For more than 80 years, researchers have explored the link between diet and arthritis, trying to discover whether some nutrients trigger symptoms and if others may calm them. The answers are evolving but are far from complete.
The key may be foods that ease inflammation, which is common in rheumatoid arthritis (RA) and which may also play a role in osteoarthritis (OA): the wear-and-tear arthritis associated with aging.
Adopting one or all of the following six diet strategies, recommended by a rheumatologist with nutrition expertise and by three patients with arthritis, may help you, too.
1. Eat Heart-Healthy Foods
If you have arthritis, you may only be thinking about how your diet might ease pain and inflammation. That's understandable, but you should also be thinking about your heart, says rheumatologist Rebecca Manno, MD, assistant professor of medicine in the rheumatology division at Johns Hopkins University School of Medicine in Baltimore, who's conducted research on the role of diet and nutrition in inflammation.
That's because people with rheumatoid arthritis are at a higher risk for cardiovascular disease. She advises her patients to eat a heart healthy diet and watch their cholesterol, which is good advice for anyone. But, as Dr. Manno tells her RA patients, "It applies 20-fold to you." What's good for your heart, as it turns out, may also be helpful in relieving your arthritis symptoms.
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Looking to make some quick and easy swaps for a heart-healthy diet? Trade chips for nuts like walnuts, spread avocado on your sandwich instead of mayonnaise, select spices instead of salt when seasoning foods, and choose beans over fatty cuts of meat.
2. Adopt a Mediterranean Mindset
Eating a Mediterranean style diet with plenty of fruits, vegetables, whole grains, fatty fish, and a little red meat may help people with inflammation. When experts compared a group of people with RA who followed the diet to those who did not, the people on the Mediterranean plan reported less need for anti-inflammatory drugs and an increase in physical functioning.
Cristina Montoya, RD, 33, who has RA and is a member of the CreakyJoints online community, is a strong proponent of the Mediterranean diet. The resident of the Canadian province of Ontario said that eating less red meat in particular has lessened her fatigue and inflammation.
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"Once or twice a month, I'll have red meat," Montoya says. And cutting back was easier than she thought it would be. "I really don't miss it," she adds.
It’s relatively painless to make some Mediterranean diet swaps. Try trading butter for olive oil, switch beef for salmon, and pick whole wheat breads over white versions.
3. Consider Fish Oil
"Several studies in past years have shown a nice effect of fish oil," Manno says. While not all studies agree, she notes that some research has shown that fish oil's omega-3 fatty acids are beneficial in reducing RA inflammation in blood work, though it’s unclear how much symptom relief patients actually get.
But patience may pay off, she says. Studies often show that benefits aren't seen until after at least 12 weeks of continuous use. She also tells patients that until more is known about fish oil in supplement form, she recommends increasing intake of fatty fish, such as salmon, herring, or mackerel, for an omega-3 fix.
4. If a Food Affects Your Symptoms, Avoid It
Many people with arthritis have found that certain foods trigger symptoms. While Manno says this phenomenon is real, researchers aren’t yet able to reliably identify specific food triggers for people. But her patients with RA often tell her that a specific food or foods make their RA symptoms worse.
Manno tells them it’s not in their heads. She often hears patients say they feel better if they avoid artificial sweeteners and preservatives, for instance. Some people report that they feel better if they avoid gluten, opt for a vegan diet, or use certain spices for arthritis relief. A bit of trial and error can help you find what works for you.
5. Skip Refined Sugars
The more refined sugar you eat (think sweets and junk food), the more inflammation you might have, research shows. Cutting back on sugar has made a difference in symptoms for Abigail Auer, 42, of Atlanta, who was diagnosed with RA in 2013.
"My new rule is no sweets until after 5 o'clock," she says. It's helped her eat less sugar.
Cutting back on sugar has also helped Chantelle Marcial, 36, of Boston, with her RA. "I know sugar is a trigger for a flare [for me]," she says. Although most of us crave sweets, she says, eating less of them is worth it. Marcial didn't realize how much sugar she was eating until she began to read food labels more carefully.
But instead of cookies or pie, indulge in dark chocolate. Auer used to prefer milk chocolate but learned to like dark chocolate, which has antioxidants that may reduce inflammation.
An ounce of dark chocolate a day should suffice for this effect, experts suggest. Antioxidants are also plentiful in tea, red wine, and fruits and vegetables.
6. Keep Diet in Perspective
"You read so much about diet for RA," says Auer. "Just don't let diet become another hardship in your life. Focus on fresh, healthier foods and less sugar, and don't feel pressured to follow a diet to the letter."
In time, ongoing research may provide more specific information about what to eat and avoid in general to ease arthritis symptoms, but each person with arthritis may have to find out for themselves what helps and what hurts.
If you think certain foods might be triggering arthritis flares or exacerbating symptoms, you might want to eliminate some foods thought to trigger arthritis symptoms, like dairy, citrus fruits, and nightshade vegetables. During an elimination diet, you’ll need to carefully read food labels, keep a food diary, and make sure you’re still getting enough calories and nutrients to keep you energized and nourished throughout the day. You’ll probably have to stick to the diet for a few weeks before you see results. And, as always, before you try an elimination (or any other stringent) diet, be sure to talk to your doctor, who can provide more guidance on dos and don'ts.