How can my diet choices influence rheumatoid arthritis (RA)?

There has been a lot written about so-called arthritis diets, but no one food causes arthritis, and no one food can cure it. However, research suggests that eating a typical Mediterranean-style diet—plenty of fruit, vegetables and healthy unsaturated fats (olive oil, nuts and fish)—may help reduce inflammation and improve the symptoms of rheumatoid arthritis. Vitamin E, omega-3 and omega-6 supplements may also help reduce inflammation and pain.

Rheumatoid arthritis and some of the medications used to treat it can lead to low levels of protein, folic acid, and calcium—nutrients your body needs to stay healthy and strong. People with RA have an increased risk of developing osteoporosis as well, so consider taking calcium and vitamin D supplements to help maintain bone strength or a daily multivitamin to cover all your bases.

Talk to your doctor before taking supplements or making major changes in your diet.


Lona Sandon
Nutrition & Dietetics Specialist

If you have rheumatoid arthritis like I do, you will benefit from including a variety of foods in your daily eating pattern. In reviewing the research literature, a Mediterranean diet pattern is likely to have the best health promoting effects for people with RA. A Mediterranean diet is rich in fruits, vegetables, whole grains, nuts, seeds, olive oil and fish. Phytonutrients found in fruits, vegetables and whole grains may help lower body wide inflammation along with the healthy fats found in nuts, seeds, olive oil and fatty fish.

People with RA are at greater risk for heart disease due to inflammation and side effects of the medications used to treat RA. A Mediterranean diet has been shown to help lower your risk of heart disease.

Research studies do not support eliminating certain foods from the diet when you have RA. If you feel like certain foods may aggravate your symptoms, I recommend keeping a food and symptom journal for 6 to 8 weeks to help determine if those foods are truly problematic. People with RA can have food sensitivities or allergies too. If you suspect you have food allergies, see an Allergist or Immunologist for proper testing. A Registered Dietitian can help you design a nutrition plan that assures you are eating for optimal health while avoiding problem foods.

There is no scientific evidence that any specific food or nutrient helps or harms most people with rheumatoid arthritis. However, an overall nutritious diet with enough—but not an excess of—calories, protein and calcium is important. Some studies have shown that the omega-3 fatty acids in certain fish or plant seed oils also may reduce rheumatoid arthritis inflammation. However, many people are not able to tolerate the large amounts of oil necessary for any benefit, and both fish oils and plant oils have side effects, including risk of bleeding and interactions with certain medications, including blood pressure medications and psychiatric drugs. More research is necessary to find the optimal dosage of fish and plant seed oils for the management of RA.

Some people may need to be careful about drinking alcoholic beverages because of the medications they take for rheumatoid arthritis. Those taking methotrexate may need to avoid alcohol altogether. You should ask your health care professional or a registered dietitian for guidance on the issue of diet.

Joel Kremer, MD, published a study many years ago which examined the effects of giving patients with RA high doses of fish oil which contains eicospentanoic acid (EPA). While there were improvements in a number of measured parameters, neither the patients nor the physicians caring for them could accurately identify when they were taking placebo and when fish oil.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.