QUESTION: I have arthritis in my knees and hips and have a hard time tolerating prescription meds for arthritis. I have tried glucosamine, but it hasn't worked for me. Are there any other alternative therapies that you'd recommend?ANSWER: Many foods, herbs and botanical supplements have been studied for their effectiveness in treating inflammation and pain. A study published last year in the Indian Journal of Pharmacology looked at the effectiveness of boswellia (Boswellia serrata extract, or BSE) for arthritis pain. Boswellia is an herb that has been used in Aryuvedic medicine in India to treat infections and inflammation.Research has shown that the composition of our diets has a significant influence on inflammation in the body. Fatty acids from in our foods are metabolized via several pathways in the body.Healthy fatty acids like the omega-3 acids found in fish are metabolized into chemicals that inhibit inflammation. Fatty acids from animal foods, and also from vegetable oils (especially oils that have been turned into trans-fats) are shunted into inflammatory chemicals via one of two main pathways: COX and LOX.You've probably heard the term COX-inhibitor before; COX inhibitors are also called non-steroidal anti-inflammatory drugs (NSAIDs) and include medicines like aspirin and ibuprofen; these meds are used for inflammation and pain. COX-2 inhibitors like Bextra, Vioxx and Celebrex are more specific inflammation blockers that don't usually cause the stomach upset that meds like ibuprofen can.Unfortunately, almost all of these meds have been shown to increase the risk of heart attack and stroke, so they are now used with caution (in fact, Bextra and Vioxx were pulled off the U.S. market between 2004 and 2005, and Bextra is now banned in India as well).LOX inhibitors are the other class of anti-inflammatories but are not widely available as prescription drugs. The good news is that there are a number of foods and botanical supplements that work by inhibiting both COX and LOX enzymes; boswellia is one such herb.What else can you do to reduce inflammation and pain? Reduce the amount of fat in your diet, especially animal fat and trans-fats, and replace them with healthy omega-3 fats instead this will lower your inflammation burden and hopefully lessen your need for drugs or herbal remedies.And don't forget to eat plenty of dark-colored fruits and veggies which are loaded with more of nature's inflammation blockers.Drs. Kay Judge and Maxine Barish-Wreden are medical directors of Sutter Downtown Integrative Medicine program in Sacramento, Calif. Have a question related to alternative medicine? E-mail adrenalinesacbee.com.