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Food isn’t a cure-all for rheumatoid arthritis (RA), but it plays a surprisingly big role when it comes to managing the condition. Research, including a study published in 2020 in Contemporary Clinical Trials Communications, shows that making smart diet decisions can help control the inflammation that wreaks havoc in the body. Of course, the same food choices won’t be “right” for everyone—but these five tips may help put you on the right track.
This one could have been called: “Head to the produce section.” Fruits and vegetables are rich in natural antioxidants, which help stabilize molecules called free radicals that can trigger inflammation. They’re also packed with polyphenols, micronutrients thought to help lower C-reactive protein, a marker of inflammation.
Probiotic-rich foods, whole greens, and specific spices, oils, and teas can reduce the progression of RA.
Other foods to include on your grocery list? A review of studies published in 2017 in Frontiers in Nutrition found that whole grains, probiotic-rich foods, as well as specific spices, oils, and teas can reduce the progression and symptoms of RA. An ideal RA meal, suggests the researchers, might include raw or moderately cooked vegetables sauteed in olive oil with a sprinkling of turmeric or ginger, whole rice or whole wheat bread, whatever fruit is in season, yogurt, and a cup of green tea.
“Keep in mind that diets are not a one-size-fits-all scenario,” says Soumya Reddy, MD, co-director of the NYU Psoriasis and Psoriatic Arthritis Center and Assistant Professor of Medicine at NYU Grossman School of Medicine in New York City. “Specific foods that may trigger RA or be beneficial for RA can vary from person to person so it’s important to observe what works best for your particular situation.”
It’s important for everyone to maintain a healthy body mass index (BMI), but especially so for people with RA. “Excess ‘fat cells,’ or adipose tissue, produce cytokines in the body that promote inflammation, and maintaining a healthy weight can reduce this additional inflammatory burden,” says Reddy. “In addition, studies have suggested that excess weight may make some RA drugs less effective. Being overweight or obese also places additional strain on weight-bearing joints.”
Even small amounts of weight loss can be beneficial.
What’s more, according to a review of studies published in 2016 in Arthritis Care & Research, obesity decreases the odds of achieving remission in RA. “Weight loss is challenging, but the good news is even small amounts of weight loss—five to 10 pounds—can be beneficial,” adds Reddy.
To that end, try practicing portion control. Some visual clues to keep in mind: A three-ounce serving of fish is about the size of the palm of your hand; a two-ounce serving of cheese equals the size of a pair of dominoes; and a one-cup serving of veggies is the size of your fist.
No one expects you to swear off your favorite treats, but moderation is key. In a study published in 2017 in Arthritis Care & Research, researchers surveyed more than 200 patients with RA and asked whether 20 foods made their RA symptoms feel better, worse, or unchanged.
Sugary soda and desserts are often reported to make RA symptoms worse.
“The 20 foods on the survey were selected based on popular beliefs about them being ‘inflammatory,’ ‘anti-inflammatory,’ or because we thought that some patients might report worsened RA symptoms after eating them,” says the study’s lead author Sara Tedeschi, MD, Assistant Professor of Medicine at Harvard Medical School and rheumatologist at Brigham and Women’s Hospital in Boston. “About 25% of participants reported that at least one food affected their RA symptoms.”
Sugary soda and desserts were most often reported to make RA symptoms worse. To cut back on the sweet stuff, don’t forget: Sugar goes by many names so check ingredient labels for words ending in “ose” (as in fructose, glucose, sucrose).
No anti-inflammatory diet would be complete without omega-3-rich fish. In a study published in 2018 in Arthritis Care & Research, people with RA who ate non-fried fish at least twice a week reported significantly lower disease activity than those who ate fish less than once a month. Study participants ate tuna, salmon, sardines, trout, and other fish that are high in inflammation-fighting omega-3 fatty acids.
Tuna, sardines, trout, and salmon are high in omega-3 fatty acids.
Tedeschi, the study’s lead author, notes that those participants were likely doing other things that positively affect their RA disease activity, and so fish intake alone was probably not the single explanation. But there’s little doubt those omega-3's are tough on inflammation, and hey, that’s why there are multiple tips on this list—improving your health is never about doing just one thing.
Not a fish lover? “Clinical trials of high-dose omega-3 fish oil supplements have shown benefit for RA disease activity,” adds Tedeschi.
Walnuts, pistachios, pine nuts, almonds—they’re all packed with good-for-you fats. A study published in 2016 in The American Journal of Clinical Nutrition found that subbing nuts for red meat, processed meat, eggs, refined grains, potatoes, or potato chips was associated with healthier levels of inflammation.
Walnuts, pistachios, pine nuts, and almonds are packed with healthy fats.
And research suggests they can also play a key role in any weight loss plan, thanks to their satiating combination of protein, fiber, and fat.
Just keep in mind: Nuts are high in fat and calories, so limit the amount you eat to one ounce daily (about a handful). If possible, reach for raw, unsalted nuts, recommends the Arthritis Foundation.