If you have rheumatoid arthritis (RA), your doctor probably suggests medications to help stop the disease from getting worse. But there’s more you can do to feel better. For many people, diet can make a difference with RA symptoms.
Today’s popular diets can get weight off your body. Lowering the stress that extra pounds can put on your joints will ease your RA symptoms. But eating a more plant-based diet can also ease inflammation.
The paleo diet is based on what our ancestors likely ate in the Paleolithic era. In general, it includes foods that could be hunted or gathered: lean meat, fish, fruits, vegetables, nuts, and seeds. It excludes or limits foods that became common with the introduction of farming: dairy, legumes, and grains.
Pros: In a review of more than 10 studies, researchers found the paleo diet helped people with chronic diseases shed pounds, lower their body mass index, and shrink their waists. That’s good news for overweight people with RA, since weight loss can make the disease less active. Plus, the paleo diet limits unhealthy food choices, like sugary treats and heavily processed foods, which can also boost inflammation.
Cons: The paleo diet also limits some foods that are inexpensive, healthy, and may help fight inflammation, especially whole grains and legumes.
The ketogenic, or keto, diet is high in fat and very low in carbohydrates. The way it works is that your body stops burning carbs for energy and starts burning fat, entering a state known as ketosis.
Pros: If you have certain health conditions along with RA, keto can do more than help you lose weight. The diet may reduce seizures if you have epilepsy and help control blood sugar if you have diabetes.
Cons: Although you may lose weight, the foods you eat can cause inflammation. Some research shows that diets high in fat and processed meat can boost levels of blood chemicals linked with inflammation, such as:
- C-reactive protein (CRP)
- Interleukin-6 (IL-6)
Other research shows that eating a lot of saturated fat makes RA symptoms worse, while cutting back on saturated fat can help you feel better.
With a vegan diet, all the food you eat comes from plants. It’s like a vegetarian diet, only stricter: Vegans don’t even eat food that animals helped make, such as honey.
Pros: Eating this way long-term could ease your RA symptoms and help you lose weight. Plus, getting lots of whole grains, fruits, and vegetables may lower inflammatory chemicals in your blood. One study found that a 4-week low-fat, vegan diet improved RA symptoms like:
- Joint pain
- Trouble moving
Cons: A vegan diet may not provide all the nutrients you need. Vegans tend to run low on omega-3 fatty acids, which help fight inflammation. You can get them from flaxseeds, chia seeds, and hemp, or you can take plant-based omega-3 supplements.
The traditional Mediterranean diet reflects the way people have eaten in countries along the Mediterranean Sea for centuries. It features lots of fruits, veggies, nuts, legumes, and whole grains; little meat; and little dairy. It also includes olive oil, fish, and some wine.
Pros: The Mediterranean diet reduces inflammation. Doctors think high levels of grains, fruits, vegetables, and legumes you get when you eat this way may improve the balance of good and bad bacteria in your gut, which leads to:
- A decrease in CRP
- An immune system that works better
- Anti-inflammatory activity
Cons: The diet emphasizes healthy foods, most of them plant-based, in moderation. It’s hard to find a drawback to this way of eating.
Intermittent fasting involves longer-than-usual times between meals. In general, this means going 16 to 48 hours without food.
Pros: Small studies suggest that intermittent fasting can improve blood pressure, weight, chronic pain, and even quality of life. Other research has shown that fasting can ease RA symptoms, perhaps by boosting blood levels of antioxidants and cutting inflammation.
Cons: Going without food, even for a little while longer than usual, can be uncomfortable. Fasting may cause muscle pain, sleep problems, headaches, and of course hunger.
Gluten is a protein found in some grains, including barley, wheat, and rye. Eating gluten-free means you skip all foods that have any of those grains.
Pros: Going gluten-free is a must for people with certain conditions, such as:
- Celiac disease
- Wheat allergy
- Non-celiac gluten sensitivity
- Gluten ataxia, an autoimmune disorder that affects muscles
There’s no proof that going gluten-free helps with your arthritis symptoms, but there are always exceptions. Some research has found that eliminating gluten improves joint symptoms in people with celiac disease.
Cons: If you skip out on grains that contain gluten, you’ll be missing the many nutrients these grains can provide, such as:
Your doctor or a nutritionist can guide you toward foods or supplements that make up for the loss of nutrients that would otherwise come from these foods.
Frontiers in Nutrition: “Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review.”
Mayo Clinic: “Gluten-free diet,” "Paleo diet: What is it and why is it so popular?” "The truth behind the most popular diet trends of the moment.”
Nutrition Journal: “Influence of Paleolithic diet on anthropometric markers in chronic diseases: systematic review and meta-analysis.”
International Journal of Clinical Rheumatology: "Association of weight loss with improved disease activity in patients with rheumatoid arthritis: A retrospective analysis using electronic medical record data.”
The Journal of the American Osteopathic Association: "How to Monitor and Advise Vegans to Ensure Adequate Nutrient Intake.”
Vegan Health: “Omega-3s.”
BMC Medicine: "Definitions and potential health benefits of the Mediterranean diet: views from around the world.”
Gut: “High-level adherence to a Mediterranean diet beneficially impacts the gut microbiota and associated metabolome.”
Medscape: “Mediterranean Diet Lowers C-reactive Protein Levels.”
Harvard T.H. Chan School of Public Health: “Diet Review: Mediterranean Diet.”
LiveScience: “Mediterranean diet: Foods, Benefits, and Risks.”
PLOS One: “Safety, health improvement and well-being during a 4 to 21-day fasting period in an observational study including 1422 subjects.”