People living with rheumatoid arthritis (RA) may benefit from eating some specific foods, but the evidence is still inconclusive and in progress.
Thorough scientific studies which are focused on the link between diet and RA are hard to come by. Much of the research are mostly imperfect, having been conducted on low numbers of participants or only recruiting highly motivated people — those who are able to stick to the diets.
What’s more, such diets can be controversial because they may have horrific effects, such as unintended weight loss, according to a review of dietary treatments for RA published in January 2009 in the Cochrane Database of Systematic Reviews. (1)
Before accepting or trying out any diet that has been used for symptom relief in RA, please see your doctor to make sure it’s medically safe for you. (2)
The following are some dietary approaches that some claim have helped people with RA.
Fish Oil and Omega-3 Fatty Acids for RA
Though not a diet per se, fish oil — which is high in anti-inflammatory omega-3 fatty acids — seems to be helpful for people with RA. Other, less-concentrated dietary sources of omega-3 fatty acids include ground flax, flaxseed oil, and walnuts.
Overall, omega-3 fatty acids from oily fishes such as salmon, mackerel, herring, and tuna, moderately reduces joint swelling and pain, the duration of morning stiffness, and the need for anti-inflammatory drugs in people with RA, according to a review published in June 2012 in the British Journal of Nutrition. (3)
A research published in January 2015 in the journal Annals of the Rheumatic Diseases discovered that RA patients who took fish oil supplements in addition to RA drugs called DMARDs (disease-modifying anti-rheumatic drugs) were more likely to achieve remission than those who only took DMARDs. (4)
But fish oil should be taken prudently, because it has certain side effects, such as reducing the blood’s ability to clot, especially if you’re taking a blood-thinning medication. (2)
Vegan and Vegetarian Diets for Rheumatoid Arthritis
Most people living with RA follow a diet that is missing meat (vegetarianism) or even all animal-derived products, including honey and dairy products (veganism).
But there isn’t much research that points to a positive link between these diets and reduced RA symptoms.
In a research published in February 2015 in the journal Complementary Therapies in Medicine, 600 participants followed a vegan diet for three weeks, and most of them experienced a drop in their level of C-reactive protein, a marker for inflammation. (5) But the study didn’t show a corresponding reduction in RA symptoms.
With the few studies that are available, it’s difficult to draw any clear conclusions, according to the Cochrane review. (1)
One major issue is the low number of participants in these studies. For example, a study published in October 2001 in the journal Rheumatology discovered that a gluten-free vegan diet provided some benefits for people with RA — but the study included only 22 people on the diet. (6)
Well what’s more, if you don’t pay close attention to balancing your nutritional intake, a vegetarian or vegan diet can lead to deficiencies, such as a lack of vitamin B12, protein, and omega-3 fatty acids, which are important for bone health. (1)
Gluten-Free, Lactose-Free, and Other Elimination Diets for RA
Some individuals report benefits from excluding certain food groups from their diet. This suggests that an allergy or sensitivity worsens RA symptoms.
Very few studies have looked at the effect of elimination diets on RA symptoms, and those that do have found mostly short-term benefits, according to the Johns Hopkins Arthritis Center.
In a study from 30 years ago, participants saw improvement in RA symptoms, both on objective and subjective measures, after eliminating specific foods from their diet, but the study was conducted over a very short period — six weeks. The research had additional issues, such as inadequate data reporting, according to the Cochrane review. (1)
Another notable problem is that some studies on elimination diets don’t control for confounding factors. For example, trials of gluten-free diets for people with RA also includes vegan diets, making it hard to determine the real effects of gluten on RA symptoms, according to a review of diet therapy for RA that was published in the journal Current Rheumatology Reports. (7)
Benefits of the Mediterranean Diet for Rheumatoid Arthritis
The Mediterranean diet is both high in fiber and rich in seafood, vegetables, and nuts, and relies on olive oil for fat.
Anecdotal reports indicate that following a Mediterranean diet may help control RA symptoms. Sometimes called the anti-inflammatory or arthritis diet, it’s considered the “ultimate arthritis diet” for people with RA by the Arthritis Foundation.
A look at the components of the Mediterranean diet would suggest that it has some benefits for RA.
For instance, it’s high in seafood, which is rich in omega-3 fatty acids. It’s also high in fiber, which may be associated with decreased inflammation.
Some evidence also suggests that this diet is associated with decreased pain in RA patients, though it may not affect morning stiffness, physical function, or other RA symptoms, according to the Cochrane review. (1)
Fasting Diet for Rheumatoid Arthritis
Both the safety and the efficacy of committing to periods of fasting are in question.
Although some research proposed that individuals experience a decrease in arthritis pain and swelling at some point during the fast, studies have not shown persistent improvement for more than 10 days, according to the Johns Hopkins Arthritis Center. (8)
But there is some evidence that fasting followed by a vegetarian diet improves RA pain, according to the Cochrane review. (1)
Do not fast or get your nutrition from juice alone without consulting a physician first.
Specific Foods to Consume and Avoid When You Have RA
Well-researched studies are still needed to prove or disprove the various claims made for specific diets. In the meantime, the most important thing is to be sure you eat a healthy, balanced diet.
In a study published in November 2017 in the journal Frontiers in Nutrition, researchers reviewed the evidence for managing RA with dietary interventions. (9) Based on their review, they compiled a list of potential foods to consume and avoid to help with RA. An ideal meal, they found, includes:
- Raw or moderately cooked vegetables (lots of greens, legumes)
- Spices like turmeric and ginger
- Seasonal fruits
- Probiotic yogurt
Foods to avoid include processed food, high salt, oils, butter, sugar, and animal products (but, as noted before, the research on the vegetarian and vegan diets may be problematic). Other research suggests cutting soda out of your diet can improve RA fatigue and other symptoms.
Remember to always verify with your healthcare provider and rheumatologist that any dietary change is safe for you. If you have any dietary questions or concerns, consider consulting a licensed dietitian.