturated fat content. You can try reducing the sugar content by half if you like a less dessert-like muffin but do leave in the molasses or treacle - not only does it add flavour but it also give an iron boost.

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