Dr. Jodi Nishida
Hawai‘i Herald Columnist
It’s interesting how each month is named after a medical condition. To me that’s a bad sign. Is illness that prevalent? The answer is yes. May happens to be Arthritis Awareness Month and provides a terrific opportunity to discuss both the different types of arthritis and how inflammation is a key factor. More than 50 million adults and 300,000 children suffer with joint pain or disease. That’s a staggering amount! While there are more than 100 different forms of arthritis, the ones that are most common are osteoarthritis, rheumatoid arthritis, psoriatic arthritis (which I have), fibromyalgia and gout.
Arthritis isn’t something that automatically happens as you age. That is a common misconception. Arthritis is mostly triggered by wear and tear, stress, being overweight or obese, eating sugar and certain foods, and inflammation. Arthritis greatly affects one’s quality of life and is associated with a great deal of pain. As someone’s mobility goes down and their pain level goes up, depression often kicks in. Historically we’ve relied on over-the-counter and prescription medications to reduce symptoms. In the late 1800’s we took aspirin. In the mid-1900’s we did gold injections and invented steroids such as cortisone. Shortly after we discovered methotrexate, which works well but comes with a long list of serious side effects. Today, we rely on expensive medications called “biologics,” which are typically injected and cost our healthcare system hundred of thousands of dollars each month. Patients will often cycle through all the medications with varying degrees of relief, but still have “good days” and “bad days” in terms of pain relief. Even these incredibly expensive medications aren’t a cure.
I was personally diagnosed with psoriatic arthritis back in 2004. Unfortunately, it runs in my family. Mine was triggered by extreme stress and at the time I ate a very poor diet consisting of my usuals: rice, sweet bread, pasta, fast food, desserts and sugary drinks. Psoriatic arthritis affects certain joints in your hands and can eventually spread to your neck, spine, hips, knees, feet, etc. It is associated with varying degrees of the skin condition psoriasis, which presents as red, itchy, unsightly plaques. It can also cause changes to your nails such as pitting or striations. I, too, cycled through about five medications until landing on a weekly injection which I had to self-administer for 13 years. I was told that eventually it would stop working and I would end up on IV infusions. Other than being advised to avoid the nightshade family of plants (tomatoes, eggplant, potatoes, and peppers), I was given no information about the effect that different foods have on arthritis symptoms and inflammation. I was only given recommendations on medications.

In 2017, I accidentally stumbled across the ketogenic diet. Keto is low carb, moderate proteins, and healthy fats such as avocado and extra virgin olive oil. Keto eliminates processed foods from your diet and anything that turns into sugar such as bread, rice, noodles, potatoes, grains, most fruit, baked goods, snacks, white flour, and wheat flour. As I decreased these foods, my symptoms started to disappear until one day, my arthritis was in complete remission and I no longer needed the injections. This triggered me to do hundreds of hours of research only to uncover the link between sugar and inflammation in the human body. If you suffer from any of the arthritis conditions listed at the beginning of this article, I strongly suggest you start reducing carbohydrates until they’re almost eliminated from your diet. Take note if your symptoms start to improve.
The other huge dietary source of inflammation are the inflammatory seed oils. These include soybean oil, corn oil, sunflower oil, peanut oil, sesame oil, rapeseed oil (the source of canola oil), cottonseed oil, and safflower oil. The problem is in the way these oils are manufactured and produced. Extremely high temperatures, petroleum-based solvents, and harsh chemicals are used to produce an end product that is visually and aromatically appealing. Unfortunately, they are found in high amounts in all processed, packaged, and fast foods and cause tons of inflammation and damage in the human body. As much as possible, use only avocado oil, extra virgin olive oil, coconut oil, butter, ghee, or marrow tallow for cooking. These cause minimal to no inflammation once consumed.
Let me quickly detour and discuss gout. This is an important topic because it seems like so many people have it. Gout affects more men than women and is very painful. When you ask someone what triggers their gout symptoms, they often say pork, red meat or seafood. Want to know a secret? All of our keto/low carb patients no longer have gout even though they eat pork, red meat, and seafood. When we first started noticing this, our first thought was, “Could it be sugar that’s triggering gout?” We started asking our patients questions such as, “Did you eat rice with your pork the last time you had a gout attack?” The answer was always “Yes.” Beer and soda are also common triggers for gout that aren’t allowed in a low carb/keto diet. Beer and soda also turn into sugar in the body. For those of you out there with gout, you might want to start paying attention to your carbohydrate and sugar intake and see if it makes a difference. For those of you out there with osteoarthritis, reducing carbohydrates, sugar, and seed oils will not only reduce inflammation, but will help you to lose excess weight that is stressing your joints.
The human body can heal itself. I firmly believe this. When we remove the offending substances that cause damage and inflammation plus give our body what it needs to function properly, amazing things happen. In today’s world, we are bombarded with chemicals, preservatives, sugar, and inflammatory compounds in food. You need not be another statistic in healthcare. By understanding what drives illness and what you’re actually eating, you can heal and have excellent health for life!
Dr. Nishida is a Doctor of Pharmacy and accredited Metabolic Healthcare Practitioner who’s been in healthcare for over 25 years. After experiencing the ketogenic lifestyle’s effect on her own autoimmune condition, she decided to build a keto-based medical practice so others could benefit from it too. Over the last few years, she’s helped almost a thousand patients realize the benefits of clean, medically-guided keto.
With certifications in ketogenic nutrition, cardiovascular disease management, pharmacogenomics, and medication management, she works closely with each and every patient to tailor keto to their medications, medical conditions, lifestyle and socioeconomic situation. Dr. Nishida is also in training for processed food addiction recovery. To learn more, or to contact Dr. Nishida, visit her website at theketoprescription.com.
The content of this column is not meant to be medical advice. Please consult your doctor before starting any diet or lifestyle change and understand that there is no blanket approach to keto. Keto should be tailored to each individual through the guidance of a trained professional.