Stiffness, pain, and swelling are just a few common symptoms of rheumatoid arthritis and are often some of the most difficult to manage. The progression of these three symptoms is usually a sign that the disease is getting worse. Visibly swollen or tender joints, symmetrical pain, and increased stiffness are all signs of progression to later stages of RA.
The connection between these three symptoms is inflammation. There is no single method to combat inflammation, but there are several lifestyle modifications you can make to help reduce it, like following an anti-inflammatory diet.
A study published in Arthritis Research and Therapy found that patients with rheumatoid arthritis have significantly more pro-inflammatory diets and that those who were able to follow a diet associated with less inflammation over the course of 6 years also maintained lower disease activity. Another study looked at how diets impacted levels of pain in RA patients. The study concluded that anti-inflammatory diets resulted in significantly lower pain compared to ordinary diets.
What’s the Link Between Inflammation and RA?
Rheumatoid arthritis is a chronic autoimmune disease where the body’s immune system mistakenly attacks and damages its own healthy cells. With RA, the immune system targets the soft tissue that lines the surface of joints called synovium. Synovium is the soft, connective tissue that lines the inside of the joint. When damage occurs to the synovium it causes inflammation in the joints to thicken and destroys the cartilage and bone near the joints, resulting in common symptoms of rheumatoid arthritis.
Research shows that systemic inflammation and autoimmunity begin before the onset of rheumatoid arthritis symptoms, like joint pain and swelling. When inflammation is left unchecked, it can continue to build and cause irreversible damage to the joints as seen in later stages of RA. This suggests that inflammation occurs before RA. While there is no cure for RA, following a specific diet to help reduce inflammation can help prevent and minimize symptoms.
What Are the Best Foods to Eat for RA?
1. Use Olive Oil, Often
Extra virgin olive oil is known for its rich and complex flavor, along with its ability to be incredibly versatile. But what many people don’t know, is that olive oil is packed with antioxidants and healthy fats, and works in similar ways as non-steroidal anti-inflammatory drugs (NSAIDs).
In recent years, researchers have spent more time investigating the benefits of dietary fatty acids and their ability to regulate the inflammatory process in the body. Studies found that a specific compound in olive oil called oleocanthal prevents the production of pro-inflammatory COX-1 and COX-1 enzymes, just like ibuprofen does. COX (cyclooxygenase) enzymes form prostanoids, which are responsible for triggering an inflammatory response causing symptoms like pain and inflammation.
Like NSAIDs, which are often used to treat rheumatoid arthritis, olive oil works by prohibiting the over-production of these enzymes. This gives room for inflammation and pain to decrease. One study found that people who had a regular intake of olive oil saw a decrease in inflammatory markers including C-reactive protein, interleukin-6, and tumor necrosis factor-a.
Just 3-4 tablespoons of olive oil are equal to a 200-mg dose of ibuprofen. It’s important to note that olive oil is high in calories and fats so be cautious of how much dietary fat you are taking in from other sources. It may be helpful to spread the daily amount of olive oil throughout the day to better regulate your nutritional intake and needs.
2. Add A lot of Spice
The spices you use to season and flavor your food are just as important as the foods you are eating. More research shows that certain spices can help ease inflammation and chronic pain. This is because some spices contain antioxidants and chemical compounds that interfere with the body’s inflammation-signaling pathways. As a result, there are lower levels of pro-inflammatory cytokines. Cytokines are a group of proteins that is responsible for controlling the growth and activity of cells in the immune system that can contribute to or fight inflammation.
Turmeric is one of the most well-studied spices for its anti-inflammatory benefits. The primary compound in turmeric that fights inflammation is curcumin. A meta-analysis of the anti-inflammatory impact of culinary spices found that curcumin significantly delayed the onset, lowered incidences, and severity of arthritis. To get the greatest benefit of curcumin and ensure your body is fully absorbing the compound, pair it with black pepper. Piperine is the component in black pepper that gives it the sharp taste, carries anti-inflammatory properties, and helps the body utilize curcumin better.
Some other spices that have been proven to help reduce inflammation are ginger, garlic, cayenne pepper, cinnamon, and cloves. Try one of these anti-inflammatory spice blends to season any vegetables, meat, fish, or eggs!
3. Stalk-up on Produce
Fruits and vegetables are packed with fiber, vitamins, and antioxidants, all of which help reduce inflammation and prevent disease. Antioxidants are molecules that fight and neutralize free radicals in the body. Free radicals are compounds that cause oxidative stress and can damage healthy cells when levels get too high. Studies have found that people with RA have higher levels of oxidative stress and it may lead to other conditions like cardiovascular disease and cancer.
There are thousands of different substances that act as antioxidants, but the most familiar and well-researched are vitamin C and E, beta carotene, lutein, selenium, and manganese. While it may seem overwhelming to track which antioxidants you are getting, food high in antioxidants usually has several different kinds.
Fruits like berries (all kinds), grapes, cherries, and citrus contain some of the highest amounts of antioxidants. Spinach, kale, broccoli, carrots, and cabbage are some vegetables highest in different antioxidants. It can be harder to constantly store and prepare fresh produce, so opt for frozen instead. Frozen produce has equally as many, if not more, nutrients than their fresh counterparts and is easier to cook.
4. Go for Whole Grains
It’s well-known that when refined grains, like those found in most bread, cereals, and processed foods, are eaten in excess, it can increase the risk of cardiovascular disease, type 2 diabetes, obesity, and even rheumatoid arthritis. This is because refined grains have been linked to higher levels of inflammatory markers in the blood.
Grains are made of three parts: Bran is the outer layer of the grain kernel, the germ is the innermost part that grows into a new plant, and the endosperm is the center that provides food for the plant. Whole grains contain all three parts of the grain. Refined grains on the other hand have both the bran and germ removed, leaving only the endosperm, and stripping away most of the vitamins, minerals, and protein.
Grains are an important part of a balanced diet, so it’s not recommended to give them up entirely. Instead, opt for whole grains which are high in vitamins, antioxidants, and fiber. Some whole grain options include:
- Brown rice
- Swap Fish for Meat
5. Swape Fish for Meat
Like olive oil, many types of fish are high in essential fatty acids that fight off inflammation. Fish are high in two specific types of omega—3 fatty acids: eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). This omega-3s also interfere with cytokines and immune cells called leukocytes, both of which play a primary role in the body’s inflammatory response. Leukocytes, also known as white blood cells, help the body fight infection. When your body senses an infection or an injury, they locate the site of an infection and send signals to other white blood cells to come to help defend the body from an unknown organism. Studies have found that people with RA have higher activation and inappropriate accumulation of leukocytes in the body.
Marine omega-3 fatty acids help neutralize leukocytes and cytokines, preventing inflammation from spreading. The research found that people who regularly eat fish high in omega-3s are less likely to develop rheumatoid arthritis compared to those who don’t. They also found that those who have the disease saw a reduction in joint pain and swelling.
The best sources of marine omega-3 fatty acids come from salmon, tuna, sardines, and mackerel. Just 2 to 4 servings a week can help lower inflammation and protect your heart. It’s important to know that many fish rich in omega-3s are also high in mercury. Mercury can cause nervous system damage when eaten in large quantities. Smaller fish, like trout and salmon, are lower in mercury compared to larger fish like tuna.
If you don’t like fish, you may want to consider a fish oil supplement. While this is a good substitute, evidence suggests that our bodies don’t absorb omega-3s as well from supplements compared to eating fish.
6. Get a Little Nutty
Nuts and seeds are a convenient little snack or addition to any meal that is full of polyunsaturated and monounsaturated fats, protein, antioxidant vitamins, and minerals. Some nuts and seeds are known for being high in alpha-linoleic acid (ALA), a specific type of anti-inflammatory omega-3. Other nuts are high in magnesium, l-arginine, and vitamin E, which also helps keep inflammation under control.
A 2011 study found that people who consumed nuts had a 51% lower risk of inflammatory diseases like RA. The analysis collected dietary data of 2,514 participants using a food-frequency questionnaire to determine intake levels of nuts. Over the course of 15 years, 214 participants died of inflammatory disease. Researchers also found that women who had higher intake levels of nuts had a 44% reduced risk of inflammatory disease mortality.
Researchers at Brigham and Women’s Hospital also found that a greater intake of nuts is associated with lower levels of inflammatory biomarkers, like C-reactive protein (CRP), interleukin 6 (IL6), and tumor necrosis factor receptor 2 (TNFR2). The study included more than 120,000 female nurses and 50,000 male health professionals. By using diet questionnaires and taking blood samples, they found that participants who consumed more than 5 servings of nuts per week had lower levels of CRP, IL6, and TNFR2.
The nuts and seeds highest in anti-inflammatory properties include walnuts, pistachios, almonds, cashews, pine nuts, sunflower seeds, pumpkin seeds, and chia seeds. A small handful of nuts or seeds can serve as the perfect snack. You can also add them to your favorite recipes for an added anti-inflammatory punch.
7. Have a Tea Party
Green tea has long been studied for its numerous health benefits like improving brain function, reducing the risk of heart disease, and decreasing inflammation. This is because green tea is rich in polyphenols, a natural compound that has been shown to reduce inflammation and fight cancer. It also contains two specific catechins, a type of antioxidant, called epigallocatechin-3-gallate (EGCG) and epicatechin-3-gallate (EGC). Research shows that EGCG is the more effective catechin that gives green tea its medicinal properties.
EGCG makes up about 63% of the total catechins in green tea and has been shown to have better bioavailability, which means the body can absorb and utilize it better. One study found that when used in appropriate dosages, EGCG inhibits inflammation caused by immune cells. Another study looked at the impact of tea consumption in patients with RA. The study looked at how much tea was consumed on a daily basis by 2,237 RA patients and by 4,661 controls. Among the participant, 57.3% were considered high tea consumers, drinking 2 or more cups of tea per day. They found that those who drank tea were at a lower risk of RA compared to those who didn’t drink tea regularly.
This evidence suggests that 1-2 cups of green tea per day can significantly reduce the risk of RA. If you already have the condition, drinking tea on a regular basis can help reduce inflammation and minimize symptoms.
8. Remember to Hydrate
Staying hydrated is vital for your body to function optimally, especially if you have rheumatoid arthritis. Dehydration can lead to sleepiness, fatigue, headaches, and increases the risk of heat injury or low blood volume shock. It also decreases the amount of fluid available to cushion the joints and protect the body from inflammation.
When you’re dehydrated, the body goes into a type of survival mode where it tries to hold as much water as possible to protect your organs. This often means taking fluid away from the other parts of the body that help keep arthritis aches and pain at bay. Water helps create synovial fluid, the thin layer of fluid that cushions and provides nutrients to the joints. Because the body’s first response is to protect larger organs like the brain, heart, and lungs, it may have a more difficult time creating synovial fluid. As a result, more joint friction, and pain.
Water is critical for cartilage, a strong and flexible tissue that covers the ends of the bone. Cartilage allows bone to glide over one another, helping you move better and preventing them from rubbing against each other. It acts much like a sponge; when it has enough water it fills up and becomes soft and when it dries out, it becomes flat and stiff.
The amount of water you need will vary based on gender, environment, and activity level. Men typically need more water than women. If you live in warmer climates or have a more active lifestyle, you will also need more water to stay hydrated. The U.S National Academics of Sciences, Engineering, and Medicine has determined that adequate fluid intake is:
- 15.5 cup (3.7 liters) of fluid per day for men
- 11.5 cups (2.7 liters) of fluid per day for women
It’s best to spread your water intake throughout the day to help keep you hydrated and avoid any stomach aches from drinking too much at one time. If you have trouble remembering to drink water, try to get into the habit of drinking one glass at every meal, and increase from there. It may also be helpful to set reminders on your phone or another device as you start to develop the habit.
Find the Support You Need
Living with rheumatoid arthritis can be incredibly difficult, especially on days when symptoms are heavy. Making lifestyle changes, like altering your diet, can help you feel better and reduce the symptoms you are feeling in the long term. If you are struggling to adhere to a more nutrient-dense diet, know you are not alone. There are thousands of members at PatientsLikeMe who understand what you are going through. Join the community to connect with other members with rheumatoid arthritis who can support you through your journey.