diet for Rheumatoid Arthritis -
Is it Effective?

To understand whether a diet for rheumatoid arthritis (RA) is really effective, we need to grasp what causes the condition.

If you've read the previous page on the causes of rheumatoid arthritis, you'll realise that not all factors contributing to the condition are completely undestood, but most researchers agree that the disease develops as a consequence of an auto-immune response triggered by environmental factors in a genetically predisposed person.



Some of the risk factors associated with RA

  • being over weight
  • high consumption of the wrong type of fats (saturted fats, and excess of omega-6 fatty acids)
  • high consumption of sugary drinks high in fructose
  • higher consumption of protein and red meat
  • low intake of vegetables, olive oil and vitamins

According to researchers environmental factors responsible for development of RA may present and act even before disease symptoms become apparent, or patients start to have joint problems.

Obviously, we cannot do much to change the genetic component, but we can do a lot to alter the environment we live in, especially our diet. But is this approach effective in improving the symptoms?

Medications are the preferred method of treatment by doctors and patients alike, but unfortunately they have unwanted side effects or are often expensive. But if diet, to a degree, is responsible for triggering the symptoms, does it not make sense to try changing our diet first?

Several studies have shown that several diets can bring about an improvement of symptoms in RA patients and, in some cases, even remission, so you might want to try one of these first, or in addition to the medications recommended by your physician.

some suggested diets for rheumatoid arthritis

It seems that being overweight may increase inflammation aaffect the way the body responds to treatment and reduces the likelihood of disease remission, as well as increasing the risk of disease mortality.

There is increased evidence that people with RA suffer with an altered intestinal flora giving rise to several gastrointestinal problems, such as bloating, postprandial fullness (feeling full even after a small meal), nausea, early satiety (you are unable to eat a full meal), stomach pain, burning and belching, mucosal ulceration, and altered bowel habits (constipation/diarrhea), to name a few.

Many researchers put forward the "gut-joint axis" hypothesis, that is, they now believe that this altered microbiota is at the origin of the condition, not just another symptom of the disease, or consequence of medications.

With the increasing evidence of altered microbiota in the gut of RA patients being responsible for pathogenesis as well as disease progression, it makes sense for rheumatologists to advocate a supplemental diet therapy to RA patients, in other words, to adopt a diet for rheumatoid arthritis aimed at reducing inflammation and promoting intestinal health.

Let's look more closely at some of the suggested diets and nutrional interventions that have proven to provide beneficial long-term effects for relieving symptoms, delay disease progression and associated damage in RA patients.

Seven Days Fasting Followed by Vegan Diet

Several studies have observed that a 7–10 day fasting had an immunosuppression effect, relieving symptoms of RA compared to non-fasting groups.

A fasting of 7–10 days with partial nutrient intake of vegetable broth, herbal teas, parsley, garlic, and decoction of potatoes; juice extracts from carrots, beets, and celery; and a controlled daily energy intake followed by 1 year of a vegan diet as compared to omnivorous diet was studied in different trials. Together these studies observed remarkable decrease in swollen and tender joints, pain, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

The study reports clinically and statistically significant beneficial long-term effect on RA patients, which may be used as a treatment for the disease.

Therefore, fasting followed by vegan diet or vegan diet alone can potentially reduce symptoms and disease activity in RA patients independent of changes in intestinal microflora. Improvements observed can be attributed to reduced exposure to potential antigens contributed by the omnivorous diet of RA patients.

mediterranean diet

Diets high in oleic acid, omega-3 fatty acids, unrefined carbohydrates and phytochemicals, like the Mediterranean and Cretan diets, have been tested to see whether they would offer any benefits to RA patients.

And indeed they have! In one study, they administered a Cretan diet to RA patients, which included olive oil, cereals, fruits, vegetables, fish, legumes, less red meat, and moderate amounts of red wine, and the result was that inflammation was reduced, vitality and physical functions were improved.

Particularly beneficial is olive oil, rich in oleic acid, with properties very similar to omega-3 fish oils, and has similar anti-inflammatory effects, also reducing factors that contribute to joint damage.  Interstingly, studies have also shown that incorporating olive oil in the diet decreases the risk of developing RA.

Elemental diet

Another diet for rheumatoid arthritis is the elemental diet providing food in simplest form consisting of glucose, vitamins, trace elements, and essential amino acids. It's hypoallergenic, contains all nutrients for daily requirements, and is thought to cause fewer immune reactions.

In one study, this diet was as effective as taking 15 mg/day of oral prednisolone, a drug usually prescribed for RA, and provided improvement in early morning stiffness and pain. But unfortunately, there was a relapse of symptoms after the diet was discontinued, which really proved that food antigens play a role in the chain of events leading to the disease and development of symptoms.

Other studies also proved the same thing, proving that the aggravation of symptoms of RA may be an effect of certain food allergens that are absent in elemental diets.

Elimination Diet

An elimination diet for rheumatoid arhtitis has been suggested in order to identify components in your diet that might act as triggers. 

A damaged intestinal barrier could allow food components or micro-organisms to enter the blood stream, triggering inflammation, so any approach that encourages healing of the intestinal lining should be considered.

How can you find out what foods are aggravating your condition? This is where the elimination diet comes in. It's like conductiong an investigation to see which food or foods are responsible for your symptoms.

To have an idea on how to go about it please, have a look at this page Elimination Diet for IBS and Other Food Sensitivities. Although originally written to help you identify triggers for symtoms of IBS, it can be very uselful to highlight which foods have an effect on your RA symptoms.

diet for rheumatoid arthritis - Specific foods


Dietary fibre - Foods rich in dietary fibre, such as whole wheat and cereals in general, are recommended to maintain or re-establish good intestinal health. But, of course, you may need to determine wheher you tolerate these foods, or, indeed, they are the cause of your problems, hence the elimination diet mentioned earlier.

Fruits and vegetables - Diet rich in fruits have been found very beneficial in the reduction of RA symptoms, among other conditions. The phytochemicals present in all fruits can reduce oxidative strees and inflammation. 

Compounds that have been found to be very effective in the reduction of bone and cartilage destruction and to relieve symptoms of RA are:

  • Polyphenols in dried plums
  • Antocyanins in black rice, aubergine (eggplant), and balck soya beans
  • Resveratol from black grapes
  • Mangiferin in mangoes
  • Kaemferol in grapefruit
  • A mixture of epigallocatechin, tannin acid and quecitin (found in green tea and onions)
  • Coumarin in grapes, oranges, apples, tomatoes, spinach and potatoes
  • Genistin in soybeans
  • Beta-cryptoxanthin in freshly squeezed orange juice
  • Bromelain in pineapple

So really all antioxidant compounds found in abundance in fruits anf vegetables are excellent at reducing inflammation and symptoms of RA, which should encourage you to include as many as you can in your diet for rheumatoid arthritis.

Supplements that support joint health

Joint Support Formula

Delivers a combination of glucosamine hydrochloride, horsetail extract, MSM, boron and niacin, alongside manganese, which contributes to the normal formation of connective tissue.

Glucosamine HCl

Delivers 750mg vegetarian Glucosamine Hydrochloride per capsule. It is an important building block for cartilage tissue, a structural component within the skeleton that forms part of the connective tissues in joints between the bones such as the elbows, knees and ankles.

Supplements that support joint health

Joint Support Formula

Delivers a combination of glucosamine hydrochloride, horsetail extract, MSM, boron and niacin, alongside manganese, which contributes to the normal formation of connective tissue.

Glucosamine HCl

Delivers 750mg vegetarian Glucosamine Hydrochloride per capsule. It is an important building block for cartilage tissue, a structural component within the skeleton that forms part of the connective tissues in joints between the bones such as the elbows, knees and ankles.


Articles in the Arthritis Series:

Causes of Arthritis and Joint Pain

Osteoarthritis and Diet

Causes of Rheumatoid Arthritis

Diet for Rheumatoid Arthritis




References:

  1. Managing Rheumatoid Arthritis with Dietary Interventions - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682732/ by Shweta Khanna, Kumar Sagar Jaiswal, and Bhawna Gupta
  2. Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review - https://www.frontiersin.org/articles/10.3389/fnut.2019.00141/full by Jihad Alwarith1, Hana Kahleova, Emilie Rembert, Willy Yonas, Sara Dort, Manuel Calcagno, Nora Burgess, Lee Crosby and Neal D. Barnard
  3. The role of diet in rheumatoid arthritis - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142028/ by Marta Skoczynska and Jerzy Swierkot


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Supplements that can help combat inflammation


Antartic Krill Oil

Delivers highly bioavailable and sustainable natural sources of beneficial Omega 3 fatty acids EPA and DHA.

Evening Primrose Oil

High potency 1000mg Evening Primrose Oil containing 80mg Gamma-Linolenic Acid (GLA) per soft gel suitable for vegetarians and vegans.

Aloe Vera Juice

Nutrigold’s Aloe Vera whole leaf juice undergoes careful processing to ensure that the bioactive phytonutrients (including polysaccharides and polyphenols, vitamins and minerals) are maintained to the highest levels and in bioactive forms that can be utilised by the body.

Curcumin/Turmeric

This supplement has specific delivery system that increases absorption of total curcuminoids over standard curcumin by 46-times. This particular delivery format for the curcuminoids achieves a significantly higher level of absorption than traditional food use.

Alka Greens

Alka-Greens is a convenient and easy to blend alkalising greens powder formulation that can be enjoyed by all the family. Every ingredient in Alka-Greens powder is organically certified by the Soil Association. The improved formulation of Alka-Greens contains organic spinach powder instead of pre-sprouted barley so is naturally gluten-free.