The connection between diet and health conditions, such as RA, is something that both doctors and patients have been interested in for centuries. Recently, there has been a surge in interest among doctors about the potential benefits of dietary interventions in managing RA. Individuals with RA may notice certain dietary choices seem to exacerbate their symptoms while others help them feel better.
Diets for RA inflammation and symptoms
While there is not enough high-quality research to provide recommendations for using special diets to control RA symptoms, researchers have examined a number of dietary interventions for RA. These include specific diets, such as the Mediterranean diet, which emphasizes plant foods (vegetables, fruits, cereals, beans, nuts, and seeds), olive oil, and fish.
Studies have also looked at the benefits of vegetarian diets, vegan diets, and diets designed to eliminate potential allergens that seem to trigger symptoms in some RA patients.
A Mediterranean diet emphasizes the consumption of plant-based foods, including vegetables, fruits, whole grains, pasta, cereals, legumes, nuts, and seeds. These food sources are typically eaten fresh, with limited preparation. Olive oil is the main source of fat in the diet. Fish is eaten frequently, and red meat is only eaten a few times per month. Additionally, a small amount of red wine is included on most days.
Several studies have shown symptom improvements in RA patients following a Mediterranean diet. In one study, patients reported reduced inflammation, increased ability to perform physical activities, and increased feelings of vitality when compared to RA patients who continued their regular diet.1,2
Vegetarian or vegan diets
Other studies have investigated the effects of vegetarian and vegan diets on RA symptoms. A gluten-free vegan diet helped decrease LDL cholesterol levels and reduce inflammation in RA patients. A 7-10 day fast followed by a year-long vegetarian diet helped reduce inflammation, pain, stiffness, and swelling of joints and improved grip-strength in RA patients when compared to those who followed their usual diet. These improvements were evident one month into the diet, and lasted for the entire 1-year duration of the study.
A third study tested the effects of a very low fat (<10% calories from fat) vegan diet and found that after 1 month patients lost weight, had reduced RA symptoms, and lower levels of inflammation than they did before they changed their diet.3-6
Gluten- or allergen-free
A subset of RA patients may have undiagnosed food allergies or sensitivities that contribute to their RA symptoms. For these individuals, diets that remove typical food allergens such as wheat, barley, rye, oats (that are not gluten-free) and milk may help reduce symptom severity.
One single-blind, placebo-controlled elimination study conducted in 53 patients with RA found that a diet which eliminated foods that triggered RA symptoms resulted in significant decreases in pain and improvements in morning stiffness, joint involvement, grip strength, and walking speed. A majority of patients who completed the study reported that they felt “better” or “much better” when they adhered to the diet that avoided certain foods.3,4,7
It is important to note that allergen-free diets did not help all RA patients, only a small portion that already had food allergies.
Why are these diets helpful?
The Mediterranean diet, vegan, and vegetarian diets typically boost fruit and vegetable consumption. The increase in antioxidants and boost in healthy-fat consumption may account for why the diets help reduce systemic inflammation.
To date, there are no special diets officially recommended for the treatment of RA. Each individual should discuss with their doctor or nutritionist what diet is best for them.