The Link Between Sugar and Osteoarthritis

Sugar has long been considered the bad guy in many health problems, but new research is making a link between sugar consumption and osteoarthritis. Is your sugar habit adding to your arthritis pain?    

Twenty-seven million Americans have osteoarthritis, an inflammatory and degenerative condition that affects joints. It's often caused by wear and tear, aging and injury to affected joints. Osteoarthritis of the knee is among the most common complaints patients bring to their doctors for medical attention. In fact, by age 85, fifty percent of people will have osteoarthritis in their knees. While many people assume arthritis is inevitable, scientists and doctors are interested in learning why many people avoid getting it, what factors contribute to developing it and how people can live well in spite of it. One factor that's getting new attention is the impact diet has on arthritis symptoms including joint pain and stiffness.

A recent study of 2149 participants (men and women with osteoarthritis in their knees) conducted by Researchers at Brigham and Women's Hospital and Tufts Medical Center in Boston, and Brown University in Providence, R.I., evaluated the effect of soda consumption on arthritis symptoms. At the beginning of the study, they evaluated participant's soda consumption, not including sugar-free beverages. Then they followed the participants one, two, three and four years later to track their arthritis progression by measuring joint space in their knees. After taking body mass index and gender into account they discovered that men who drank the most sugary sodas had more joint damage and pain then men who drank fewer or no sodas. More surprising, it wasn't the participant's weight that caused the increased damage. Researchers discovered that men who weighed more, but drank fewer sodas had less joint damage than lighter men who drank more sodas. Women weren't affected the same way by sodas at all, even when they were overweight. This study was not able to find a direct correlation between sodas and joint damage. More research is necessary to determine its direct relationship.

We know that soda consumption is related to obesity and weight gain. We know weight gain directly affects joint health because every pound of excess weight contributes four additional pounds of weight on knee joints. We've also known that sugar contributes to inflammation for quite some time. Inflammation is one of the factors that cause pain and stiffness with osteoarthritis. A 2002 study published in the American Journal of Clinical Nutrition linked consumption of processed sugars (like the kind present in sodas) and other high-glycemic starches (like white flour, white rice and potatoes) with increased inflammation, which causes pain, overheating, redness and swelling.

Should I Avoid Processed Sugars Entirely?

Most physicians agree that avoiding sodas, candy, white flour, sugar and white rice, high-fructose corn sweeteners and other foods high on the glycemic index is good advice for every body. Most would also agree that total abstinence would be unrealistic for most people. A more do-able approach would be to limit consumption of sugary foods and be aware that they may contribute to more aches and pains.

Are Sugar Substitutes Safe?

Diet soda doesn't seem to have the same affect on osteoarthritis in male participants. Artificial sweeteners have come under suspicion, however for causing other health problems. The Food and Drug Administration says that artificial sweeteners like Aspertame, saccharine and Sucralose are safe in limited quantities. Other alternative sweeteners like Stevia are also considered "safe." Natural alternatives to sugar like agave nectar, maple syrup and honey all break down to sugars that are high on the glycemic index and should be consumed in limited quantities.    

The best advice for everyone with arthritis is to focus on eating a healthy diet and getting enough exercise. And just for good measure, maybe cut out the sodas.   

Nathan Wei, MD, FACP, FACR reviewed this article. 




American College of Rheumatology (ACR) (2012, November 10).
Weekly soft drink consumption bubbles up knee osteoarthritis; especially in men.

Science Daily

American Journal of Clinical Nutrition
July 2002 vol. 76 no. 1 266S-273S

Glycemic index: overview of implications in health and disease 1-4

David JA Jenkins, Cyril WC Kendall, Livia SA Augustin, Silvia Franceschi, Maryam Hamidi, Augustine Marchie, Alexandra L Jenkins, and Mette Axelsen