Adherence to a proper diet is of great importance in rheumatoid arthritis (RA). Are you complaining about severe pain and stiffness in your joints? Change your daily menu! Check which products will help you relieve rheumatic ailments and regain your well-being, and which are better to avoid to reduce inflammation.
A diet for rheumatoid arthritis (RA)will help you reduce your pain. Rheumatoid arthritis, until recently called rheumatism, is a chronic inflammation that causes severe pain, stiffness and restriction of joint mobility. The causes of rheumatism include genetic and hormonal factors, smoking and long-term stress. But not only.
Contents:
- Diet for rheumatoid arthritis - what is RA?
- Does diet affect rheumatoid arthritis, RA?
- Diet for rheumatoid arthritis, RA - research studies
- Diet for rheumatoid arthritis, RA - what to eat? Recommended products
- Nutritional deficiencies in rheumatoid arthritis
- Diet for rheumatoid arthritis, RA - contraindicated products
Diet rheumatoid arthritis - what is RA?
Rheumatoid arthritis is a chronic inflammatory disease in which the connective tissue that builds up various joint structures degenerates. It is an autoimmune disease in which the immune system malfunctions, attacks its own cells, treating them as an intruder and destroying them. The source of the disease has not been clearly identified, but attention is drawn to a combination of genetic and environmental factors. In RA, the joints are occupied symmetrically. In the initial stages, the inflammatory changes affect the joints of the fingers, wrists, feet and knees. At a later stage, also the shoulders, elbows and hips. RA leads to disability or invalidity. It most often affects women over 40. It manifests itself as pain and swelling in the affected joints and morning stiffness lasting at least 1 hour. About 1% of the world's population suffers from rheumatoid arthritis. In Europe, far fewer people develop RA in the southern regions than in the northern regions. In Poland, the disease affects 0.5-2% of the population. Rheumatoid arthritis clearly lowers the qualitylife of the sick and affects its length.
Does diet affect rheumatoid arthritis, RA?
The primary treatment for rheumatoid arthritis is through various types of drug therapy. Properly selected drugs allow to achieve remission of the disease in a large proportion of people. However, they are not indifferent to the body and have many side effects. In the treatment of RA, the role of diet is still quite skeptical, despite the evident and growing evidence of its effectiveness in improving the quality of life and reducing inflammation. It is also important that the hypothesis of the so-called "Joints of the intestine" - a strong influence of the condition of the intestines on the disease and course of rheumatoid arthritis. People with RA often suffer from gastrointestinal problems - dyspepsia (indigestion), irritation and ulceration of the mucous membranes, constipation or diarrhea. A relationship was found between the composition of the intestinal microbiota and the incidence of RA. The presence of Prevotella copri bacteria in the intestines is of great importance, as it is many times more common in people with arthritis than in he althy people.Dietusedin rheumatoid arthritis (RA) , as with all autoimmune diseases, its purpose is not to stimulate the immune system and reduce the chronic inflammation in the body.
Diet for rheumatoid arthritis, RA - research results
The relationship between diet and rheumatism has been analyzed since the 1930s. Already a 1989 study involving over 1000 patients showed that products that worsen the condition of people suffering from rheumatoid arthritis are: dairy products, red meat, sugar, fat (today it is already known that it is mainly about hydrogenated trans fats), s alt, caffeine and nightshade plants. Based on the current state of knowledge, four dietary methods are considered recommended.
- 7-day fast
Based on research conducted by Fraser and colleagues and Michalsen and colleagues, it was found that fasting for 7-10 days has a positive effect on reducing blood markers of inflammation and reduces symptoms of RA. Foods allowed during fasting included vegetable broth, herbal teas, garlic, parsley, extracts of carrot, beetroot, and celery juices, and potato decoction. All studies on fasting in RA have shown a reduction in joint swelling, pain, and inflammatory markers - ESR and CRP. Fasting should not be used alone, but only after consulting a doctor. Similar effects can beachieve with balanced nutrition based on the right products.
- Vegan diet
The use of a vegan diet based only on vegetables and fruit reduces the level of pro-inflammatory substances in the body: cytokines, leukotrienes and interleukins. People on a vegan diet reduced pain and joint stiffness. The probable mechanisms of the diet's action are related to the elimination of food containing antigens that stimulate the immune system from the menu. The intestinal microflora also undergoes the desired modifications.
- Mediterranean diet
The Mediterranean diet is the most recommended diet for rheumatoid arthritis. Its healing effect has been demonstrated many times. The Mediterranean diet is based on eating plenty of vegetables rich in bioactive compounds, fish with anti-inflammatory omega-3 fatty acids, unprocessed carbohydrates and olive oil with oleic acid. In addition, very low consumption of dairy products and red meat, and moderate consumption of red wine give the diet a strong antioxidant potential. This translates into a significant reduction in the production and activation of pro-inflammatory factors in the body. In people following the Mediterranean diet, a reduction in pain and stiffness in the joints as well as an improvement in vitality have been repeatedly observed.
- Elimination diet
In rheumatoid arthritis, it is recommended to exclude allergenic and intolerant foods from the diet. It has been shown that antigens in food can worsen the condition of RA patients. It is said that 70% of immunity depends on the gut. When immune cells in the intestines come into contact with food antigens, the abnormal responses of the immune system that cause autoimmune diseases are enhanced. In addition, people treated with non-steroidal anti-inflammatory drugs are characterized by greater permeability of the intestinal epithelium, which means that allergens, another undesirable stimulant of the immune system, pass through the intestines into the blood. Not all scientific studies clearly confirm the need to eliminate antigens from food, but some of them clearly indicate that food allergens are potential triggers of immune system cells leading to inflammation by activating macrophages and other effector cells.
Diet for rheumatoid arthritis, RA - what to eat? Recommended products
1. Vegetables and fruits - the diet of a person with an inflammatory disease should be based on vegetables and fruits. Every day you should eat 500-700 g of vegetables and300-500 g of fruit. These are foods very rich in vitamins, minerals and antioxidants, e.g. polyphenols, carotenoids. A vegetable-based diet has a strong anti-inflammatory potential and is effective in treating many diseases associated with chronic inflammation.
2. Oily Sea Fish - Salmon, mackerel, herring, sardines, tuna and other marine fish provide anti-inflammatory omega-3 fatty acids that are drastically insufficient in the average diet. Numerous studies show that taking omega-3 reduces the number of swollen joints and their soreness, reduces morning stiffness in the joints, lengthens the time it takes to wake up fatigue, and increases the strength of a grip, and overall - reduces disease activity. Eating oily fish at least twice a week and supplementing with omega-3 fatty acids is crucial to reducing symptoms and worsening the disease.
3. Whole grain products - groats, rice, cereals or wholemeal bread are a source of fiber. Research into the effectiveness of fiber in reducing blood inflammation markers is inconclusive. Some show high activity, others - no effect. Despite these incompatibilities, dietary fiber is very important for he alth, so it is worth including it in your diet.
4. Legume seeds - provide fiber, mineral s alts and anti-inflammatory antioxidants.
The best products for RA
| olive oil |
contains monounsaturated fatty acids effective in reducing inflammation in the body and oleocanthal - a compound that gives a burning, bitter aftertaste when consuming olive oil. Scientific evidence has shown a significant role of oleocanthal in reducing inflammatory markers and its effectiveness in treating diseases associated with degeneration of the joints. |
| coriander, turmeric, ginger, cinnamon |
they are rich in various types of bioactive compounds with anti-inflammatory properties. demonstrated the ability to alleviate the symptoms of RA and lower levels of inflammatory markers, as demonstrated in animal studies. |
| pineapple bromelain |
is found mainly in the pineapple sip, which is inedible, so high-quality dietary supplements can provide bromelain. research suggests that appropriate preparations can even replace non-steroidal anti-inflammatory drugs. |
| green tea | contains the powerful antioxidant EGCG, which inactivates inflammatory proteins. |
| dark fruit | cherries,blueberries, raspberries, pomegranate, and black currant are rich in anthocyanins with antioxidant and anti-inflammatory properties. |
| parsley | contains the flavonoid luteolin that blocks pro-inflammatory proteins. |
Author: Time S.A
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Find out moreWorth knowingNutritional deficiencies in rheumatoid arthritis
In one study, an analysis of the diet of 52 women with RA revealed an insufficient intake of omega-3 fatty acids, and thus a severely disturbed n-6 / n-3 fat ratio. Moreover, their menus were poor in folic acid, vitamin D, potassium and calcium. These food ingredients are among the most deficient in people with rheumatoid arthritis. Nutritional deficiencies in this disease are closely related to the type of medications used. NSAIDs increase the permeability of the mucosa of the small intestine, vascular inflammation, secondary anemia and excessive protein loss. Particularly important nutrients are iron, folic acid, vitamin C, B6 and B12. Steroids have a negative effect on the condition of the skeleton, so when taking them, a diet rich in calcium (which does not come from dairy products, but e.g. from broccoli and dried figs) and vitamin D. Methotrexate is an antagonist of folic acid, therefore the number of products should be increased in the diet. However, methotrexate in combination with sulfasalazine increases the concentration of homocysteine in the blood, and this significantly translates into a greater risk of cardiovascular disease. The diet should then be enriched with omega-3 fatty acids, vitamins B6 and B12 and folic acid.
Diet for rheumatoid arthritis, RA - contraindicated products
People suffering from rheumatoid arthritis must first of all eliminate highly inflammatory trans fats from their diet. They are found in hard margarines, in-store sweets, donuts, buns, fast food, stock cubes, and some ready-to-eat meals. This means that you must exclude highly processed foods from your diet.
Sugar and alcohol are also not recommended. Research results show a relationship between the severity of RA symptoms and the frequency of alcohol consumption. In the diet, attention should be paid to restricting consumptionred meat and milk, which many people cannot tolerate.
There are no unambiguous studies indicating the negative impact of dairy consumption on the course of the disease, but the analysis of individual cases shows that dairy products actually exacerbate the symptoms of RA.
Other products that need to be restricted are:
- fried and grilled foods - products prepared in this way at high temperature turn brown, which is a typical process called the Maillard reaction. Very harmful chemicals produced during this reaction are the end products of glycation (AGE). There is no clear evidence of a relationship between AGEs and RA, but there is no doubt that these compounds increase inflammation in the body. That is why it is worth switching frying to boiling, stewing and baking at least 3-4 times a week
- allergenic and intolerant products - due to the increased permeability of the intestinal epithelium, food causing allergies and food intolerances is even more harmful than in the case of he althy people, because it penetrates the blood more easily and stimulates the immune system more, which in turn intensifies inflammation . In the case of RA, it is worth testing for food allergies and intolerances and adopting a diet that eliminates problematic products.
- Nightshade vegetables - Tomatoes, peppers, potatoes and eggplant can be problematic due to their alkaloids content. Whether they exacerbate RA is a very individual matter that requires checking. It is worth excluding nightshade from the diet for 2 weeks and see if the symptoms of the disease are less severe. Then eat them again, analyzing if the pain and swelling in the joints is getting worse
- nuts and seeds - are a matter of dispute because they are very nutritious. At the same time, however, they are also a source of omega-6 fatty acids, which the average diet provides too much. Nuts and seeds rich in omega-6s include peanuts (which are not botanically nuts), almonds, sesame seeds, pumpkin and sunflower seeds. Their amount should be controlled in the diet.
Sources:
1. Khanna S. et al., Managing rheumatoid arthritis with dietary interventions, Frontiers in Nutrition, 2022, https://doi.org/10.3389/fnut.2017.000522. https://www.frontiersin.org/files/Articles/301603/fnut-04-00052-HTML/image_m/fnut-04-00052-t001.jpg.webp3. Meyfroidt S. et al, Nutritional interventions in the management of rheumatoid arthritis: A review of the literature, http://www.reumanet.be/sites/default/files/170914_PosterNutrition.pdf4. Tatara T. et al., The role of diet in rheumatoid arthritis - a systematic review of research, Medycyna Rodzinna, 2015, 2, 70-78 5. Foods andarthritis, http://pcrm.org/sites/default/files/pdfs/he alth/pv_arthritis.pdf6. Wnęk D., Food products helpful in the treatment of rheumatoid arthritis, https://dieta.mp.pl/diety/diety_w_chorobach/132476,produkty-aktywnosciowe-pomocne-w-leczeniu-reumatoidalnej-zapalenia-stawow7. Nowak A. et al., Assessment of the nutritional value of food rations of women with rheumatoid arthritis, Reumatologia, 2012, 50 (6), 487-4928. https://www.prevention.com/food/diet-changes-for-rheumatoid-arthritis9. Parkinson L. et al., Oleocanthal, a phenolic derived from virgin olive oil: A review of the beneficial effects on inflammatory disease, International Journal of Molecular Sciences, 2014, 15 (7), 12323-1233410. https://www.everydayhe alth.com/hs/rheumatoid-arthritis-treatment-management/foods/