Nutrition Guidelines for People With Rheumatoid Arthritis

While there’s no cure for RA, eating certain foods can help you manage its symptoms.


People with rheumatoid arthritis (RA), a chronic, painful, inflammatory disease that affects joints and connective tissue, are constantly seeking to ease its symptoms with food and dietary supplements. While researchers have turned up no magic elixir to cure RA, several studies seem to show a connection between certain foods and the inflammation that characterizes this autoimmune condition. Before embarking on a special diet or taking supplements, though, consult your doctor. Either approach can interact with traditional RA medications in unintended ways.

The best approach to food for people with RA – or anyone else – is a well-balanced diet which, according to the U.S. Food and Drug Administration, should be centered on plant-based foods. Approximately two-thirds of your diet should come from fruits, vegetables and whole grains. The other third should include fat-free or low-fat dairy products and lean sources of protein.

Foods That Help Fight Rheumatoid Arthritis

Be sure your diet includes fish such as herring, mackerel, trout, salmon and tuna. Because while there may be no magic elixir, the omega-3 fatty acids in fish oil are the most promising anti-inflammatory in food, says Ruth Frechman, registered dietitian and spokesperson for the American Dietetic Association.

Studies have shown that fish oil can relieve tender joints and ease morning stiffness. It has also allowed some people to reduce the amount of conventional medication they take for RA. Servings of fish provide about one gram of omega-3 fatty acids per 3½ ounces of fish. If you choose to try fish oil supplements, talk to your doctor about a dosage. People with RA can often take a higher level of fish oil than is recommended for the general public, but there can be side effects. Higher doses of fish oil may interact with certain drugs, including those for high blood pressure.

Increasing your intake of fiber from fruits, vegetables and whole grains may also help reduce inflammation. Studies show that adding fiber to the diet results in lower levels of C-reactive protein (CRP) in the blood; CRP is an indicator of inflammation. Strawberries, either fresh or frozen, seem to have an especially beneficial effect on CRP levels.

Extra-virgin olive oil may also help reduce inflammation, in the same way that a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or aspirin can – it contains a compound called oleocanthal that blocks the enzymes that cause inflammation.

However, you might not want to empty your medicine cabinet just yet. It would take 3½ tablespoons of olive oil – 400 calories worth – to equal the anti-inflammatory properties of one 200-mg ibuprofen tablet. Instead, use the oil as a low-fat alternative to other cooking oils and butter.

Supplements and Inflammation

Research has shown that people with RA have low levels of selenium, a mineral found in whole-grain wheat products and shellfish such as oysters and crab. It contains antioxidants, which are believed to help control inflammation. It may also increase the risk of developing diabetes, so talk with your doctor before taking selenium supplements.

Vitamin D, usually associated with calcium and protection against osteoporosis, may also help lower the risk of RA in older women by helping to regulate the immune system. Good sources of vitamin D include eggs, fortified breads, cereals and low-fat milk.  

Can Food Cause Inflammation?

While some foods seem to ease inflammation, compounds in others have been found to increase it. Eating hamburgers, chicken or other meats that have been grilled or fried at high temperature can raise the amount of advanced glycation end products (AGEs) in the blood. Although no direct correlation between AGEs and arthritis has been identified, high levels of AGEs have been detected in people with inflammation.

Another culprit that may boost inflammation is omega-6 fatty acids, which are found in corn, sunflower, safflower, soybean and cottonseed oils, many snack and fried foods, margarine, egg yolks and meats. Consuming more omega-6 fatty acids than omega-3s raises your risk of joint inflammation and obesity. Keep fresh fruits and veggies on hand to help you avoid processed snacks that often contain omega-6 fatty acids.

As a result of menopause or steroid treatment, some people with RA may not get enough of certain vitamins and minerals. The most common deficiencies are in folic acid, vitamins C, D, B6, B12 and E, calcium, magnesium, selenium and zinc. Nutritionists agree that most nutrients should come from your food, rather than from supplements. However, a supplement may be necessary if you suffer from malnutrition. Again, talk to your doctor before taking any supplements.

The bottom line when considering nutrition and RA is to maintain healthy, well-balanced diet. One way to achieve this is to consider adopting a Mediterranean diet which includes plenty of omega-3 fatty acids, fruits, vegetables and whole grains, the benefits of olive oil – even a glass of red wine if your doctor allows.

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