Sugar intake may trigger RA flare
DEAR DOCTORS: I stopped eating sugar while losing weight. When holiday sweets started showing up, I indulged. Hip pain from rheumatoid arthritis, which stopped while I was dieting, came back again. Did the sugar do this?
DEAR READER:
Studies have identified added sugars in the diet as a contributing factor to a range of adverse conditions. These include Type 2 diabetes, increased body fat percentage, obesity, cardiovascular disease and metabolic syndrome.
As researchers have widened their focus, a number of studies have drawn a connection between added sugar in the diet and an increased risk of developing chronic low-grade inflammation. Although inflammation is often understood to be a bad thing, the key word is “chronic.”
Low-grade inflammation is actually a tool the immune system uses to fend off potential threats. When things are working properly, immune cells known as inflammatory macrophages get alerted to a problem. They arrive at the site, perform needed maintenance and recede. The departure of the macrophages ends that episode of inflammation. But sometimes the immune system malfunctions. The macrophages don’t retreat, which means that the low-grade inflammation persists. This leads to gradual and ongoing damage to tissue.
Chronic low-grade inflammation plays a role in a wide range of autoimmune diseases. This includes rheumatoid arthritis, or RA, the condition your mention in your letter. RA is a chronic inflammatory disorder that can affect joints and internal organs. Unlike osteoarthritis, in which physical wear and tear erodes the tissues of the joints, the damage in RA occurs due to chronic low-grade inflammation. It’s a mistaken response by the immune system, which has begun to attack the body’s own tissues.
The link between excessive sugar intake and inflammation is straightforward. It involves cytokines, which are proteins that modulate inflammation. There are proinflammatory cytokines, which trigger an immune response, and antiinflammatory cytokines, which ease the attack. Research shows that when the diet gets loaded up with added sugars, pro-inflammatory cytokines are released. They act as messengers, summoning and urging on the immune cells needed to deflect an invader. The result is inflammation and physical symptoms such as pain, swelling, stiffness and a sensation of heat that are part of RA.
Based on the sequence of events you described, it’s possible the sudden and significant increase in sugar may have played a role in the RA flare. When you have RA, your levels of pro-inflammatory cytokines are high. You went from removing a potential source of inflammation during the months you cut sugar from your diet to suddenly adding it in high amounts.
With the holidays over, it would be wise to return to an anti-inflammatory diet. You don’t have to cut out sugar completely, but do prioritize your intake, and choose wisely.