The Best Diet For Rheumatoid Arthritis: Reviewing The Evidence


Published:

Rheumatoid arthritis is one of the most common autoimmune diseases. It affects up to 1.3% of the population worldwide, mostly women. New research indicates that diet may influence traditional treatments for rheumatoid arthritis. This article summarizes the current science and recommendations.

What Is Rheumatoid Arthritis?

Rheumatoid arthritis affects the structure and function of the joints.

A membrane called the synovium lines the joints, creating space and fluid for lubrication and movement.

In rheumatoid arthritis, the immune system attacks the synovium. This leads to an inflammatory immune response that causes pain, joint deformity and disability as it progresses (1).

The exact cause of rheumatoid arthritis remains unknown, but genetics and health of our gut bacteria appears to play a strong role. That said, those who carry the genes may never develop the disease.

Symptoms Of Rheumatoid Arthritis

Common signs and symptoms of rheumatoid arthritis include:

  • Joint pain or tenderness
  • Redness or swelling in the joints
  • Joint stiffness, especially in the morning
  • Low-grade fever
  • Fatigue
  • Anemia (low red blood cell count)
  • Firm lumps under the skin
  • Poor joint mobility.

Rheumatoid arthritis symptoms may occur in “flares”, during which symptoms appear or worsen for a period of days to weeks.

If you’re experiencing two or more of these symptoms please speak with your doctor. Left untreated it can cause permanent bone and joint damage within the first year.

Possible Foods To Avoid With Rheumatoid Arthritis

Medication is the first line of treatment for rheumatoid arthritis. This includes non-steroidal anti-inflammatory drugs (NSAIDs), anti-rheumatic drugs (DMARDs), and corticosteroids.

However, early research and patient anecdotes suggest some pharmaceuticals and eating patterns can influence disease activity as well. This includes drugs such as adderall, and foods such as gluten and dairy.

Gluten

Those with an autoimmune disease, including rheumatoid arthritis, are more likely to produce anti-gluten antibodies (2, 3). These are the same antibodies seen in celiac disease, which is why celiacs must strictly avoid gluten.

Researchers are unsure how gluten would directly impact rheumatoid arthritis, but it could be related to increased intestinal permeability or “leaky gut”. Some small studies have found benefits with a gluten-free diet, while others found no difference (4, 5).

It seems that those who are producing anti-gluten antibodies will directly benefit from a gluten-free diet. For others, it will be an indirect benefit from cutting out junk foods that often contain gluten.

Eggs and Dairy

Early research suggests that egg and milk consumption may be problematic. These foods produces certain immune antibodies and inflammatory markers associated with rheumatoid arthritis symptoms, at least in rodents (6).

However, these effects are related to food allergy, as opposed to gluten which is a food intolerance. Therefore unless the individual already had symptoms of egg or milk allergy, it’s most likely not an issue.

For this reason, if you suspect any food allergy or intolerance, see your doctor to be tested. Keeping a food and symptom journal is also helpful (a sample can be seen here).

Foods And Nutrients That May Help

The addition of certain foods and nutrients may help reduce rheumatoid arthritis inflammation. Most studies have used supplements rather than whole food sources, as a high nutrient dose is often required. Note that patients should not add supplements without medical supervision due to the risk of drug interactions and side effects.

Omega-3s Fatty Acids

Omega-3 fats (especially DHA and EPA) from fish oil are known to have anti-inflammatory effects. In a study of 140 rheumatoid arthritis patients, one group had 5.5 grams of fish oil per day while the second group (control) had only 0.4 grams of fish oil per day. All participants were also given several anti-rheumetic drugs throughout the study. Both groups experienced a decrease in disease activity, but the first group had higher rates of remission (relief from symptoms) (7).

Change in rheumatoid arthritis activity (DAS28-ESR) and modified Health Assessment Questionnaire (mHAQ) over 1 year. Lower score is better.

So it appears that a fish oil dose of at least 2.7 grams of DHA plus EPA daily can boost the effectiveness of anti-rheumetic, at least in the first 6 months. An earlier fish oil study also found similar benefits. Interestingly, the effect was much stronger when paired with a largely vegetarian diet (low in arachidonic acid) (8). Note that fish oil supplements may interact negatively with certain rheumatoid arthritis drugs, so always speak with your doctor first.

Vitamin K2

New research suggests a specific form of vitamin K2 (also called MK-7) can help improve the effectiveness of rheumatoid arthritis medication. Out of 84 rheumatoid arthritis patients, the first group received 100 mcg/day of MK-7 for 3 months, while the second group received dummy pills.

The first group had large improvements for markers of inflammation and disease activity score assessment. Additionally, MK-7 use increased the level of the active form of osteocalcin, an important marker of bone health (9).

It’s currently unknown if food sources of vitamin K2 have the same effects.

Vitamin D and Calcium

Those with rheumatoid arthritis are at increased risk of bone disease because of chronic inflammation, decreased physical activity, and use of corticosteroids. While vitamin D and calcium do not appear to directly affect rheumatoid arthritis risk or symptoms, it’s important to maintain adequate levels to reduce risk of fractures (10, 11, 12).

Vitamin D is fundamental for good health and yet is the number one nutrient deficiency in the Western world. Where adequate sun exposure is not possible, vitamin D + calcium supplements are strongly recommended. Food sources are also recommended, including fatty fish, egg yolks, fortified milk, and offal.

What Is The Best Diet Or Eating Pattern For Rheumatoid Arthritis?

Vegetarian Diet

Limited evidence suggests that vegetarian and vegan diets are beneficial on their own (13, 14). In fact, many of the studies that endorse a vegetarian diet include more than one intervention for rheumatoid arthritis, such as fish oil, physical therapy or fasting (5, 8, 13). Vegetarian diets also tend to be lower in omega-3 fats and vitamin D, nutrients that could be significant in rheumatoid arthritis (15).

Some may also find vegetarian diets overly restrictive if the sole purpose is for health reasons.

Paleo Diet

The Paleo Diet is an eating pattern that eliminates several food groups. This includes wheat (gluten) and dairy, known to cause inflammation in some people.

Anecdotal (self-reported) evidence indicates a Paleo diet helps with rheumatoid arthritis. This is likely because those sensitive to either gluten or dairy will immediately notice improvements. Rheumatoid arthritis disease activity (DAS28 score) at baseline and at weeks 6 and 12 of Mediterranean diet vs control diet. Lower score is better. Click to enlarge.It’s also rich in omega-3 fats and cuts out junk food, which can only be beneficial.

Unfortunately the Paleo diet also recommends cutting out affordable, nutritious foods such as legumes and potatoes, which is unnecessary.

Mediterranean Diet

The Mediterranean diet consists of traditional foods that those in countries like Croatia and Greece ate before the 1970s. It emphasizes fruits, vegetables, legumes, whole grains, olive oil, and seafood. It’s shown promise for treating rheumatoid arthritis, possibly due to its favorable ratio of omega-3 fats to arachidonic acid (13).

In a 3-month study of 51 rheumatoid arthritis patients, one group followed a Mediterranean diet while the control group ate a standard Western diet.

As you can see in the graph, the Mediterranean diet group showed large improvements in physical function and vitality (16).

Sample 3-Day Diet Plan for Rheumatoid Arthritis

The following is a sample meal plan based on the research summarized above. It excludes gluten and incorporates principles from the Mediterranean diet.

Water is the preferred beverage with all meals.

Day 1

  • Breakfast: ¼ cup rolled oats cooked in water (or milk), topped with ½ banana. (Oats are naturally gluten-free, but purchasing a gluten-free variety ensures the product was not exposed to gluten-containing foods during packaging.)
  • Lunch: Lentil salad, 1 small apple.
  • Dinner: 4 ounces oven-roasted salmon, 1/2 cup rice (cooked), ½ cup asparagus roasted in olive oil.

Day 2

Day 3

Summarizing The Best Diet For Rheumatoid Arthritis

There is compelling evidence that diet changes can complement traditional medical treatment of autoimmune disease. The Mediterranean diet in particular appears the most useful and well-studied diet for rheumatoid arthritis.

Patients with suspected food allergies or intolerances may benefit from eliminating gluten from their diet. Dairy and eggs may also cause problems, but this is based on weak evidence. At the very least it’s worth trialling a gluten-free diet for one month to see if symptoms improve.

Fish oil and vitamin K2 supplementation may also help combat inflammation, and are certainly worth a try alongside rheumatoid arthritis medications.

But due to the risk of side effects or drug interactions, be sure to speak with your doctor before starting a new meal plan or supplement.

Kim Yawitz is a registered dietitian and nutritionist in St. Louis, Missouri. She currently works with sports nutrition and weight management clients for a private practice. Prior to that Kim worked as an inpatient clinical dietitian, developing nutrition care plans for patients with health concerns ranging from autoimmune disease to critical illness.

This article was republished from Diet v.s. Disease.

See also:
What Does The Environment Have To Do With Diseases That Affect The Immune System?
Baking Soda — An Inexpensive Treatment Aid For Autoimmune Diseases Like Arthritis

Edit Module
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags

Daily Astrology

September 24, 2019

Before sunrise the Moon enters Leo where she harmonizes with the Libra Sun and puts the day on comfortable footing. Everyone is a star in some way. Mental Mercury is also in a fine sextile with optimistic Jupiter today. Mental faculties are sharp and…
Edit ModuleShow Tags

Alternative Health Directory

Browse all listings »

Edit ModuleShow Tags
Edit ModuleShow Tags

Calendar

September 2019

It’s time for a workshop!  One plus one always equals two. In a similar fashion EFT plus Law of Attraction always equals effective and positive change. Teaching Emotional Freedom...

Cost: $40

Where:
21 Wiles Farm Road
Northboro, MA
View map »


Sponsor: Medicine My Way
Telephone: 508-523-7132
Website »

More information

In this 90 minute workshop you will find clarity in what brings you joy. You will create your personal vision statement that will help guide you to living a more satisfied, balanced life. This...

Cost: $25 early-bird till 9/20 ($30 after)

Where:
Sohum Yoga and Meditation Studio
30 Lyman Street, Suite 108B
Westborough shopping center
Westborough, MA  01581
View map »


Sponsor: www.SOHUM.org
Telephone: 508-329-3338
Contact Name: Ritu Kapur
Website »

More information

Witness the healing power of mediumship! Join New England's own trusted spirit medium Raylene Sousa and top UK medium Dominic Boag from Scotland for an afternoon of spirit messages. If...

Cost: $40

Where:
The Little Meetinghouse
723 Roosevelt Trail
Windham, ME  04062
View map »


Sponsor: Raylene Sousa Medium LLC
Telephone: 207-956-0220
Contact Name: Raylene Sousa
Website »

More information

Come shine with us! Join us in harmony and in our goal to bring the light of Spiritualism forward to all those who are searching.

Where:
VFW Post 2597
775 Boston Rd, Rt 3A
Billerica, MA
View map »


Sponsor: The Spiritualist Fellowship Church Of New England
Website »

More information

Show More...
Show Less...

2nd and 4th Monday of every month This psychic message circle is for anyone wishing to raise their connection using their psychic centers known as the “clairs.” Learn how to use...

Cost: $20

Where:
Messages From Heaven Healing and Learning Center
646 Central Street
Suite 3
Leominster, MA
View map »


Website »

More information

Show More...
Show Less...

Members of the Reflexology Association of NH will be offering “mini” hand or foot reflexology sessions at the Salt Cave within Bien Soigne in honor of World Reflexology Week.

Cost: Donations suggested $15 - $20

Where:
Bien Soigne Salt Cave
350 North Broadway
Salem, NH  03079
View map »


Sponsor: Reflexology Association of NH
Website »

More information

Show More...
Show Less...

September 25–October 29, 2019 Expert Tai Chi instructor and Qigong Master Instructor Terry Dunn will be giving a total of four five-day intensive workshops in October 2019 at Eastover...

Where:
Eastover Estate & Retreat
430 East Street
Lenox, MA  01240
View map »


Telephone: 866-264-5139
Website »

More information

Show More...
Show Less...

September 26–29 This training at the Center for Mindfulness and Mindfulness-Based Cognitive Therapy (MBCT) uses mindfulness meditation and cognitive therapy to break the cycle of...

Cost: $1,390

Where:
Center for Mindfulness and Compassion
1035 Cambridge St, Suite 21A
Cambridge, MA  02141
View map »


Sponsor: Center for Mindfulness and Compassion
Telephone: 617-591-6132
Contact Name: Center for Mindfulness and Compassion
Website »

More information

Come detox, relax and renew yourself for the fall in our sanctuary! We have an intimate gathering of great readers and healers providing services at sampler rates to enjoy their services while...

Cost: $60: 3 Pack Service Special; $25: Single Service

Where:
Healing Power Of Flowers—Heaven and Earth
68 Stiles Rd
Salem, NH  03079
View map »


Sponsor: The Healing Power of Flowers - Heaven and Earth
Telephone: 603-275-7688
Contact Name: Stacey Smith
Website »

More information

Mirabai Starr was an adjunct professor of Philosophy and World Religions at the University of New Mexico-Taos for 20 years. Her emphasis has always been on making connections between the perennial...

Cost: $20

Where:
First Parish in Lexington
7 Harrington Road
Lexington, MA  02420
View map »


Sponsor: Lexington Community Education
Telephone: 781-862-8043
Contact Name: Craig Hall
Website »

More information

Show More...
Show Less...

Maryellen Labelle, David Sholemson and Steve Cunningham are excited to announce Qigong for Inner Peace teacher training fall term 2019. This 50 hour certification training is appropriate for a wide...

Cost: $1100 / $800 early registration

Where:
Yoga Depot
17 Depot Square
Lexington, MA  02420
View map »


Sponsor: Qigong for Inner Peace
Telephone: 617-721-7215
Contact Name: Maryellen Labelle / David Sholemson
Website »

More information

Join life coach Cheryl Richardson and her husband, Michael Gerrish, a psychotherapist and gifted intuitive, for a special evening designed to help you upgrade your life! During this event,...

Cost: $35

Where:
Circles of Wisdom
386 Merrimack Street
Suite 1A
Methuen, MA  01844
View map »


Sponsor: Circles of Wisdom
Telephone: 978-474-8010
Contact Name: Cathy Kneeland
Website »

More information

This Dating Program is the follow-up to Kerri Morrison's workshop, Deliberate Dating: 5 Keys to Successful Online Romance; held Friday, August 16th, 2019 from 6:30-7:30pm. View that event...

Cost: $199

Where:
Awaken Holistic Counseling Services
2 Liberty St., Unit 2L
Newburyport, MA  01950
View map »


Sponsor: Awaken Holistic Counseling Services, LLC
Telephone: 978-255-7893
Contact Name: Kerri Morrison
Website »

More information

Show More...
Show Less...

Learn Reiki—revitalizing self-care and healing in the palm of your hands. Facilitated by Lou Orsan, Reiki Shihan (master teacher.) This one-day class covers the...

Cost: $150

Where:
Northeast Reiki Center
61 Nicholas Road
Framingham, MA  01701
View map »


Sponsor: Northeast Reiki Center
Telephone: 508-808-5696
Contact Name: Lou Orsan
Website »

More information

With Laura Haley, IET Master Instructor Trainer  This class provides you with everything you need to conduct a powerful Integrated Energy Therapy session on yourself or others (either in...

Where:
Circles of Wisdom
Methuen, MA


Telephone: (978) 474-8010
Website »

More information

Learn the benefits of yoga for families as well as how to develop character in children to get them more focused, respectful, and confident before returning back to school this fall! This class...

Cost: $45 early bird till 9/25 (includes child and a parent), $50 after

Where:
Sohum Yoga and Meditation Studio
30 Lyman Street, Suite 108B
Westborough shopping center
Westborough, MA  01581
View map »


Sponsor: www.SOHUM.org
Telephone: 508-329-3338
Contact Name: Ritu Kapur
Website »

More information

September 28–29 Saturday 10 am Registration; 10 am–5 pm  Sunday 10 am–5 pm This practitioner training takes place over 2 days and offers students the opportunity to...

Cost: Course Fee: $450; Recalibration Appointment: $333

Where:
The Hampton Inn Coventry Warwick
850 Centre Of New England Boulevard
Coventry, RI
View map »


Telephone: 617-366-6042
Website »

More information

September 28–29 Learn hands-on techniques for the cervical, thoracic and lumbar spine, as well as the sacrum, psoas and ilium. Leave with tools you can use right away. Coming in...

Where:
Downeast School of Massage
Waldoboro, ME


Telephone: (617) 678-8920
Website »

More information

Learn to overcome spinal tensions through therapeutic postures, designed to decompress your spine and relieve pain. Taught by a certified yoga therapist, classes bring you through poses...

Cost: 5/$50

Where:
Bliss Through Yoga
484 Bedford St
East Bridgewater, MA  02333
View map »


Telephone: 508-331-3564
Contact Name: Janice O'Brien
Website »

More information

Show More...
Show Less...
Edit ModuleShow Tags
Edit Module Edit ModuleShow Tags