Can your diet help ease rheumatoid arthritis symptoms? The research is mixed, but this much is true: RA pain and stiffness is caused by inflammation, and some foods have an anti-inflammatory effect in the body.
While changing your diet won’t eliminate your RA symptoms completely, learning which foods to add to your diet -- and which to avoid -- may help you feel better and improve your overall health.
"Although there's no one diet that’s recommended for people with RA, we do have a few hints about foods that might be helpful," says Alan Friedman, MD, a spokesperson for the American College of Rheumatology. "There are some foods that reduce inflammation in the body and others that may make inflammation worse."
Eat to Reduce Inflammation
Research shows that many foods associated with the Mediterranean diet -- fish, olive oil, fruits, vegetables, and whole grains -- reduce inflammation. Although much of this research has been done in test tubes, some studies -- but not all -- have found a connection between eating these foods and an improvement in RA symptoms.
"There's a good reason to believe these foods reduce inflammation, but they are most effective if you make them part of your daily lifestyle, not just something you eat occasionally," says Lona Sandon, MEd, RD, a spokesperson for the Academy of Nutrition and Dietetics.
Here are a few Mediterranean-inspired foods to try.
- Fish. "Fish oil has the best research behind it," says Sandon. Many studies link the omega-3 fatty acids in fish and fish oil to reduced inflammation in the body, and reduced morning stiffness and pain in the joints. Fatty fish, such as salmon, albacore tuna, herring, lake trout, sardines, and mackerel, are highest in omega-3s.
Fish is also a good source of lean protein. "Getting lean protein at each meal helps protect against the muscle loss RA can cause," Sandon says.
- Olive Oil. Research has found that a compound in extra-virgin olive oil called oleocanthal also helps reduce inflammation. The stronger-tasting the oil, the more oleocanthal it contains. To add olive oil to your diet without piling on extra calories, try using it in place of other fats, such as butter or margarine.
- Fruits and Vegetables. Many fruits and vegetables are packed with antioxidants and phytochemicals, compounds found in many plants. Like omega-3 fatty acids, these compounds may help decrease enzymes that cause inflammation in the body. Some fruits and vegetables that are especially potent include tart cherries, apples, citrus fruits, red and yellow onions, shallots, ginger, potatoes, and strawberries.
- Whole Grains. Whole grains also contain compounds that help lower inflammation. Research shows that many Americans don't get enough whole grains in their diet. Look for breads, crackers, and cereals that list whole grains or whole wheat as the first ingredient. Other good choices include brown rice and oatmeal.
Are There Any Foods to Avoid?
There doesn't seem to be a connection between most foods and worsening RA symptoms. One exception may be red meat. "Some studies have shown a connection between higher red meat consumption and a worsening of RA symptoms," says Friedman. Not all studies have found a link, though, so more research is necessary.
However, Friedman and Sandon agree that cutting back on red meat for better heart health is a good idea anyway. "Heart disease is the number one cause of death in people with RA, so eating with heart health in mind is certainly important," says Friedman.
The Role of Food Sensitivities
Some people with RA may have sensitivities to certain foods that make their symptoms flare. You can try eliminating suspect foods to see if you feel better. Then, add the foods back one at a time to see if your symptoms return. "Many of my patients report feeling much better when they go gluten free," says Friedman, although he doesn't recommend this diet for everyone. "I'm still a bit of a skeptic," he says.
Sandon says that how food affects RA symptoms is very individual. "It doesn’t always fit with what the science tells us. But if a particular food seems to increase your symptoms, you don't need to eat it."