What Diet to Recommend to Patients with Rheumatoid Arthritis?

Taken from: NRAS magazine, Spring 2014

 The following is a summary of a useful article written by Vanessa Caceres, freelance medical writer in Bradenton, Florida. The article is aimed at healthcare professionals advising RA patients about diet, but has good information which may be of interest to healthcare professionals and patients alike.

The authors acknowledge that:

  • there are no clear cut answers on which diet is most helpful to patients with RA, however, when treating someone with RA it is important to consider food choices along with medication, exercise, and other factors.
  • there are some drawbacks with using diet as a way to help RA symptoms:        

   a) there’s limited scientific proof regarding the effectiveness of a dietary approach aimed to help RA

   b) a dietary approach can be hard to follow in the long term

  • although there may not be one, be all, end all dietary approach to help those with RA beyond a well balanced diet, there are still some reasons why the diet discussion might be an important one to broach with patients.
  • Even if the jury’s still out on the ideal RA diet, excess body weight, cardiovascular disease and osteoporosis can be more common in RA patients, so these conditions alone are enough reason to advocate a balanced diet.

What to Advise Patients Regarding Diet

So, with all the conflicting evidence, what’s the best thing to advise RA patients regarding diet?  The article recommends the following:

  • to eat a balanced diet - plenty of fruit and vegetables and whole grains
  • to get enough protein from lean meat but not go overboard
  • to aim for fish more often than other kinds of protein
  • to also include almonds and other nuts, which provide healthy fats

These foods will help provide patients with vitamins A, C and E, which can be important in targeting systemic inflammation.

Food for thoughtThe Mediterranean style diet, as described above, is accepted as not just helpful for inflammation, but also for heart disease. Researchers found that a Mediterranean eating plan and fasting followed by a vegetarian eating plan seemed to improve pain when compared with an ordinary diet. They also point out that there were no effects on physical function, stiffness, or other important outcomes.

The article also adds that evidence for the benefits of a gluten free diet as it relates to RA is not that strong. Although it’s anecdotal evidence, this may prove to be helpful to a number of RA patients who are sensitive to gluten. Using an elimination trial approach (experimenting with cutting foods out of your diet) with gluten, dairy, beef or alcohol can be helpful for certain patients if they are willing to give it a try. However, the article suggests that every patient is different and this doesn’t provide blanket recommendations for everyone with RA. The article also discusses the value of omega-3 supplements and the use of CherryFlex, a fruit supplement that contains antioxidants and anthocyanins.

A study published last year in the journal Nutrition with 37 RA patients found that intake of omega-3 acids seemed to affect disease activity and have beneficial effects on RA by decreasing inflammation.

Omega-3 supplements may also enable someone with RA to use fewer anti-inflammatory medications 

All of the emphasis on diet doesn't mean one should ignore medications. The article suggests that a balanced approach is best and that medical treatment is needed to help control symptoms and pain and help prevent the disease from progressing. However, maintaining the body through physical activity and diet is also important and combining all these elements gives the best outcome.

 

RA Diet Myths
These foods are frequently cited as natural treatments for RA or foods for patients to avoid, although there is no research demonstrating their effectiveness in reducing RA symptoms.
EAT
  • Raw food diet
  • Cider vinegar
  • Gin-soaked raisins
  • Gelatin
AVOID
  • Nightshade vegetables ( tomatoes, potatoes, peppers)
  • Dairy products
  • High-acid foods
  • Citrus fruits
Source: Arthritis Foundation

 

 A link to the full article can be found in the Healthcare Professional area of the NRAS website. Further information on diet can also be found in the lifestyle section of the NRAS website.