“The typical Western diet has a heavy reliance on high-fat, high-sugar, processed foods that promote an inflammatory state, which may contribute to a number of chronic health conditions,” says Janet Lewis, MD, associate professor of internal medicine and chief of the division of rheumatology at the University of Virginia School of Medicine in Charlottesville. “If someone comes to us with RA, we evaluate their diet and try to clean it up," adds Linda Antinoro, RD, a registered dietitian with Brigham and Women’s Hospital in Boston. This means including whole foods as often as possible and removing refined or processed foods. An article published in September 2019 in the journal Frontiers in Nutrition that reviewed the latest thinking in managing RA with diet agrees. The article recommends that people with RA avoid animal products, and emphasized that the fiber found in plant-based foods can improve gut bacteria, thus reducing inflammation and joint pain.
The Mediterranean Diet: A Winner for RA
The Mediterranean diet is highly recommended when it comes to fighting RA inflammation — in part because it integrates so many of these RA-friendly foods in one meal plan. “This is the diet that we focus on most — all of the individual components have anti-inflammatory properties,” explains Antinoro. Based on the foods that are easily accessible to people living in countries around the Mediterranean Sea, this way of eating focuses on whole grains, fruits, vegetables, and healthy fats such as olive oil, nuts, legumes, and fish. It’s also the dietary approach with the most research to support it. According to a review of studies published in May 2018 in the journal Rheumatology International, the Mediterranean diet can reduce pain and increase physical function in people living with RA. In general, polyunsaturated fats and antioxidants, found in many foods included in the Mediterranean diet, are helpful.
What About Other Special Diets?
People with RA report mixed success with other special diet plans. Antinoro points out that feeling better after making a dietary switch may be due, in part, to the fact that if you’re eating more whole foods, you end up with fewer refined and processed foods going in to your body. Other special diets people with RA may try include:
Vegan By excluding all animal products, including meat, dairy, cheese, eggs, and fish, and focusing on vegetables, fruits, and grains, this diet can help reduce inflammation, and it may help ease joint pain and other symptoms. But it can be tricky to get the right amount of fats, protein, and calcium if you’re on a fully plant-based diet. Antinoro suggests that people considering a vegan diet work with a dietitian to make sure they’re still getting all necessary nutrients.Paleo Based on how our hunter-gatherer ancestors ate, this diet includes grass-fed meat, fish, fruit, and vegetables and excludes legumes, dairy, and grains. But the jury’s still out on whether it’s a good choice for people with autoimmune conditions like RA, as there are no current studies to prove or disprove its benefits for arthritis. “I support the fruit, vegetable, fish, and grass-fed meat components, but I’m a little concerned about cutting out legumes and whole grains,” Antinoro says.Gluten-free A gluten-free diet excludes all products that contain gluten, a protein found primarily in wheat, barley, and rye. Substitute grains include rice, quinoa, and millet. Antinoro points out that people who happen to have gluten sensitivity or celiac disease in addition to RA might notice a reduction in joint pain as a result of a gluten-free diet. But if you don’t have gluten sensitivity, a gluten-free diet may not make sense for you, as it can potentially lead to nutritional deficiencies. Talk to your doctor first if you’re curious about trying a gluten-free diet.
How to Update Your RA Diet
Improving your diet doesn’t have to be complicated, says Barbara Searles, LMT, a massage therapist and author of the memoir Kick Pain in the Kitchen. Searles resisted dietary change when she was first diagnosed with RA in 2009. “I loved my pastries,” she says. But in 2012 she decided to try a gluten-free diet and says she eventually felt less pain and was able to cut down on her RA medications. “It’s not about buying a lot of packaged, gluten-free food," Searles says. “If you normally have cereal for breakfast, switch to smoothies. If you normally have sandwiches for lunch, switch to salads. If you normally have pasta for dinner, switch to stir-fry.” “I felt stronger, more flexible, and mentally sharper," Searles says of her dietary switch. “I was more excited and motivated about my business and my life.” Although it’s difficult to connect dietary changes to improved RA symptoms, she says that she hadn’t changed anything else, so she assumes making the switch to a gluten-free diet is what helped improved her quality of life. Sticking to a new diet can be a challenge. During the hard moments, Searles tells herself, “I will stick to my diet because the extra pain I’d experience without being gluten-free isn’t worth it.” Regardless of which RA diet you want to try, be sure to talk to your doctor first to make sure any changes you make are in line your RA treatment plan. Additional reporting by Erica Patino
