By Lindsay Cunningham, D.O., RhMSUS
Rheumatoid Arthritis Awareness Day is February 2, so this blog post addresses the top questions asked in my clinic regarding rheumatoid arthritis (RA):
- What can I do for myself to help my RA?
- Is there something that I should or should not be eating?
- What diet will help with my rheumatoid arthritis symptoms?
These are great questions, and unfortunately, there is not a straightforward answer with regards to diet. Diets impact our health in more ways than we could imagine, making it a very difficult subject to study. Despite the host of limitations, there is still some evidence that certain dietary changes can reduce general inflammation or symptoms from rheumatoid arthritis. One key thing to remember: Changing inflammation in our body or improvement in RA symptoms does not mean that we are changing the inflammatory process in our joints.
There is no evidence to show us that changes in diet will slow progression of rheumatoid arthritis. Dietary and lifestyle changes should only be one aspect of your complete rheumatoid arthritis care and should not be relied on solely for treatment.
There is not one specific diet recommended for rheumatoid arthritis. Symptomatic relief with regards to arthritis and diet varies greatly among individuals. There is evidence that some aspects of our diets can improve certain types of inflammation, and if desired, could be incorporated into your daily life. The changes with the most evidence include the following: high intake of foods rich in monounsaturated fats and fiber and low intake of processed foods and foods with high content of saturated fats.
The fiber intake is best if it comes from the foods we eat, not from supplementation or pills. These foods include vegetables, fruits, beans, nuts, and whole grains. Food sources rich in omega-3 fatty acids include fish, such as salmon, mackerel, oysters, etc. Try cooking with virgin olive oil, instead of vegetable oil. Remember that the focus is on a well-balanced diet that includes foods rich in fruits, veggies, healthy fats, and fiber. Other than cutting out processed foods and “junk food,” there really hasn’t been an established food group to eliminate.
One thing that’s important to notice: These dietary changes tend to be viewed as good suggestions for most health conditions, not just arthritis. Are these improvements related to weight reduction and other lifestyle improvements, or to the foods themselves? Most of the studies can’t really tell us. There’s probably a little truth to both, although the link to weight loss and reduced disease activity has been fairly well established.
Physical activity is highly recommended for those with rheumatoid arthritis. There is no evidence that being physically active does any additional damage to the joints of those with RA; however, evidence has shown that physical activity improves functional capacity. Find physical activities that focus on aerobic capacity and muscle strengthening with low joint impact overall. If you’re having trouble getting started, physical therapy is a great place to get direction.
And finally, the dreaded but most important topic: weight. Being overweight not only increases your risk of developing RA, but it also increases your body’s level of inflammation (fat tissue produces inflammatory chemicals) and has been shown to worsen control of RA.
If you are overweight, the best news to take from prior studies: weight loss has been shown to reduce disease activity! Weight loss appears to be the most important player in non-pharmacologic management of RA. Weight loss and physical activity should be emphasized over specific dietary changes.
Lifestyle, diet, and other non-pharmacologic changes are important to include in your care of rheumatoid arthritis but should not be done as the sole treatment for RA. Weight loss has been shown to have the largest benefit. Individualized improvements of RA symptoms have been noted with dietary changes, especially with incorporation of vegetables, fruits, fiber, and healthy fats. Consult with your rheumatologist regarding the best way to manage your rheumatoid arthritis in entirety, and do not rely on diet or weight loss alone.
Remember that not all diets or lifestyle changes are safe for all people. If you’re considering any changes to diet or physical activity, you should consult with your health care provider first.