Q. Are there any kinds of food that I should avoid when I have arthritis?

A. If you are suffering from one of these common kinds of arthritis (like osteoarthritis, rheumatoid arthritis and psoriatic arthritis) you do not need any special diet. If you have gout, you are advised to have a "low-purine" diet and you should minimise your consumption of meats, beans and alcohol. A dietician will be able to provide you with more detailed advice. Prawns are not believed to worsen arthritis, so there is no need to avoid them.

Q. Are there any kinds of food that I should eat more of?

A. Recently, doctors in Europe found that eating more fish, especially when it is baked or broiled, benefits patients suffering from rheumatoid arthritis. This is a new finding and more studies should be done before we can advise this diet to such patients. No special diets are recommended for other kinds of arthritis. Naturally, eating a good balanced meal is important for all patients with arthritis. General advice includes taking a diet high in vegetable fibre, low in unsaturated fats and high in calcium.

Q. Can food cause arthritis?

A. Generally speaking, food does not cause arthritis. However, one type, called "reactive arthritis" can start after an episode of food poisoning but this is due to the bacteria in the food rather than the food itself.

Q. Does this mean I do not have to pay attention to food when I have arthritis that is not gout?

A. Attention to food is still important in the management of your arthritis. Firstly, a healthy, nutritious and balanced diet is essential regardless of your arthritis. Secondly, you must pay attention to any special diet that your doctor or dietician has advised you about. For example, eating less protein is appropriate if the kidney function is affected in SLE. Thirdly, some medicines must be taken at the right time in relation to meals. Painkillers like Ponstan, Aspirin and Indocid are best taken after food. Bone-strengthening medicines like Etidronate and Alendronate are taken with an empty stomach because they are not well absorbed in the presence of food.

Q. What do you think of traditional food supplements like bird's nest, tree fungus, lingzhi and essence of chicken?

A. There is no evidence they can improve your arthritis. As they generally do not cause harm and are part of our culture, we do not advise against consuming them. It is advisable to inform your doctor of the type of food supplement you are consuming. However do not stop taking the medicines your doctor has prescribed to you.

Q. I was told some medicines may disturb my appetite. Tell me about them.

A. Prednisolone, commonly used to treat SLE and rheumatoid arthritis, can give you a voracious appetite. Many patients put on a lot of weight because of this. A good way to handle this is to keep non-fattening food, like carrot or celery sticks, in your refrigerator and chew on them when you feel that you have to eat something outside of your mealtime. Cyclophosphamide, sometimes prescribed to SLE patients, can cause appetite loss or even nausea and vomiting. If this happens, let your doctor know and he or she can order another medicine for you to remove this unpleasant sensation.