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Oh Sugar, Really? You’re Giving Me Joint Pain and Inflammation?

Slavery is alive and well in our society, but it’s not what you may think.  Americans are slaves to sugar, and the bonds are tightening every year at a rate of nearly 2%.  Back in the 1700s, before the conveniences of modern industrialized life, we consumed, on average, 4 pounds of sugar per year. Nowadays, it’s more like 78 pounds per year.  This infographic puts our sugar indulgence in perspective.

And how is that affecting us?  Is it any wonder or coincidence that disease rates have followed a similar sharp increase, as we have been adopting a high-sugar/high-refined carbohydrate diet over the years?  It has taken us many years to finally connect the dots between sugar and disease.

It has been a long road because first, we had to come to understand inflammation and disease and then sugar and inflammation.  We also went through a phase of fearing and blaming fat, while turning a blind eye to and cranking up our sugar consumption via highly processed foods and beverages.

It starts with chronic inflammation and intestinal permeability (leaky gut)

It is now common knowledge that chronic, low-grade inflammation is where disease starts.  Inflammation is the body’s immune response to conditions like infection, injury, fatty acid imbalance or foreign substances like undigested proteins or bacterial waste products called endotoxins finding their way into the bloodstream.  They maneuver their way into the bloodstream when the tightly fitting cells of the intestinal mucosal lining spread apart, which is called intestinal permeability.  This occurs for a number of reasons.

One big reason is gut microbial imbalance, which can result from antibiotic use and/or a low-fiber/high- sugar diet.  Another probable cause of intestinal permeability is emulsifiers in pharmaceuticals and processed foods.  A third and major cause of intestinal permeability is gluten consumption, which causes this issue by stimulating the release of a protein called zonulin.

When toxins and proteins get into the blood stream, the immune system recognizes them as foreign, or non-self, and proceeds to attack the perpetrator as well as its own tissues with inflammatory chemical messengers called cytokines.  This is the essence of autoimmunity.

Genetics determine your weakest link organs and tissues, so to speak, and those can end up taking the brunt of the inflammatory response.  This is why, in response to intestinal permeability, microbial imbalance and even the same environmental trigger, such as gluten, one person will develop Hashimoto’s Thyroiditis, another will develop Rheumatoid Arthritis, another will develop Sjogren’s and so on.  In this indirect fashion, by promoting microbial imbalance, sugar can be a major culprit in not only autoimmune diseases, but the secondary symptoms that come with them. Autoimmune super symptoms, which includes joint pain, is discussed elsewhere on this website.

An estimated 52.5 million U.S. adults (about 1 in 5) report having doctor-diagnosed arthritis (inflammation of the joints) an autoimmune condition.  Arthritis is also the nation’s most common cause of disability.  It limits the activities of 22.7 million Americans—for example, preventing them from being able to climb stairs or walk more than short distances.  Not all joint pain stems from autoimmunity, so where is all of this inflammation coming from?

Sugars, carbs, blood sugar and inflammation

Sugars, particularly refined and processed sugars and even those from refined grains, cause and/or contribute to inflammation in ways other than fueling the autoimmune fire via microbial imbalance or perpetuating intestinal permeability.  Whether or not you have autoimmunity or are predisposed to it, when you eat sugary foods and drink sugary beverages, you will get a sharp spike in blood sugar and insulin levels.  In response to a sugar-laden meal or snack, the body typically pumps out more insulin than is needed, and a subsequent blood sugar crash ensues.  This then leads to intense hunger and carbohydrate/sugar cravings in order to bring the blood sugar back up.

Unfortunately, that intense hunger most often leads to another sugar binge, causing the blood sugar to spike again, and the cycle just keeps repeating itself.  This is bad news from multiple angles for those who suffer from joint pain, whether autoimmune in nature or not.  The first reason is that high blood sugar alone causes inflammation.  What’s worse is that these intense swings in blood sugar cause even more inflammation than sustained high blood sugar.  Beyond blood sugar, elevated insulin levels lead to inflammation and increased pain as well.  So, if you have joint pain as well as a potato chip, pasta or candy bar addiction, you can expect to continue having joint pain until you break your addiction to carbs and sugar.

A secondary problem with high blood sugar is that it promotes the production of advanced glycation end-products, or AGEs.  AGEs are inflammatory compounds that form when excess protein and sugar bind together.  These compounds prematurely age our bodies and have been linked to many different serious health concerns, all stemming from increased inflammation.

Break the sugar habit = decrease inflammation and joint pain

Eating for optimal blood sugar, meaning not skipping meals and focusing your palate on getting just the right amounts of quality proteins, healthy fats and colorful veggies, with added sugars, processed foods, refined and even whole grains taking a smaller role, is a great way to lower your intake and production of AGEs and improve your overall inflammatory status.  This will not only help to decrease inflammation and pain, it will help to prevent premature or excessive aging and chronic disease.

When we break the sugar habit, we are able to appreciate the sweetness of whole foods like fruits and vegetables; however, forever abstaining from sweet treats is a bit more austere than most of us care to live our lives.  What we can do is choose alternatives to sugar that provide intense sweetness without the dramatic glycemic (blood sugar) impact.  Coconut palm sugar and honey are examples of sugar alternatives with lower glycemic indexes.

Just make sure to eat alternatively sweetened treats just as sparingly as you would sugar-laden treats.  Most still contain simple sugars, which if eaten to excess or along with a high-carbohydrate meal, can contribute to increased inflammation and joint pain.  For an extensive breakdown of the natural sweeteners available and their respective glycemic index ratings, see this list.

Reducing your sugar intake and eating for optimal blood sugar is one of the most fundamental things you can do to reduce inflammation and pain.  You can eat loads of superfoods and take all of the best anti-inflammatory supplements, but if you’re not covering the basics with your diet, you will continue to live in pain.  Balance your blood sugar and be amazed at the changes you feel.


About the Author

Angie King-Nosseir MS, RD is an Integrative and Functional Registered Dietitian, with a passion for walking with people along their path toward health transformation. Angie has a Master’s degree in Nutrition, is a Certified LEAP Therapist, corporate wellness health coach, freelance nutrition and wellness writer, and certified yoga instructor. She is trained in Functional Nutrition and Medicine through the Institute for Functional Medicine and in Food as Medicine through the Center for Mind-Body Medicine.

This blog post was originally published by, written by Angie King-Nosseir, and first published on Feb 24, 2015.

This post contains the opinions of the author. Autoimmune Association is not a medical practice and does not provide medical advice, diagnosis, or treatment. It is your responsibility to seek diagnosis, treatment, and advice from qualified providers based on your condition and particular circumstances. Autoimmune Association does not endorse nor recommend any products, practices, treatment methods, tests, physicians, service providers, procedures, clinical trials, opinions or information available on this website. Your use of the website is subject to our Privacy Policy.

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