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Diet and Nutrition

Reviewed by: HU Medical Review Board | Last reviewed: December 2022

Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that affects roughly 1 to 2 percent of the world’s population. The way RA develops is not clearly understood. Genetic and environmental factors both seem to play a role in RA.1,2

Environmental factors related to RA include diet, smoking, and the presence of unique bacteria in the gut. Recent research suggests that diet plays an important role in not only the development but also the progression of RA.1,2

Unhealthy diets can lead to excess body weight and can trigger inflammation. These types of diets have been shown to worsen RA symptoms. Excess body weight also can add extra pressure to achy joints and can make RA medications less effective. Eating a healthy diet can help you reduce inflammation and maintain a healthy body weight.2,3

What type of diet is best for people with RA?

Some research suggests that the best option for people with RA may be a Mediterranean diet. This diet is high in:1,3

  • Fruits
  • Vegetables
  • Whole grains
  • Healthy fats

People following the Mediterranean diet limit or avoid certain other foods, including:1,3

  • Red meat (limit to 1 to 2 times per month)
  • Refined sugar
  • Salt
  • Alcohol
  • Coffee

There is also research that has found benefits in not eating animal products. Eating a plant-based diet can improve the mix of the bacteria in your gut. Experts think this may decrease inflammation and joint pain.1,2

Following a vegan diet also may decrease body weight and RA symptoms. More research is needed to determine how effective plant-based and vegan diets are in reducing joint pain, inflammation, and other symptoms in people with RA.1,2

What foods should people with RA eat?

The list below includes foods that may help lessen the symptoms or progression of RA. Consider including more of these foods in your diet, but always talk to your doctor before starting a new diet plan.1,2

  • Fatty fish, such as salmon, tuna, sardines and herring. These fish are high in omega-3 fatty acids, which help control inflammation. Fatty fish may be eaten 1 to 2 times per week.
  • Fruits and vegetables. These are high in antioxidants and can help reduce inflammation. Aim for 5 servings of vegetables or fruits per day. Fresh or frozen options are best.
  • Whole grains, such as oats, whole wheat, brown rice and quinoa. These may also lower inflammation levels and can help reduce the risk of heart disease.
  • Legumes, such as peas and beans. Legumes are high in protein and are important for muscle health.
  • Nuts, such as pine nuts, pistachios, hazelnuts, almonds, and walnuts. Nuts are great sources of healthy fats and contain heart-protecting properties. But nuts are also high in calories, so eat them in moderation.
  • Olive oil. Research suggests daily olive oil use is beneficial.
  • Vitamin D. Getting enough vitamin D is essential for bone health in people with RA. Low vitamin D levels have been linked to RA progression. Increased intake of vitamin D has been linked to decreasing pain and flares of RA. However, more research is needed in this area.

Lifestyle changes such as following a healthier diet and increasing physical activity can have many benefits for people living with RA. The long-term effects of these lifestyle changes could lead to slower disease progression and reduced need for RA medicines.1

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