Polymyalgia Rheumatica (PMR) is an inflammatory condition primarily affecting adults over 50, causing pain and stiffness, particularly in the shoulders and hips. While the primary treatment involves medication, especially corticosteroids, diet plays a supportive role in managing inflammation and mitigating treatment side effects. Certain foods promote systemic inflammation, the underlying factor in PMR, and should be limited or avoided. Furthermore, PMR medication requires specific dietary adjustments to safeguard long-term health.
Common Culprits of Systemic Inflammation
Foods that promote systemic inflammation should be avoided by individuals with an inflammatory condition like PMR. Refined sugar is one of the most significant contributors, found in sweetened beverages, candies, and many processed foods. Excessive sugar consumption leads to rapid blood sugar spikes, which promote inflammation by increasing the production of advanced glycation end products (AGEs).
Refined carbohydrates, such as white bread and white rice, behave similarly to sugar because they are quickly broken down into glucose. Heavily processed and packaged foods, including processed meats like hot dogs and salami, contain refined ingredients, unhealthy fats, and excessive sodium that contribute to inflammation. It is also important to limit trans fats and excessive amounts of omega-6 fatty acids found in some vegetable oils and fried foods. A high ratio of omega-6 to omega-3 fatty acids is associated with increased inflammation.
Navigating Dietary Risks While on Corticosteroids
Treatment for PMR involves corticosteroids, such as Prednisone, which require careful dietary management due to side effects. Corticosteroids can cause fluid retention and increase blood pressure. Sodium restriction is a necessary adjustment to help manage these effects and reduce the risk of hypertension. Healthcare providers often advise limiting sodium intake.
Corticosteroid use impacts blood sugar and can sometimes induce steroid-related diabetes. Patients must carefully manage their carbohydrate intake. Paying attention to the glycemic index of foods helps prevent sharp rises in blood sugar. This management includes monitoring the total amount of carbohydrates consumed, not just avoiding refined sugars.
Corticosteroids accelerate bone breakdown and decrease calcium absorption, greatly increasing the risk of osteoporosis and fractures. To counteract this bone thinning, patients need adequate amounts of calcium and vitamin D. Calcium sources include dairy, leafy greens, and fortified non-dairy milks. Vitamin D can be obtained from fatty fish, egg yolks, and fortified products.
Corticosteroids often increase appetite and can lead to weight gain, which puts additional stress on affected joints and muscles. Limiting calorie-dense foods and focusing on nutrient-rich, whole foods is a practical strategy. Dietary choices should directly mitigate these adverse health outcomes caused by the medication.
The Role of Individualized Food Sensitivities
Beyond general inflammatory foods and medication restrictions, some individuals with PMR may find relief by identifying personal food sensitivities. This area often lacks strong scientific consensus, making it a highly individualized concern. Certain foods, like gluten or dairy, are common triggers in other inflammatory conditions, and some PMR patients report symptom improvement upon their removal.
Nightshade vegetables, including tomatoes, potatoes, peppers, and eggplant, are frequently discussed. These vegetables contain glycoalkaloids, which anecdotal reports suggest may worsen joint pain in sensitive individuals. Nightshades are nutritious, so removing them should only occur if a sensitivity is strongly suspected.
The most reliable way to identify a sensitivity is through a supervised elimination and reintroduction diet. This process involves removing a suspect food group, then slowly adding it back to observe symptoms. Consult a healthcare professional or registered dietitian before starting a restrictive diet to ensure nutritional adequacy.