Friday, 12 November 2021

What I Eat During a Flare as a Dietitian with Psoriatic Arthritis

 From healthline.com

By Laura Krebs-Holm


When I had a terrible psoriatic arthritis flare during a week that my husband was travelling for work, I found myself worried and alone.

With pain in my feet and hands, cooking meals from scratch presented a bit of a problem. I couldn’t stand on my feet for more than 10 minutes at a time, and it was excruciating to use my hands to grip, pinch, pull, or try to open anything like a jar.

I started looking for healthy foods that would help tamp down inflammation and that were also easy to cook and prepare.

When you’re in pain and fatigued, nourishing foods that are easy to prepare become especially essential. With that in mind, here are the foods that I always have on hand in my fridge, freezer, and pantry for when a PsA flare strikes.

When you live with arthritis, your body experiences chronic inflammation, which can lead to long-term damage. Antioxidants work to reduce oxidative stress in your body that an often accompany chronic inflammation.

Studies have shown that people with arthritis have a lower antioxidant status than others without arthritis. Beyond this, those with low antioxidant status also reported higher disease activity and longer flare-ups.

Fruits and vegetables are a great source of antioxidants, but it can be difficult to eat enough produce. These are some of my go-to options for making sure I am getting enough fruits and vegetables in my diet, even during a flare:

  • Frozen vegetables: I always have frozen veggies on hand. Frozen vegetables now come in steamable bags so you can just toss the whole thing in the microwave and cut it open (carefully) with scissors. I try to avoid those that come with pre-added sauces. These can add fats, sodium, sugar, or use ingredients that can be a trigger.
  • Frozen fruit: Along with veggies, I also make sure my freezer is stocked with frozen fruit. Frozen fruit can be thawed and used to top plain Greek yogurt or whipped up into an anti-inflammatory smoothie.
  • Fresh produce that is pre-cut and pre-washed: Having pre-washed and pre-cut fruits and vegetables during a flare can make it much easier to prepare salads or healthy snacks. Pre-prepared options can often be found in trays or bags at your grocery store.

Omega-3 fatty acids are essential healthy fats that have a well-known reputationTrusted Source for their anti-inflammatory properties.

In a recent study, participants with obesity who took flaxseed flour saw a decrease in the inflammatory markers C-reactive protein (CRP) and serum amyloid A. Similarly, participants with overweight who took EPA and DHA supplements for 6 weeks experienced a decrease in CRP levels.

Another study found that after taking an omega-3 supplement for 24 weeks, participants with PsA experienced a decrease in joint tenderness and redness, inflammatory activity, and need for over-the-counter (OTC) pain medications. 

Fatty fish like salmon and tuna are great sources of omega-3 fatty acids. However, if you’re like me, you may not feel up to grilling a plank of salmon when you’re in the midst of a flare-up.

Instead, I always keep these omega-3 rich foods on hand:

  • Frozen salmon burgers: These take only a few minutes to cook in a skillet with a bit of olive oil. Then you can use them as a burger patty or chop them up to add to a salad. A personal favourite is having them atop rice or quinoa with cucumber, avocado, and nori seaweed for a sushi-inspired grain bowl.
  • Salmon and tuna pouches: I find these pouches to be a great alternative to canned fish. They’re easy to cut open, and I often use them in salads, wraps, or served on whole grains.
  • Raw or lightly roasted walnuts: Walnuts are great as a snack with a piece of fresh fruit or sprinkled on yogurt or oatmeal.
  • Flax and chia seeds: I call these “healthy sprinkles”! I love to add them to oatmeal, yogurts, salads, and grain bowls for a little omega-3 boost.

Eating whole grains is a great way to get more nutrients and healthy fibre in your diet.

Because whole grains are digested slowly, they’re less likely to cause spikes in your blood sugar and insulin levels. Whole grains are generally lower in their glycaemic levels as well.

In a recent study, participants who ate foods with a higher glycaemic index also saw an increase in inflammation marker levels. Those who ate a lower glycaemic diet saw a decrease in inflammation activity.

Other researchTrusted Source notes that there may be a link between insulin resistance, obesity, and chronic inflammation. For this reason, it’s a good idea for people living with PsA to be mindful of their weight and blood sugar levels.

There’s some evidence that patients with psoriasis or PsA could be at increased risk for celiac disease or non-celiac gluten sensitivity, and vice versa. The National Psoriasis Foundation reported that up to 1 in 4 people with psoriasis may also have a gluten sensitivity. 

I always keep the following easy-to-prepare whole grain options around:

  • Pre-cooked frozen quinoa: Frozen quinoa is easy to warm up in the microwave and pour in a bowl, then top with beans, healthy proteins, and steamed veggies.
  • Shelf-stable pouches of brown rice: Similar to quinoa, I like to warm these pouches up in the microwave and use the rice as the base of a grain bowl or in homemade sushi or kimbap rolls. 
  • Oatmeal: The breakfast of champions! I try to avoid flavoured packets which tend to have less fibre and more sugar. You can make your own oatmeal in the microwave or on the stovetop in minutes. I love to top mine with nuts or nut butter, healthy fruit, and a touch of honey.

In addition to omega-3 rich foods, there are many other healthy proteins that don’t promote inflammation.

Studies suggest that eating more red meat and processed meatTrusted Source was linked to higher inflammatory levels in adults. I try to limit my red meat intake, especially during flare-ups.

Eating more plant proteins and dairy proteins can help support your metabolism without increasing inflammation. To make sure I am getting enough protein in my diet without red meat, I always have some of the following foods in my home:

  • Frozen grilled chicken breast or a rotisserie chicken: They’re so easy to warm up and serve as a main dinner course, or slice and add to salads, wraps, or atop a bowl of vegetables for lunch.
  • Canned soups like black bean, lentil vegetable, or split pea: I opt for low-sodium versions that will deliver protein and fibre without too much salt.
  • Hummus: Hummus is full of plant-based protein, healthy fats, and fibre. I dip vegetables in it or use it as a healthy sandwich spread.
  • Plain Greek yogurt: A great snack or breakfast food that packs in protein and calcium without added sugar, which has been linked to inflammation. 

Finally, don’t forget to use your tools. There are a lot of handy kitchen gadgets and tricks that can make putting a healthy meal together during a flare much less painful.

I often find myself depending on electric can openers, scissors to open packages and even to cut up food, rice cookers, and other appliances that make my life just a little bit easier.

When you’re dealing with the pain and fatigue of a flare-up, prioritizing nutrition can feel near impossible. It’s important to remember that with diet and nutrition, small changes can make a big difference.

Finding a couple go-to meal ideas to start with can help make eating well during a flare-up much less intimidating.

Laura Krebs-Holm, MS RD LD, is a registered dietitian who believes that good nutrition can make a huge difference in your health. She earned her Masters of Science in Human Nutrition and completed her dietetic internship at Texas State University in San Marcos. Ever since, she has been helping people feel their best through the power of food. Her own diagnosis of psoriatic arthritis has shaped her view of using food as medicine. For nutrition tips and anti-inflammatory recipe ideas, you can follow her on Instagram: @waterloonutrition.

https://www.healthline.com/health/psoriatic-arthritis/what-i-eat-during-a-flare-as-a-dietitian-with-psoriatic-arthritis

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