Chronic inflammatory conditions are often resistant to conventional drug treatment and whilst anti-inflammatories are often able to alleviate some of the symptoms and make the patient more comfortable, they do not have much effect on the long term outcome.

Hard Line drugs such as Sulphazalazine, Methotrexate, Penecillimine etc, are supposed to limit the disease process, in my experience I have never been convinced of this, and with the effects they have on the body I will remain unconvinced that they are worthwhile.

Steroids even injected locally have an adverse effect on the joint, and whilst they can sometimes be a very effective pain relief, they are not the answer. However as the pain is sometimes so intense patients often take this course; providing they are short, sharp treatments and not long term use, they have their place.

One of the first things that has a positive effect is to remove toxins from the body with some kind of fast. Doing this with some kind of cleansing programme is often the answer; if the patient is able to cope with this. I find the easiest fast especially for the older patient is one consisting of Pears, Rice and Root Vegetables. You may eat as much as you like and I find that cooking up a pan of Root Vegetables and dividing it into 2, blending half into a soup and keeping the rest whole for evening meal works best. A steamer cooks rice really well and you can even steam the pears for a change, especially for breakfast. Lots of water completes the fast, at least 3 Litres per day preferably drunk warm or at room temperature. Keeping this up for 3-5 days is adequate, but even 2 will help.

Toxins deposited in the joints are acidic and for reasons that are not completely understood they seem to be deposited in adipose tissue at the ends of long bones which lead to a chronic inflammation. These toxins are formed from animal proteins such as meat, sea food and dairy products, some of which seem to be more detrimental than others. Pork is worse than chicken, milk and cheese worse than yoghurt with seafood seemingly the worst of all. Other acid forming foods are alcohol, chocolate, coffee, eggs, gooseberries, pickles, polyunsaturated margarine and processed fats, red & black currants, red meat, rhubarb, tomatoes, vinegar (except cider vinegar) and wheat. After the fast of anything from 3 - 5 days a maintenance diet avoiding the foods above with limited amounts of cereals and grain and with no artificial, processed foods is best. This fast can be carried out on a shorter basis, say for one day a month in future. Drink before or between meals not with or straight after meals. Diluting digestive juices prevents adequate digestion of proteins and can cause indigestion and slow down the rate of absorption of proteins thereby intensifying allergic reactions. Try to avoid mixing protein and starch together at the same meal as each require a different pH range for digestion to satisfactory. Certain juices are also found to be helpful during the maintenance diet. Black Cherry, Celery and apple, Celery and parsley.

Osteoarthritis is a degenerative disease that usually occurs in the weight bearing joints of older people. The bone cartilage wears away so the bones become thickened and distorted and the joint becomes painful, stiff and swollen. Taking plenty of anti-oxidants such as Vitamin C, Vitamin E and Beta-carotene. Magnesium and Potassium are necessary for maintaining muscle strength and preventing spasms. Zinc and Selenium are also useful. Eat mostly vegetables, with two or three small portions of protein or fish per week. In Osteoarthritis there is much evidence to suggest that Solanaceae foods may cause joint pain. They inhibit normal collagen repair and aggravate the joint. Avoiding these foods means cutting out Aubergine, Cayenne, Peppers, Potatoes, Tomatoes and Tobacco.

Rheumatoid Arthritis is a chronic complaint effecting more women than men and affecting the synovial membrane around the joint which becomes painful and swollen resulting in pain and stiffness, resulting in progressive destruction of articular and periarticular structures. In Rheumatoid Arthritis there seems to be a problem with citrus fruits so Grapefruits, Lemons, Limes & Oranges should be cut out or kept to a bare minimum. Supplements for Rheumatoid Arthritis should include large doses of fish oils containing Eicosapentaenoic acid (EPA) enhances anti-inflammatory prostaglandins (PG3 series) and inhibits the formation of inflammatory leukotrines. 1.8 gms is the best dose. Magnesium at 200 -400mg daily, Zinc at 15 - 30mg per day and Selenium at 250mcg per day. Calcium panthothenate at 2g per day proves useful for some. Gammalinnolenic acid (GLA) the active constituent in Evening Primrose Oil acts in a similar way to the EPA in Fish Oil by enhancing the production of anti-inflammatory prostaglandin’s (PG 1 & 2 series)but a dose of 3,000mg daily is needed. Selenium at 250mcg per day. Calcium panthothenate at 2g per day proves useful for some. Zinc at 15 - 30mg per day and Selenium at 250mcg per day. Calcium panthothenate at 2g per day proves useful for some.

Sample diets can be provided on request as can exercise sheets.

Dairy Free Diet.

Cow's milk, which is a staple food for many people, especially children, can be the cause of many problems, including allergic reactions, digestive disorders and catarrhal congestion. This surprises many people, as we have been brought up to believe that milk is supposed to be the most natural, health-giving food. Milk however was designed for calves who 1. grow at a much faster rate than babies and 2. have a build up of the correct fermentative bacteria in their intestines, to enable them to digest grass and differs considerably from human milk which is specifically designed for babies. Therefore it does not seem so surprising that in some people cow's milk creates a lot of fermentation, producing gas which causes distension, discomfort and in some cases severe pain. Some people are allergic to the protein in milk, particularly 'atopic' (genetically inherited) children who develop infantile eczema often followed by asthma and hay fever. They may be able to tolerate Goats Milk, which has a slightly different protein, otherwise Soya Milk (made from the Soya bean) is a good substitute. There are many kinds on the market now, most of which have a perfectly acceptable taste. Cow's milk is high in saturated fats and gives many people problems. It is high in cholesterol and increases the risk of heart and circulatory problems. Goats and Soya milk are much more easily digested. Many people, who have suffered all their lives from catarrhal problems including sinusitis, tonsillitis, ear infections including 'glue ear' in children and so on, experience a dramatic improvement if they cut out milk and milk products from their diet. Some, who are actually allergic to milk, must cut it out altogether, others benefit by reducing them to a minimum, and may tolerate skimmed milk, cottage cheese and yoghurt. There are many products on the market made from the Soya bean such as Tofu (fermented Soya curd) and Soya flour, a variety of Soya breads and Soya ice creams etc. can now be easily obtained. The risk of protein deficiency as a result of a milk free diet normally only applies to vegetarians or vegans who do not eat meat, fish, poultry, eggs etc., and rely heavily on cheese as a source of protein. They should be particularly careful to obtain enough protein from nuts, seeds and grains etc.

Foods To Avoid.

Milk: fresh, dried, condensed and evaporated. Cheese: Hard, cottage , cream etc. Cream and creamed foods : custards cream soups, ice creams, quiche etc. Butter, buttermilk and margarine. Cakes, muffins, biscuits, pancakes, chocolate etc. Hamburgers, sausages and all processed foods containing milk products. Milk based sauces. Baking Mixes. Any food or medical product containing any milk derivative (and there are loads) e.g. casein, casinate, whey, lactose or milk solids.

Food Substitutes.

• Instead of Milk use Soya Milk or Goats milk (if allergy is only to cow's milk)
• Instead Of Ice Cream use Fresh fruit sorbets, Soya ice cream (e.g. Swedish Glace) .
• Instead Of Mayonnaise use Tofu dressings, Soya yoghurt(you can flavour this).
• Instead Of Cheese use Soya cheese( which is a little easier to obtain now).
• Instead Of Butter or Margarine use Soya margarine, flax or a blend of flax and other high quality organic, cold pressed oils. Do not use polyunsaturated fats as they are full of trans fatty acids that are carcinogenic. Quark is partially fermented and pre-digested and is often tolerable.
• Nut Milk : 1 handful of nuts per cup of water. Soak overnight then push through blender in the morning. Will not keep well so drink within 2 hours.
• Tofu Dip or Dressing: Place 250gms of soft tofu in a blender or processor. Add one tablespoon of tahini (Sesame Seed Paste) a splash of tamari (Soy sauce),the juice of 1/2 Lemon chopped chives and crushed garlic or any other flavouring you like. Process till smooth and eat within 48 hours.
• Tofu Cheese Cake. Blend 350gms of soft tofu with the juice of 2 lemons,2 mashed bananas and a little honey. Simmer 2 teaspoons Agar powder in 1/4 cup of fruit juice for 4 minutes. Blend into Tofu. Bake in a pie crust and sprinkle with cinnamon. Bake at 180 degrees centigrade for 20 minutes.

The dangers of a Dairy Free Diet is calcium deficiency, as milk products are often used as the main source of calcium. The daily requirement is thought to be between 400 and 1000mg. In Great Britain it is 400mg. Only 40% of calcium intake is actually absorbed. These days many foods are calcium enriched. The rate of absorption depends on several factors, the presence of Vitamin C and Vitamin D and magnesium. So if taking a supplement make sure it contains Magnesium and Vitamin D. Factors that prevent the good absorption of Calcium are foods containing oxalic acid ( in spinach and rhubarb) and phytic acid (present in grains particularly wheat bran).

Sources Of Dietary Calcium.

• Milk Products mg./100g.
• Cheddar Cheese 800
• Camembert Cheese 380
• Yoghurt 180
• Goats Milk Fresh 129 (Most are now calcium enriched)
• Cows Milk 12
• Cottage Cheese 60

Nuts, Seeds & Beans.

• Almonds 250
• Soya Flour 250
• Brazil Nuts 180
• Haricot Beans 180
• Red Kidney beans 140
• Tofu 128
• Sunflower Seeds 120
• Buckwheat 114
• Butter beans 85
• Walnuts 61
• Peanuts 61
• Soya Milk 21
• Sesame Seeds 11

Fish.

• Whitebait (fried) eaten whole 860
• Sprats Fried eaten whole 710
• Sardines 550
• Shrimps 320
• Pilchards 300
• Prawns 150
• Haddock 110
• Oysters 110
• Salmon (Tinned) 93

Vegetables & Fruit.

• Parsley 330
• Dried Figs 280
• Turnip Tops 250
• Kale 225
• Watercress 220
• Broccoli 100
• Dried Apricots 92

Other.

• Kelp 1093
• Blackstrap Molasses 579
• Black treacle 500
• Carob Powder 352
• Brewers yeast 210
• Tripe 150
• Egg Yolk 130
• Cocoa powder 130