Your diet plays a crucial role in helping you avoid or control osteoarthritis. The first objective of a healthy diet is to help you lose weight if you are overweight. Being overweight can cause additional stress to your joints. The second way a balanced, varied diet can help ease the pain of arthritis is by providing vitamins and minerals that keep your joints healthy.

If you have arthritis or knee or hip pain, vitamin C and vitamin D can help prevent bone and cartilage destruction. And a multivitamin can help ensure that you always get the nutrition you need.

Here are some other healthy (and delicious) choices to include in your diet.

Fresh pineapple. Bromelain, an enzyme in pineapple, reduces inflammation. Be sure the pineapple is fresh, not canned or frozen.

Cherries. Recent research has shown that tart cherries are an excellent source of nutrients that may help to reduce joint pain and inflammation related to arthritis.

Fish. Cold-water fish such as salmon and mackerel contain omega-3 fatty acids, which help keep joints healthy as well as reduce pain and swelling. If you don't care for fish, consider supplementing your diet with fish oil capsules.

Next time you go grocery shopping, take this printable shopping list with you. It will be a good reminder of which nutrient-rich foods to stock up on.

Before starting any diet or taking any supplements, it's best to talk with your doctor about which choices are best for you.

More Arthritis-Fighting Foods

Milk, yogurt, cheese, and ice cream. Dairy products are an excellent source of calcium, which can help keep bones strong. Choose low-fat or nonfat dairy products or add powdered milk to puddings, gravies, and other recipes. Other calcium-rich foods include spinach, tofu, and salmon.

Tomatoes. The antioxidants lutein and lycopene, both found in tomatoes, have been shown to lower the risk of osteoarthritis.

Oranges and orange juice. Research shows that vitamin C reduces the risk and the progression of osteoarthritis.

Olive oil. Olive oil contains vitamin E and other antioxidants, which have been shown to possess anti-inflammatory properties and may ease arthritis pain better than nonsteroidal anti-inflammatory drugs (NSAIDs).

Nuts. Many varieties of nuts, such as almonds, hazelnuts, pistachios, and peanuts, are excellent sources of vitamin E, an antioxidant that helps to reduce inflammation.

Way to go! You now have about half of the information you need to keep your joints healthy and pain-free.

If you have joint pain or tenderness, you may be tempted to avoid regular exercise, but exercise actually can help relieve your pain. It also can strengthen muscles and tissues around the joints, providing more support for weakened or damaged joints. You can improve your fitness, your flexibility, and your outlook on life with an exercise program.

Ready to Get Started?

The first step is to design an exercise program that fits your physical needs and is enjoyable. Your doctor can help you determine which exercises are best for your physical condition. Learn more about getting yourself ready for a workout. Have Fun When You Work Out Studies show that if you participate in a program that is appealing, you are more likely to stick with it. If you enjoy group activities, check out community programs. You may want to try country line dancing or ballroom dancing. Join a yoga class or play golf with friends.

If you prefer exercising on your own, you may want to include walking, hiking, weight lifting, or riding a bicycle. Use a stationary bicycle if you are worried about keeping your balance or falling. Water exercises are great, too. The water provides resistance, helping to build muscle, and the buoyancy reduces stress on your knees, hips, and spine so you can work out without worry of injury. More exercise ideas.

Just remember: Starting an exercise program is difficult for anyone in the beginning; however, if you choose activities that you enjoy and do a little bit every day, your program should get easier with time. Your doctor may recommend that you speak with a physical therapist, occupational therapist, or orthopedist for further assistance in designing an exercise program that is most appropriate for you.

Exercise may be the best long-term prescription for low back pain. Although patients in a study reported no immediate decrease in their back pain after a 10-week exercise program, down the road they experienced important rewards. The 2-and-a-half-year follow-up revealed that the people who had completed the exercise program tended to need less prescription pain medication than the group that had not exercised.

RealAge Benefit: A physical activity program that builds stamina, strength, and flexibility can make your RealAge as much as 8.1 years younger.

Some back pain patients saw immediate benefits to exercising. During a 10-week exercise intervention, they experienced improvement in their moods. A positive attitude may help people better deal with difficult situations, such as chronic pain or lifestyle limitations. See your healthcare provider for advice on exercise programs that are gentle on the back.

Some people can manage arthritis with diet and exercise alone, but for others a more comprehensive treatment program might be necessary. If you would like to experience better relief from your joint pain, make an appointment to talk with your doctor.

Take Note To get the maximum benefits from your visit, prepare before you go. Use this printable worksheet to write down everything you remember about your symptoms. Also, list any medications or nutritional supplements you are taking. Bring this worksheet to your appointment.

Assessing Your Needs

At your appointment, tell your doctor about your symptoms and any other medical conditions you may have. It's important to get your doctor's opinion about your symptoms; there are over 100 different kinds of arthritis and the type of arthritis that you have and the kinds of symptoms that you are experiencing will determine the direction of your treatment program.

Symptoms Q&A Besides a routine physical examination, your doctor may check your reflexes and muscle strength as well as look for any tenderness, bony swelling, thinning of muscles, excess fluid, and joint instability. Your doctor may have you move your limbs in order to assess whether your movement is restricted. Your doctor also may order tests, such as X rays, blood tests, or joint fluid samples, if more information is needed.

Once a diagnosis is made, together you and your healthcare provider can devise a plan for keeping arthritis symptoms at bay and preserving your movement.

When to See a Doctor

Arthritis Professionals

If you are diagnosed with osteoarthritis, don't despair! There are many ways to help manage the condition and many people who can help show you how.

• Physical therapists can help you improve joint function and reduce pain through exercises, relaxation techniques, and applications of heat and cold.

• Occupational therapists instruct you on how to protect your joints, minimize pain, and conserve energy. They also can show you how best to perform everyday tasks.

• Orthopedists are surgeons who specialize in the treatment of diseases of bones, joints, muscles, and tendons. They perform surgical procedures such as joint injections and joint replacement for osteoarthritis patients.

Your Weight Is As Important To Us As It Is To You!

Over the past few years it has become clear that weight is an important health issue. Being overweight is a risk factor for health problems such as diabetes, high blood pressure, high cholesterol and triglycerides, arthritis, gall bladder disease, gynecologic problems, some cancers, and even lung problems. Some people who need to lose weight for their health don't recognize it, while others who don't need to lose weight, want to get thinner for cosmetic reasons. We understand that in some ways your weight is different from, for example, your cholesterol level or your blood pressure, because you can't see what these are by looking at someone. Many patients have had health-care providers who approached their weight in a less-than-sensitive or helpful manner. Some patients may have had health-care encounters in which they felt blamed, but not helped. Please be assured that when we bring up your weight, it's because we know that this is an important aspect of your overall health care. We understand, though, that successful weight management is a long-term challenge.

By the same token, we may discuss weight goals that are different from those you select. Weight can affect a person's self-esteem. Excess weight is highly visible and evokes some powerful reactions, however unfairly, from other people and from the people who possess the excess weight. The amount of weight needed to improve your health may be much less than you wish to lose when you consider how you evaluate your weight. If we suggest an initial weight goal that seems too heavy for you, please understand that our major emphasis is on your health and that your health can be greatly improved by a loss of 5-10 percent of your starting weight. That doesn't mean you have to stop there, but it does mean that an initial goal of losing 5-10 percent of your starting weight is both realistic and valuable.

Behaviors That Will Help You Lose Weight and Maintain It

Set The Right Goals

Setting the right goals is an important first step. Most people trying to lose weight focus on just that one goal: weight loss. However, the most productive areas to focus on are the dietary and exercise changes that will lead to that long-term weight change. Successful weight managers are those who select two or three goals at a time that they are willing to take on, that meet the following criteria of useful goals:

Effective goals are 1) specific; 2) attainable; and 3) forgiving (less than perfect). "Exercise more" is a commendable ideal, but it's not specific. "Walk five miles everyday" is specific and measurable, but is it attainable if you 're just starting out?" Walk 30 minutes every day" is more attainable, but what happens if you're held up at work one day and there's a thunderstorm during your walking time another day? "Walk 30 minutes, five days each week" is specific, attainable, and forgiving. In short, a great goal!

Nothing Succeeds Like Success

Shaping is a behavioral technique in which you select a series of short-term goals that get closer and closer to the ultimate goal (e. g., an initial reduction of fat intake from 40% of calories to 35% of calories, and later to 30%). It is based on the concept that "nothing succeeds like success." Shaping uses two important behavioral principles: 1) consecutive goals that move you ahead in small steps are the best way to reach a distant point; and 2) consecutive rewards keep the overall effort invigorated.

Success (But Not With Food)

Rewards that you control can be used to encourage attainment of behavioral goals, especially those that have been difficult to reach. An effective reward is something that is desirable, timely, and contingent on meeting your goal. The rewards you administer may be tangible (e. g., a movie or music CD or a payment toward buying a more costly item) or intangible (e. g., an afternoon off from work or just an hour of quiet time away from family). Numerous small rewards, delivered for meeting smaller goals, are more effective than bigger rewards, requiring a long, difficult effort.

Balance Your (Food) Checkbook

Self-monitoring refers to observing and recording some aspect of your behavior, such as calorie intake, servings of fruits and vegetables, exercise sessions, medication usage, etc., or an outcome of these behaviors, such as weight. Self-monitoring of a behavior can be used at times when you're not sure how you're doing, and at times when you want the behavior to improve. Self-monitoring of a behavior usually changes the behavior in the desired direction and can produce "real-time" records for review by you and your health care provider. For example, keeping a record of your exercise can let you and your provider know quickly how you're doing, and when the record shows that your exercise is increasing, you'll be encouraged to keep it up. Some patients find that specific self-monitoring forms make it easier, while others prefer to use their own recording system.

While you may or may not wish to weigh yourself frequently while losing weight, regular monitoring of your weight will be essential to help you maintain your lower weight. When keeping a record of your weight, a graph may be more informative than a list of your weights. When weighing yourself and keeping a weight graph or table, however, remember that one day's diet and exercise patterns won't have a measurable effect on your fat weight the next day. Today's weight is not a true measure of how well you followed your program yesterday, because your body's water weight will change much more from day to day than will your fat weight, and water changes are often the result of things that have nothing to do with your weight-management efforts.

Avoid A Chain Reaction

Stimulus (cue) control involves learning what social or environmental cues seem to encourage undesired eating, and then changing those cues. For example, you may learn from reflection or from self-monitoring records that you're more likely to overeat while watching television, or whenever treats are on display by the office coffee pot, or when around a certain friend. You might then try to sever the association of eating with the cue (don't eat while watching television), avoid or eliminate the cue (leave coffee room immediately after pouring coffee), or change the circumstances surrounding the cue (plan to meet with friend in non-food settings). In general, visible and accessible food items are often cues for unplanned eating.

Get The (Fullness) Message

Changing the way you go about eating can make it easier to eat less without feeling deprived. It takes 15 or more minutes for your brain to get the message you've been fed. Slowing the rate of eating can allow satiety (fullness) signals to begin to develop by the end of the meal. Eating lots of vegetables can also make you feel fuller. Another trick is to use smaller plates so that moderate portions do not appear meager. Changing your eating schedule, or setting one, can be helpful, especially if you tend to skip, or delay, meals and overeat later.

Here's an extra reason to get your daily dose of vitamin D: it may help keep your colon healthy. High-fiber diets have long been touted as a path to better colon health, and now new research suggests that getting adequate intakes of vitamin D also may have a protective effect. In a study, participants with higher intakes of vitamin D appeared to have less risk of developing serious colon polyps -- intestinal growths that could turn cancerous.

RealAge Benefit: Getting 400 IU of vitamin D and 1,200 milligrams of calcium per day can make your RealAge as much as 1.3 years younger.

Vitamin D is important for bone health because it helps the body to utilize calcium, a bone-building mineral. Many people do not get enough vitamin D during times of the year when daylight hours are scarce. This makes it especially important to find a multivitamin or a calcium supplement that can provide you with an adequate daily amount of vitamin D -- approximately 400 IU per day.

Are you gaining weight and have no idea why? The culprit could be your bedtime.

If you don't get enough sleep at night, it doesn't matter what you eat and how much time you spend on the treadmill. If you're exhausted, your diet just won't work. Why? Sleep deprivation affects the hormones that control appetite and weight reduction. According to Jewish World Review, physical exhaustion thwarts your diet efforts in both obvious and unexpected ways.

If you don't get enough sleep at night:

You'll eat more during the day in an attempt to stay alert. The hormones that control appetite and weight reduction won't function properly. Your resistance to insulin will be increased, which in turn interferes with your ability to digest and process carbohydrates. And that can make you gain weight. But so far, scientists have just found a LINK between sleep loss and weight gain. They don't know the mechanism--if any--that actually causes this, according to Carl Hunt, M.D., director of the National Center for Sleep Disorders at the National Heart, Lung, and Blood Institute.

If you know you're not getting enough sleep most nights, you're not staying up late alone. As many as 70 million Americans aren't putting in enough pillow time often due to the pressures of a 24/7 lifestyle. At the same time, obesity is becoming a national crisis.

And that's just the point, according to Pat Smith, a registered dietitian and sports consultant based in Orlando, Florida. She told Jewish World Review reporter Bev Bennett, "Nutrition, exercise, and rest are the 'trifecta' for weight loss. We're in the middle of a diet debate over fats or carbohydrates (for optimal weight loss), but the part rest plays is missed in the debate."

Sleep is not a luxury. If you don't get enough sleep every night, it could be as damaging to your diet as splurging on ice cream every night. And crashing on the weekends to make up for a weekday sleep deficit won't cut it.

If that's not enough reason to go to bed earlier, note this: Researchers at Brigham and Women's Hospital in Boston have determined that women who have a sleep imbalance--that is, sleep five or less hours a night or nine or more--run a greater risk of getting heart disease than those who sleep eight hours a night. While the study involved 121,700 female nurses that began in 1976, the results are likely to apply to men as well.

Reuters reports the specifics of the research results: More than 71,000 women in the study were asked in 1986 about their sleep habits. None had heart disease at the time, but 10 years later there were 934 heart attacks among them, 271 of them fatal. After taking into account other risk factors for heart attacks (snoring, smoking, and obesity), the researchers determined that those who got five hours of sleep or less per night had a 45 percent higher risk of having a heart attack, while those who slept nine or more hours had a 38 percent higher risk. For those who got six and seven hours, the increased risks were 18 percent and 9 percent respectively.

Eight hours is the ideal amount of sleep. It may also be the secret to living a long and healthy life.