Rheumatoid Arthritis Diet Rules to Follow
There is no medication and no alternative remedy that can cure rheumatoid arthritis (RA). However, taking medications as prescribed and following the advice of your doctor can decrease inflammation. Likewise, eating the right foods can help you to manage RA symptoms.
The best diet for people with RA — or anyone who wants to eat healthy — is a one that is well-balanced.
What is a Healthy and Well-Balanced Diet?
A healthy and balanced diet gives your body all the vital nutrients it needs to function well.
According to the Dietary Guidelines for Americans, a healthy and balanced diet has certain requirements:
- A variety of vegetables.
- Whole grains.
- Fat-free and low-fat dairy.
- A variety of proteins, including seafood, lean meats, soy products, nuts and seeds.
Two-thirds of your diet should consist of fruits, vegetables and whole grains. The other one-third should come from low-fat dairy and lean proteins.
People with RA should always try to eat real food and avoid processed foods that contain huge amounts of preservatives, extra sugars and saturated fats. The more you work on controlling eating habits, the less RA pain and symptoms you will experience.
Connection Between Rheumatoid Arthritis and Diet
There aren’t enough studies to confirm a definitive link between RA and diet, but studies have shown inflammation is connected to certain foods. Foods that are considered anti-inflammatory, including fruits, vegetables and omega-3 fatty acids, may improve RA symptoms and possibly reduce the number of disease flare-ups.
Two studies, presented at the 2015 American College of Rheumatology annual meeting suggest a connection between the development of RA and diet. The first study looked at over 93,000 women, ages 25 to 45, who shared their diet habits over a period of four years, and during that time 347 women developed RA. Most of the women who were diagnosed with RA ate a diet high in red and processed meats, fried foods, high-fat dairy and sugars. This was compared to the women who ate a healthier and more nutritious diet and who didn’t develop the disease.
The second study investigated how the American Dietary Guidelines affected the risk for RA in young and middle-aged women. What they found was women who followed these dietary guidelines had a decreased risk for RA and other chronic diseases.
If RA is a culprit in disease development, it is also possible symptoms can be reduced in patients who currently have the condition if they make simple and good health choices.
In fact, recent survey results published in the Arthritis Care & Research found at least one-quarter of people with longstanding RA were reporting a connection with diet and RA symptoms. The results came from a survey of 300 subjects who were asked if they ate specific foods and how these foods affected their RA.
Benefits of an RA-Friendly Diet
It is possible that a diet rich in fruits and vegetables and low in saturated fats can help you to manage your RA symptoms. While research on a specific diet has been limited, people who eliminated certain foods from their diets — red and processed meats, caffeine, dairy, etc. — have reported symptom improvement.
It seems avoiding certain foods with RA is an option worth trying. Of course, it is not a good idea to exclude an entire food group or too many foods without first talking to your doctor or a dietician.
Adding certain foods to your diet also helps. Foods rich in vitamin D, fish and other anti-inflammatory foods have been helpful in reducing inflammation related to RA.
You should also reduce the amount of and the type of fats you use when cooking. One reason is because RA is associated with a higher risk for heart disease. A second reason is because certain fats – or too much fat — influence levels of joint pain and inflammation.
Rheumatoid Arthritis Diet Tips
The role of diet and its influence on RA symptoms is controversial, but many foods and supplements have been tried by others with RA who have reported good results. There is even some research confirming the role some foods and supplements play as part of an RA-friendly diet.
1. Omega-3 Fatty Acids
Foods high in omega-3 fatty acids have inflammation-fighting qualities. In fact, one recent report published in Arthritis Care & Research finds eating fish two or more times a week is linked to lower disease activity in people with RA.
Sources of omega-3 fatty acids include fish sources (salmon, mackerel, tuna and sardines), ground flax and flaxseed oil and walnuts. Fish oil supplements are also a good way to get your omega-3 fatty acids but they can cause unpleasant stomach and intestinal side effects.
2. Saturated and Trans Fats
There are some studies indicating a link between inflammation from statured fats found in red meat and full-fat dairy products. Similar arguments have been made for trans fats, which are found in hydrated oils, margarine and fried foods.
Monounsaturated fats, like olive oil, are less likely to increase inflammation. While there isn’t a daily intake recommendation for monounsaturated fats, they can replace saturated and trans fats, provided they are used in moderation.
3. Vitamin D
Research has linked low vitamin D levels to increased risk of RA. Studies also show RA symptoms tend to be worse in people with low levels of vitamin D.
One report, published in Therapeutic Advances in Endocrinology and Metabolism, finds vitamin D deficiency is widespread among people with RA and that vitamin D supplementation can offer pain relief.
The Office of Dietary Supplements in the U.S. recommends 4,000 international units (IUs) of vitamin D for ages 9 and up. Reduced doses are recommended for children aged 8 and younger.
Few foods are rich in vitamin D and include oily fish and fortified milk and juice. Most people need daily supplements and sunlight a few times per week to maintain adequate levels of vitamin D.
4. The Mediterranean Diet
Many people who are seeking to decrease inflammation have adopted the Mediterranean diet, so it should come as no shock that this diet plan may also decrease symptoms for RA sufferers.
So, what does the Mediterranean diet entail? The Mediterranean diet is rich in fats and fiber. Omega-3 fatty acids from fish are a staple; primary choices include salmon, sardines, herring and anchovies.
Olive oil is also prominent. The fats in fish and olive oil are good fat and can help lower chemicals in the body that cause inflammation.
Fruits and vegetables are also a main component of the diet. These are essential because they are rich in antioxidants, which are known to decrease inflammation. Fruits and vegetables that are bright in color tend to be higher in antioxidant levels; excellent choices include berries, sweet potatoes, oranges, melons, broccoli, tomatoes and carrots.
In general, supplements should be taken only with the approval of your doctor. Supplements may interact with medications, so it best to get the go ahead.
It is also best to get the necessary nutrients from foods, if possible. However, sometimes supplementation may prove beneficial.
According to the Arthritis Foundation, a selenium supplement is believed to help control inflammation because it is an antioxidant. Selenium is found naturally in whole-wheat foods. However, it may increase the risk of developing diabetes, so pros and cons should be weighed with your doctor and those who have diabetes may not want to take this supplement.
Vitamin D may help older women to ward off rheumatoid arthritis because it is known to boost immune function. It can be taken as a supplement or can be consumed by eating foods rich in vitamin D. There are not a lot of foods that contain vitamin D, but foods that contain this vitamin include mushrooms, egg yolks, and fortified foods such as bread, milk and juice.
For some RA patients, eliminating some foods from their diet has helped, as certain foods may promote inflammation and worsen RA pain.
Here are some of the foods I limit or have completely removed from my diet that may exacerbate inflammation, pain and other RA symptoms:
6. Fried and Processed Foods
My experience with fried and processed foods is they increase my RA symptoms and pain. Research from Mount Sinai School of Medicine confirms cutting back on fried and processed foods can help reduce inflammation and restore your body’s natural defenses regardless of your age or health.
7. Red Meat
My RA symptoms seem to worsen when I eat red meat more than once in a week, and research has shown red meat can worsen inflammation in some people.
Red meat worsens RA symptoms because it contains omega-6 fatty acids, which are contributors to inflammation especially when intake is too high. Lean red meat is a better option because it provides protein and the nutrients you need without the added inflammation.
While milk, cheese and yogurt are healthy options, they contain proteins that irritate joint tissues. I have had to substitute these for non-dairy options as these appear to be trigger foods.
Foods substitutes for dairy include spinach, tofu, beans, lentils and quinoa. Alternatives to dairy milk include soy, rice and almond milk.
9. Refined Sugars and Sweets
Spikes in blood sugar prompt the body to produce cytokines, which promote inflammation. Moreover, sweets and foods containing refined sugars can cause you to gain weight and put stress on your joints.
Foods containing refined sugars have been triggers for my RA symptoms, and while they taste good, I choose to eat natural sugars (fruits) and unsweetened foods that help me rather than cause me physical pain.
While I have eliminated most caffeine sources (e.g. soda and energy drinks) from my diet, coffee has been difficult to completely cut out and I am quite stubborn about switching to decaffeinated coffee. I do, however, limit myself to one or two cups of coffee per day.
At least one study – published in the medical journal, Arthritis Research & Therapy – finds a connection between excessive caffeine consumption and the development of RA. Further, the research shows RF-positive RA is linked to coffee consumption. (The rheumatoid factor, or RF, is a protein that causes the immune system to attack healthy tissues.)
While research on the link between RA and caffeine consumption is still developing, you may want to consider cutting or limiting caffeine from your diet to see if this minimizes RA symptoms.
Gluten is the protein found in wheat and grains. Some people with RA are also gluten sensitive, which means eating gluten causes them increased joint inflammation. Gluten sensitivity in RA is a controversial topic but some people do find relief after removing or minimizing gluten from their diets.
If you find consuming foods containing gluten increases your RA pain, you should try reducing or eliminating gluten from your diet to see if this helps with reducing inflammation and pain.
12. Refined Carbohydrates
Foods like white bread, white rice and pasta are inflammation triggers for me. This is because they are made with white flour, which stimulates inflammatory responses.
Switching to healthier alternatives, such as corn flour and brown rice flour, can help to keep RA inflammation and pain at bay.
Foods That Increase Inflammation
Just as there are foods known to decrease inflammation in the body, there are also foods known to increase inflammation, such as:
- Grilled foods. Grilling foods may cause inflammation, as grilling can increase advanced glycation end products (AGEs).
- Omega-6 fatty acids. Consuming omega-6 fatty acids may also contribute to inflammation. These are easily confused with omega-3 fatty acids, but they are not the same thing. In addition to increased inflammation, omega-6 fatty acids may also contribute to joint inflammation and obesity. Foods that contain omega-6 fatty acids include oils, such as corn, sunflower, safflower and sunflower oils. Snack foods and fried foods may also contain omega-6 fatty acids.
While there is no specific diet for RA, the best diet is one that is balanced, ensures protection against severe disease outcomes and minimizes your risk for RA complications. This means living with RA can be made easier when you eat healthy and whole foods.
To make your diet RA friendly, make sure you include fruits, vegetables, healthy meats, low-fat dairy and whole grains. You should also avoid foods that make RA symptoms worse, such as processed and fried foods, refined sugars and red meat.