Are You Getting the Nutrients You Need?

What you eat can make a difference in how you feel with rheumatoid arthritis. Tasty, natural foods with the right balance of nutrients help you feel better and stay at a healthy weight. And the foods you eat may do even more than that. Some may help cut down inflammation, which makes your joints swollen and stiff.

The Best Way to Eat

Experts keep studying the effects of diet on RA, but they still haven’t found what everyone wants: a diet that improves RA or its symptoms.

Until they do, planning your diet is simple. "People with RA should eat a healthy diet, just like anyone else," says Ruchi Jain, MD, a rheumatologist at Rush University Medical Center in Chicago.

Aim for:

  • 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

"People with RA can get fixated on fasting, skipping meals, or finding the perfect foods," says M. Elaine Husni, MD, MPH, director of the Arthritis and Musculoskeletal Treatment Center at the Cleveland Clinic. Instead, she says, just 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, Husni says.

Foods That Might Help With RA

There’s no magic RA diet. But research shows that some foods are better for you than others. It depends partly on your health and the medication you take.

  • Fatty fish. The omega-3 fatty acids in fish like herring, mackerel, salmon, and tuna -- as well as in fish oil supplements -- may help with RA pain and morning stiffness. Omega-3s contain a natural chemical that's similar to some painkillers.
  • Olive oil. Try it instead of other cooking oils. It's better for your heart and may block inflammation.
  • Fiber. Fiber, which you get from plant foods like fruits, vegetables, and whole grains, can lower levels of C-reactive protein, which is linked to inflammation.
  • Calcium and vitamin D . RA and some drugs used to treat it can weaken your bones and lead to osteoporosis. This makes you more likely to get broken bones. Get enough calcium and vitamin D (in fortified foods) to help prevent this.
  • Other vitamins and minerals. 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.
  • Folic acid . If you take methotrexate, your doctor may recommend folic acid supplements. They can help prevent side effects. Folic acid is also in foods like spinach and citrus fruits.

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You may want to cut back on highly processed foods like packaged snacks, baked goods, and lunch meats. Some research shows that the saturated fat in them raises inflammation. It’s not clear that these foods affect RA symptoms. But cutting back on them may be good for you in general, so it's worth trying.

Also, you may need to cut back on alcohol if you take medications for RA (like methotrexate). Some people can have one or two drinks a week at most. Ask your doctor what’s OK for you.

Eating more of some of these healthy foods -- and cutting back on the unhealthy ones -- is a good idea. One way to do it is to follow the Mediterranean diet. It's rich in fruits, vegetables, olive oil, and fish and other lean proteins. One study found that people who stuck to the diet for a few months had more energy and fewer RA symptoms.

Avoid Extreme Diets

Although no food plans are proven to help RA, you may read about some that claim to, or know of people with RA who say it worked for them.

Before you try one, it’s a good idea to discuss it with your doctor, especially if it calls for megadoses of supplements or cuts out whole food groups.

If you do want to take supplements for your RA or try to use food as medicine, make sure to talk to your doctor first.

WebMD Medical Reference Reviewed by David Zelman, MD on November 04, 2018

Sources

SOURCES:

Arthritis Foundation: "Nutrient-Rich Foods That Can Be Medicine," "Nutrition Guidelines for People with Rheumatoid Arthritis," "The Relationship Between RA and the Food You Eat."

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, MPH, vice chair of rheumatology; director, Arthritis and Musculoskeletal Treatment Center, Cleveland Clinic, Cleveland.

Ruchi Jain, MD, assistant professor of rheumatology, attending rheumatologist, Rush University Medical Center, Chicago.

Johns Hopkins Arthritis Center: "Nutrition & Rheumatoid Arthritis."

National Jewish Health: "Rheumatoid Arthritis: Lifestyle Management: Diet and Pain."

NIH Senior Health: "Rheumatoid Arthritis."

Daniel J. Wallace, MD, assistant program director, rheumatology fellowship program, Cedars-Sinai Medical Center, Los Angeles.

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