Diet Recommendations for Rheumatoid Arthritis

Rheumatoid arthritis (RA) is n chronic inflammatory autoimmune disease that mostly affects the joints, although it can also affect other areas of your body. RA occurs when your body’s immune system mistakenly attacks healthy tissues causing pain, swelling, stiffness, and loss of function in the joints. While no one food or diet will cure RA, a well-balanced diet, alongside any necessary medications, can help to fight inflammation and improve your symptoms.

Foods to Eat if You Have RA

Many chronic diseases are strongly influenced by nutrition, including rheumatoid arthritis. People with rheumatoid arthritis can benefit from eating foods with anti-inflammatory properties, including foods rich in fiber, polyunsaturated fatty acids (PUFA), omega-3s, and antioxidants. 

Foods High In Fiber

Fiber plays an important role for people with RA because of its role in digestion, how your body processes vitamins, and the production of short-chain fatty acids (SCFA), which have anti-inflammatory effects. A high-fiber diet has a positive effect on your gut microbiota (the collection of bacteria and other microorganisms that live in your gastrointestinal system), which supports a healthy immune system.

Foods that are high in fiber include:

• Grains: Bulgur, spelt, teff, barley, oat, brown rice, popcorn
• Grain products: High-fiber cereal, whole wheat crackers, whole wheat tortillas
• Vegetables: Pumpkin, sweet potatoes, yam, broccoli, turnip greens, cauliflower, collard greens, kale, cabbage, okra, chard
• Fruits: Sapote, durian, guava, raspberries, blackberries, pear, kiwi, grapefruit, apples, bananas, coconut 
• Beans, nuts, and seeds: Navy beans, lima beans, lentils, pinto beans, kidney beans, chia seeds, almonds, chestnuts, sunflower seeds, flax seeds

Foods High In Omega-3 Fatty Acids

Omega-3 fatty acids are part of the “healthy fats” known as polyunsaturated fats. Your body cannot make omega-3s on its own, so it’s necessary to get these nutrients from your food. 

Omega 3s are especially important for people with RA because of their anti-inflammatory effects. Some studies have shown that omega-3 supplements can help manage RA, reduce swelling and tenderness, and can help reduce the need for pain-relief medication. However, more research is needed to determine the extent of their benefits.

Foods that are particularly high in omega-3 fatty acids include:

• Fatty fish: Sardines, salmon, seabeam, herring, mackerel, tuna, seabass, and trout
• Nuts and seeds: Flaxseed, chia seeds, walnuts
• Plant oils: Flaxseed oil, rapeseed oil, soybean oil, and canola oil
• Fortified foods: Certain brands of egg, yogurt, milk, soy beverages, and infant formulas

Foods High In Antioxidants

Antioxidants are substances that can help delay cell damage, which both naturally occurs over time and occurs due to environmental factors. Factors that can cause cell damage include oxygen deprivation (hypoxia), radiation, exposure to toxins, and diseases such as RA. 

Foods high in antioxidants are important for people with RA to consume because oxidative stress (which occurs when your antioxidant levels are low) and free radical activity (which causes cell damage) have an important role in the development and progression of RA. Consuming more antioxidants through food or supplements such as vitamins A, C, and E, flavonoids, and carotenoids may help decrease oxidative stress and free radical activity in people with RA.

Foods high in antioxidants include:

• Vitamins A and carotenoids: Beef liver, sweet potato, spinach, pumpkin, carrots, herring, tomatoes, fortified foods
• Vitamin C: Citrus fruits (oranges, grapefruit, red and green pepper, kiwi, broccoli, strawberries
• Flavonoids: Tea, fruit, vegetables, grains, legumes, nuts, and wine

Foods to Avoid

Just as certain nutrients can have anti-inflammatory properties, they can also cause the opposite effect: increasing inflammation. People with rheumatoid arthritis should avoid nutrients associated with higher levels of inflammation, including excessive fat (especially trans an saturated fat), sodium, and refined sugar.

Foods High in Fat 

Studies have shown that a high-fat diet can negatively affect those with RA, causing inflammation inside fat cells. A high-fat diet is also linked to changes in gut microbiota, some of which can further increase inflammation. Meanwhile, diets that are predominantly plant-based and low in saturated and trans fats can reduce inflammation and improve RA symptoms.

Foods high in fat include:

• Meats: Beef, lamb, pork, and poultry with skin
• Full-fat dairy products: Full-fat milk, yogurt, cheese, ice cream, and butter
• Some baked and fried foods: Fried chicken and french fries, among others

Foods High in Sodium

A diet high in sodium (salt) can trigger inflammation and, over time, contribute to the onset of RA. It is especially important for people with RA to reduce their intake of dietary sodium because corticosteroids, which are commonly prescribed to treat symptoms of RA, can cause your body to hold on to even more sodium.

Foods high in sodium include:

• Packaged, frozen, canned, and processed foods
• Fast foods such as pizza, pasta, and burgers
• Cold cuts and cured meat
• Soups

Foods High in Sugar

A high-sugar diet can contribute to the onset and faster progression of RA. Many people with RA have anti-citrullinated protein antibodies (ACPA) in their systems, which are a type of peptide that is often an early sign of RA. Some research suggests that consuming excess sugar can trigger your body to produce more ACPA.

In general, it is best to limit the amount of refined sugar you consume. However, people with RA should be especially conscientious of dietary sugars, including glucose, fructose, sucrose, and high-fructose corn syrup. inflammation.

Foods high in sugar include: 

• High fructose and sugar-sweetened beverages such as soda, juice, sports drinks, sweetened coffee, and sweetened tea
• Sauces and sweeteners such as barbecue, ketchup, spaghetti sauce, honey, maple syrup, and agave
• Baked goods such as cookies, cakes, and biscuits
• Sugary breakfast cereals, granola, or bars
• Low-fat foods such as low-fat yogurt

Meal Ideas for Rheumatoid Arthritis

Here are meal examples for someone with rheumatoid arthritis.

Breakfast

Here are simple and easy breakfast ideas:

• Greek yogurt topped with flaxseeds, walnuts, almonds, and fresh fruit
• Omelet cooked with olive oil with sauteed peppers, tomatoes, and spinach or other vegetables of your choice
• Avocado with whole wheat toast or wrap 
• Fruit and vegetable smoothie made with soy or almond milk
• Oatmeal with chia and berries

Lunch

Here are lunch ideas for people with rheumatoid arthritis:

• Chili, lentil, and/or bean soup topped with avocado 
• Baked sweet potato stuffed with beans and quinoa
• Greek salad topped with grilled fish 

Dinner

Here are dinner ideas for people with rheumatoid arthritis:

• Grilled fish with sauteed vegetables and quinoa
• Vegetable and tofu stir fry with cooked brown rice
• Roasted chicken and vegetables 

Diets for Rheumatoid Arthritis 

While there’s no specific diet for RA, the Mediterranean diet is most often encouraged for people with rheumatoid arthritis. The Mediterranean diet is rich in vegetables, unrefined cereals, fruit, legumes, fish, extra-virgin olive oil, and spices. It is also associated with a moderate intake of eggs, poultry, and dairy, and low amounts of refined sugar and red meat. This dietary pattern features a high intake of anti-inflammatory foods and food groups, including olive oil and red wine, which contain omega-3s and flavonoids.

Vegetarian and vegan diets have also been recommended for people with RA. Vegetarian diets reduce or eliminate animal products made from meat, such as poultry, fish, or beef, but many vegetarians eat other animal products such as eggs and dairy. Vegan diets consist of plants only. Vegetarian and vegan diets emphasize anti-inflammatory and high-fiber foods including vegetables, fruits, grains, legumes, and nuts, which can make them a healthy choice for people with RA.

Making significant dietary changes should always be done under the guidance of your healthcare provider. They may refer you to a nutritionist, or a healthcare provider who can counsel you on diets and eating patterns, for further discussion and evaluation.

A Quick Review

While there’s no specific diet for rheumatoid arthritis, nutrition can play a significant role in managing symptoms of this inflammatory disease. Foods that can help reduce inflammation include fruits, vegetables, nuts, legumes, and fatty fish. Foods that can aggravate inflammation include fatty meats and highly processed foods. Overall, a plant-centric diet, such as the Mediterranean diet, is most often recommended for managing rheumatoid arthritis.