Navigating the Dairy Dilemma with PMR
For those living with Polymyalgia Rheumatica (PMR), managing symptoms often extends beyond medication to include lifestyle adjustments, particularly diet. A key area of consideration is dairy consumption, specifically cheese. The relationship between cheese and PMR is twofold, and understanding both sides is crucial for making informed dietary choices.
The Case for Including Dairy: Protecting Bone Health
Long-term use of corticosteroids, such as prednisone, is a primary treatment for PMR. While highly effective in managing inflammation, these medications can lead to a significant loss of bone density over time, increasing the risk of osteoporosis and fractures. This makes obtaining adequate calcium and vitamin D essential for PMR patients.
Dairy products, including milk, yogurt, and cheese, are excellent sources of these vital nutrients. A modest intake of hard cheese can provide a considerable amount of daily calcium, helping to counteract the bone-thinning side effects of corticosteroids. Many dairy products are also fortified with vitamin D, further boosting their bone-protective benefits.
The Other Side: Dairy and Inflammation
Conversely, some individuals with inflammatory conditions, including PMR, report that dairy products may trigger or worsen their symptoms. This is often linked to the saturated fat content in high-fat cheeses. A meta-analysis examining the effects of dairy on inflammatory biomarkers showed mixed results, with some cross-over studies finding no significant effect on inflammation from dairy intake. However, personal sensitivity can vary greatly, and what affects one person may not affect another.
Furthermore, an anti-inflammatory diet is generally recommended for managing PMR. This dietary pattern, similar to the Mediterranean diet, emphasizes whole foods like fruits, vegetables, nuts, and healthy fats while limiting saturated fats, processed foods, and refined sugars. Because many types of cheese can be high in saturated fat and sodium, they may conflict with the overall goals of an anti-inflammatory eating plan.
Finding the Right Cheese for You
If you choose to include cheese in your PMR diet, there are several ways to minimize potential inflammatory effects while still reaping the benefits of calcium. Moderation is key, as is opting for certain types of cheese over others. Following an elimination diet can also help determine if dairy, or specific types of cheese, are problematic for your personal inflammation levels.
Cheese Types for PMR: A Comparative Guide
| Feature | Low-Fat Options | Fermented Options (Yogurt, aged cheeses) | High-Fat/Processed Options |
|---|---|---|---|
| Examples | Part-skim mozzarella, cottage cheese, feta | Goat cheese (chevre), Parmigiano Reggiano, Greek yogurt | Full-fat cheddar, American cheese, cream cheese |
| Inflammation Potential | Generally lower risk due to reduced saturated fat | May have anti-inflammatory or gut-health benefits for some; contains beneficial bacteria | Higher potential for inflammation due to high saturated fat |
| Calcium Content | High; an excellent source for bone health | Excellent, especially aged cheeses and yogurt | High, but comes with higher saturated fat content |
| Recommended Intake | Moderate portions, as part of a balanced diet | Moderate portions, as part of a balanced diet; can aid gut health | Limit or avoid, especially during flare-ups |
Beyond Cheese: Alternative Calcium Sources and a Wider Anti-Inflammatory Diet
Fortunately, cheese is not the only source of calcium. PMR patients can ensure they meet their daily calcium needs by incorporating a variety of foods into their diet.
- Leafy Greens: Kale, spinach, and broccoli are packed with calcium and other vital nutrients.
- Sardines and Salmon: These oily fish provide not only calcium but also anti-inflammatory omega-3 fatty acids.
- Fortified Foods: Many cereals, plant-based milks (like almond and soy), and juices are fortified with calcium and vitamin D.
- Nuts and Seeds: Almonds, chia seeds, and walnuts offer calcium, healthy fats, and antioxidants.
Adopting an overall anti-inflammatory diet is the most effective nutritional strategy for managing PMR. This means focusing on whole, unprocessed foods and reducing or eliminating those that trigger inflammation. A balanced plate of fruits, vegetables, whole grains, and healthy proteins supports the body's natural defenses against inflammation.
Conclusion
So, can you eat cheese with PMR? The answer is not a simple yes or no. For many, moderate consumption of low-fat or fermented cheese may be an acceptable way to get vital calcium, especially while on corticosteroids. However, if you notice that cheese consumption triggers your symptoms, or if your overall diet is high in saturated fats, it may be best to limit it. A diet centered on anti-inflammatory whole foods, with an emphasis on calcium-rich sources, is the most beneficial approach for managing PMR symptoms and supporting overall health. For personalized guidance, always consult with your rheumatologist or a registered dietitian. You can find more information about PMR and diet from reputable sources, like the Mayo Clinic.
