People with rheumatoid arthritis (RA) know all too well the inflammation and pain that come with the disease. Although there’s no “RA diet" that treats the condition, some foods can lower inflammation in your body. And because they’re good for you, these foods — including fruits and vegetables, whole grains, olive oil, and fish — may help you feel better overall.
Is There an RA Diet?
No. But research shows that the Mediterranean diet’s tasty fare — like olive oil, fish, greens, and other vegetables — can lower inflammation, which is good for your whole body.
In one study of women with RA, those who took a cooking class on Mediterranean-style foods and ate that way for 2 months had less joint pain and morning stiffness and better overall health than those who didn’t take the class.
Aim to eat a healthy diet with:
- Lots of whole grains, vegetables, and fruits. They should make up two-thirds of your plate.
- Low-fat dairy and lean proteins, which should make up one-third
- Small amounts of saturated and trans fats
- A little sugar
- Limited alcohol
Although no food plans are proven to help with RA, you may read about some that claim to do so or about people with RA who say a diet worked for them.
Before you try one, it’s a good idea to discuss it with your doctor, especially if it calls for large doses of supplements or cuts out entire food groups.
Instead of getting fixated on fasting or finding the perfect foods, be sensible about eating. Don’t make huge changes to your diet. Don’t skip meals. Eat three healthy meals and a couple of small snacks a day, says M. Elaine Husni, MD, director of the Cleveland Clinic’s Arthritis and Musculoskeletal Treatment Center.
Omega-3 Fatty Acids
Omega-3 fatty acids may help with RA pain and morning stiffness. Omega-3s have a natural chemical that’s similar to some painkillers.
They also lower inflammation and cut down on “bad” LDL cholesterol and triglycerides. High levels of LDL cholesterol and triglycerides (fats in the blood) put you at risk for heart disease. Since RA makes heart disease more likely, you want to take every opportunity to keep your heart healthy.
Foods to Eat With RA
They’re packed with fiber, which can help lower your levels of C-reactive protein (CRP), a sign of inflammation. Beans also give you protein to keep the muscles around your joints strong. Red, kidney, and pinto beans are good sources of things like folic acid, magnesium, iron, zinc, and potassium, all of which can give your heart and immune system a boost.
Along with other green leafy veggies like spinach, Brussels sprouts, kale, Swiss chard, and bok choy, it’s full of vitamins like A, C, and K, which protect you from free radical damage. They’re also a great source of calcium, which keeps your bones strong.
Chemicals called anthocyanins are powerful antioxidants that help hold down inflammation. They also give cherries their bright color. You can find them in other purple and red fruits, too, like raspberries and blueberries.
Oranges, grapefruits, and limes are great sources of vitamin C, which leads to a strong immune system that can help hold off inflammatory diseases like RA.
Salmon, herring, sardines, mackerel, tuna, and anchovies are great sources of omega-3s. Salmon has the most, with up to 2 grams per 3-ounce serving. Don’t overcook it, because that can destroy more than half of the omega-3s. Bake or grill fish instead of frying it to preserve healthful fat. Try to eat it twice a week.
Don’t like fish? Walnuts, canola oil, and soybeans are rich in a different type of omega-3 fatty acid. Or ask your doctor about supplements.
Gingerol compounds, which give this root its flavor, also seem to be an anti-inflammatory. Studies in animals look promising, but scientists need to do more work on people before we’re sure.
This tasty drink offers polyphenols, which are antioxidants that may lower inflammation and slow cartilage destruction. It also has epigallocatechin-3 (EGCG), which stops production of molecules that lead to RA joint damage.
A natural chemical in olive oil stops the production of the chemicals that cause inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) lower inflammation by curbing the production of these same chemicals. Olive oil is also better for your heart than other cooking oils. Choose extra-virgin olive oil. It comes from the first pressing of the olive and has the most good-for-you nutrients.
It’s a source of omega-3 fatty acids that doesn’t taste fishy. Soybeans — think tofu or edamame — are a good option. They’re also packed with fiber and protein.
This yellow spice is a star ingredient in many Indian dishes. Curcumin is the compound in it that holds promise as an anti-inflammatory. It may work better to prevent swelling and pain than to treat it once it happens. But more work needs to be done to figure out just how much it helps.
When you eat more whole grains instead of processed ones (think brown rice instead of white), you may lower CRP levels. Whole-wheat pasta and breads also have antioxidants. Some people with rheumatoid arthritis have lower levels of selenium in their blood. Another advantage of eating whole grains is that their fiber fills you up, which makes it easier to manage your appetite. That can help you stay at a healthy weight so you don’t have extra pressure on your joints.
Should You Take Supplements?
RA makes you more likely to have low levels of vitamins B6, B12, C, D, and E, and magnesium, selenium, and zinc. Ask your doctor if you might need more of these from foods or supplements.
If you take methotrexate, your doctor may recommend folic acid supplements. They can help prevent side effects.
Foods to Avoid With RA
Red meat and dairy
They’re our main sources of saturated fats, which can cause inflammation in fat tissue. Other sources include full-fat dairy products, pasta dishes, and grain-based desserts.
The culprit here is omega-6 fatty acids. You want to cut down on them while you’re going for more omega-3s. They can lead to weight gain and joint inflammation if you overdo it. Sunflower, safflower, soy, and vegetable oils are also sources.
Fried food, fast food, and processed foods
They’re the major source of trans fats, which are created when hydrogen is added to vegetable oil to extend shelf life. They can trigger inflammation throughout your body. Plus, they raise bad cholesterol and lower the good type.
Not only is too much salt bad for your blood pressure, but if you have RA and take steroids, your body may hold on to it more easily. Aim for less than 1,500 milligrams a day.
It tells your body to release chemicals called cytokines that kick-start the inflammation process. Check food labels for words that end in “ose,” like fructose or sucrose.
It doesn’t mix well with your RA meds. Nonsteroidal anti-inflammatory drugs like ibuprofen and naproxen can cause stomach bleeding and ulcers on their own. Those odds go up when you add alcohol.
If you drink while you’re taking acetaminophen, leflunomide (Arava), or methotrexate, it could damage your liver.
Fried or grilled food
Meats cooked at a high temperature raise the level of advanced glycation end products (AGEs) in your blood. They show up in people with inflammation, though there isn’t a direct link with arthritis.
- Laura Feinblum, registered dietitian and certified dietitian-nutritionist; corporate dietitian, Con Edison; private practice, Westchester, NY.
- Shawn Talbott, PhD, research director, SupplementWatch.com.
- Nathan Wei, MD, rheumatologist, The Arthritis Treatment Center, Frederick, MD.
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- Clifton O. “Bing" Bingham, MD, director, Johns Hopkins Arthritis Center; associate professor of medicine, divisions of rheumatology and allergy, Department of Medicine, Johns Hopkins University, Baltimore.
- M. Elaine Husni, MD, vice chair of rheumatology; director, Arthritis and Musculoskeletal Treatment Center, Cleveland Clinic, Cleveland. OH.
- Ruchi Jain, MD, assistant professor of rheumatology, attending rheumatologist, Rush University Medical Center, Chicago.
- Johns Hopkins Arthritis Center: “Nutrition & Rheumatoid Arthritis."
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- Daniel J. Wallace, MD, assistant program director, rheumatology fellowship program, Cedars-Sinai Medical Center, Los Angeles.