Diet and Nutrition

RATE

Proper nutrition is an important part of healthy living for everyone, especially if you have a chronic health condition like RA. Our bodies require a balanced diet to get all the nutrients and calories we need to function optimally. In fact, RA patients with low-quality diets may be at an increased risk of active disease.

Maintaining a healthy weight is essential in managing your RA symptoms. Being overweight increases stress on large weight-bearing joints, such as hips and knees, which may already be susceptible to damage from the disease processes involved in RA. Since people with RA are at increased risk for health problems including cardiovascular disease, blood clots, and osteoporosis, it is important to include heart-healthy and bone-health promoting foods in your diet. Proper nutrition can help reduce symptom severity, and should be a central part of your overall RA management strategy.

Guidelines for healthy eating

Everyone should aim to have a healthy, balanced diet that provides essential vitamins, minerals, nutrients, and calories to support the requirements for energy and fitness. For guidance on healthy eating, check out the recommendations at the government-run website www.choosemyplate.gov, which are based on the 2010 Dietary Guidelines issued by the USDA.

The 2010 Dietary guidelines stress the importance of balance between calories consumed and calories burned to achieve and maintain a healthy weight. They also focus on eating nutrient-dense foods and beverages that contain lots of healthy vitamins and minerals in each serving. Important recommendations include limiting sodium and avoiding foods that contain excess fat, sugar, or refined grains. Consumption of “vegetables, fruits, whole grains, fat-free or low-fat milk and milk products, seafood, lean meats, eggs, beans, peas, nuts and seeds” is strongly encouraged. Essentially, eating mostly whole, unprocessed foods will help you get the nutrients your body needs without exceeding your calorie needs.

Specific dietary or nutritional interventions if you have RA

In addition to general recommendations on healthy eating, there are specific nutritional interventions that may be useful if you have RA.

Many different diets and nutritional interventions have been tested for their benefits in patients with RA. For most, the evidence is not strong enough to make definitive recommendations. However, even though firm evidence may be lacking, many patients report feeling better when they eliminate certain foods from their diets, adopt specific diets that emphasize or eliminate certain foods (like increasing plant based foods or adhering to a gluten-free diet) or when they take specific supplements. Up to three-quarters of patients with RA believe that diet plays an important role in disease severity and as many as half have tried some sort of dietary intervention to get relief from symptoms.3

Some Key Nutrients to Focus on include:

Omega-3 fatty acids
The strongest evidence of RA symptom improvement with a dietary intervention is for fish oil and other sources of omega-3 (sometimes called n-3) fatty acids, which have been shown to play an important role in immune system function. Learn more about foods high in omega-3

Calcium + Vitamin D
In addition, calcium and vitamin D intake for bone health is an important strategy to manage RA. Ensuring the proper intake of calcium is especially important for women and men with RA, both because the disease process and glucocorticoid treatment can be associated with bone loss. Women with RA who are near menopause or post-menopausal are at particularly high risk for osteoporosis, which can increase risk of bone fracture.1

Calcium and vitamin D work together to maintain strong bones. The body needs sufficient amounts of vitamin D to absorb and use calcium. Vitamin D deficiency and insufficient calcium absorption can weaken existing bones and prevent the formation of strong, new bone. Vitamin D is also essential to a healthy immune system. Include food sources of vitamin D in your diet and be sure to have your vitamin D levels checked annually.

view references
1. Schur PH, Maini RN, Gibofsky A. Nonpharmacologic and preventive therapies of rheumatoid arthritis. In: O'Dell JR, Romain PR, eds. UptoDate. Wolters Kluwer Health. Accessed at: www.uptodate.com. 2013. 2. US Department of Agriculture and US Department of Health and Human Services. Dietary Guidelines for Americans, 2010. 7th ed. Washington, DC: US Government Printing Office; December 2010. 3. Stamp LK, James MJ, Cleland LG. Diet and rheumatoid arthritis: a review of the literature. Semin Arthritis Rheum 2005;35:77-94.further reading
Fox B, Taylor N, Yazdany J. Arthritis for Dummies. Hoboken, NJ: Wiley Publishing, Inc; 2004.
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