Foods to Combat Rheumatoid Arthritis Pain and Fatigue

May 10, 2019

 

Here is a link to the Facebook LIVE replay of this discussion. 

You Will Learn

  • Signs of inflammation.
  • Why proper nutrition can improve rheumatoid arthritis (RA) symptoms. 
  • Anti-inflammatory foods that help reduce pain and fatigue. 
  • Inflammatory foods that can aggravate RA symptoms.

 

Overview

As discussed in more detail in the last post found HERE, rheumatoid arthritis is an autoimmune, inflammatory condition that causes inflammation in the tissue surrounding the joint.  

This inflammation often comes a goes in what are called flare ups. Over time, severe inflammation can damage other parts of your body, too, not just your joints. The heart, lungs, skin, kidneys, blood vessels, and nerves can all be affected.  

Along with medications and physical activity, diet management can play an important role in both supplementing and complementing what you are already doing to manage your RA. 

 

Signs of Inflammation

Think of inflammation as your ‘check engine’ light in your car. When it goes off that means that something is going on that needs to be checked out. Inflammation can be caused by a number of factors.2  

For example, inflammation around your knee after a total joint replacement is caused by something completely different than inflammation around your knee from rheumatoid arthritis.  

Below are the classic signs of inflammation and their associated causes.2

  • Heat - vasodilation (i.e. blood vessel dilation)
  • Redness - vasodilation 
  • Swelling - increased vascular permeability (i.e. more fluid able to escape the blood vessels into surrounding tissues)
  • Pain - physical and chemical stimulation of pain receptors
  • Loss of function - pain, reflex muscle inhibition, disruption of tissue structures, change and hardening of tissue  

 

Can Proper Diet Reduce Rheumatoid Arthritis Symptoms?

Yes! Proper diet can reduce RA symptoms, and reduce your risk of developing long-term health conditions commonly seen in people who have RA.  

While researchers are getting closer to understanding RA, it is clear that the immune system and inflammation play a large role in RA. It is also clear that people who have RA are at a higher risk of developing several conditions including (but not limited to):

  • Insulin resistance - A major contributing factor of type 2 diabetes, high blood pressure, and high triglycerides
  • Atherogenesis, or the formation of plaques in the arteries. This contributes to heart attacks and strokes. 
  • Low bone mineral density - increasing the risk for fractures.

 

Below is a picture illustrating these long-term effects from McInnes, I. B., & Schett, G. (2011). The pathogenesis of rheumatoid arthritis. New England Journal of Medicine, 365(23), 2205-2219.

 

How Can Proper Diet Reduce Symptoms of RA?

Evidence supports that a proper diet can reduce pain, joint stiffness, swelling, tenderness, and associated disability with rheumatoid arthritis progression.1  

There is abundant research to support proper diet to prevent insulin resistance, plaque formation, and low bone mineral density. Not surprisingly, this “proper diet” is the same for preventing symptoms of rheumatoid arthritis and preventing insulin resistance, heart disease, and osteoporosis.  

One study surveyed 217 people with RA. Of the subjects, 24.0% reported that foods affect their RA symptoms, and 24.3% avoid foods to prevent worsening of their RA. From the list of 20 specific foods, blueberries and spinach were most often noted to improve RA, while soda with sugar and desserts were most commonly reported to worsen RA.5  

This study also found up to one-third of patients with RA reported their symptoms improve with vitamin/mineral supplementation and a warm room temperature.  

As the image below describes, symptoms of RA can be reduced by certain diets. This is accomplished through:

  • Decreased inflammation
  • Synovial infiltration of immune cells (the body’s immune cells attacking the thin layer of cells surrounding the joint)
  • Inflamed synovial membrane (the tissue surrounding the joint)
  • Decreased RA progression 

 

This image illustrates how proper nutrition can improve RA. Khanna, Shweta, Kumar Sagar Jaiswal, and Bhawna Gupta. "Managing rheumatoid arthritis with dietary interventions." Frontiers in nutrition 4 (2017): 52.

 

The Best and Worst Foods for Rheumatoid Arthritis 

While studies have been done comparing certain types of diets, most research does not point to one particular diet over another that improves RA symptoms. The above picture mentions the vegan, elimination, and elemental diets. All of these can be hard to sustain. Research states we should eat anti-inflammatory foods, and avoiding inflammatory foods.  

Remember that obesity is a risk factor for rheumatoid arthritis, and high glucose and fructose (sugar and starch) intake has been shown to cause obesity. Read more about starch and sugar HERE. So if you are trying to combat RA symptoms but also control your weight, go easy on the higher sugar fruits and the beans.  

 

Anti-inflammatory Foods to Enjoy

  • Vegetables: kale, spinach, artichoke, bell peppers, chili peppers, broccoli
  • Fruits: avocados, strawberries, raspberries, blueberries, blackberries, cherries, tomatoes, oranges
  • Healthy fats: Olive oil, salmon, almonds, walnuts, other nuts, chia seeds, cocoa
  • High fiber carbs: beans, oats, cocoa
  • Others: turmeric, ginger, mushrooms, green tea, garlic4  

 

Inflammatory Food to Avoid

  • Refined grains: bread, pasta, bagels, flour products
  • Sugar: candy, pop, sweets
  • Processed meat: sausage, bacon, ham, smoked meat, and beef jerky 
  • Trans fats: margarine, shortening, fried foods 
  • Excessive alcohol  

 

Bottom Line

Proper nutrition can help combat the inflammation, pain, and fatigue associated with rheumatoid arthritis. Eating anti-inflammatory foods, and avoiding foods that cause inflammation can reduce RA symptoms.  

 

Action Items

  • Track what you eat for 3 days using a phone application such as Carb Manager or My Fitness Pal. Tracking your food will make you more mindful of what you are actually putting into your body. 
  • If you are eating foods that are inflammatory, try to cut them out of your regular diet and save the sweets for special occasions. 
  • Try keeping healthy, anti-inflammatory snacks on hand. Berries and nuts are a great quick snack. 
  • Keeping fresh chopped vegetables in the fridge at eye level will make you more likely to forget they are in your fridge.  

 

Resources

1. Khanna, Shweta, Kumar Sagar Jaiswal, and Bhawna Gupta. "Managing rheumatoid arthritis with dietary interventions." Frontiers in nutrition 4 (2017): 52.

2. Scott A, Khan KM, Cook JL, et al. What is “inflammation”? Are we ready to move beyond Celsus? British Journal of Sports Medicine 2004;38:248-249.

3. Singh, Jasvinder A., et al. "2015 American College of Rheumatology guideline for the treatment of rheumatoid arthritis." Arthritis & rheumatology 68.1 (2016): 1-26.

4. Shivappa, N., Steck, S. E., Hurley, T. G., Hussey, J. R., & Hobert, J. R. (2014). Designing and developing a literature-derived, population-based dietary inflammatory index. Public health nutrition, 17(8), 1689-1696.

5. Tedeschi, S. K., Frits, M., Cui, J., Zhang, Z. Z., Mahmoud, T., Iannaccone, C., ... & Solomon, D. H. (2017). Diet and rheumatoid arthritis symptoms: survey results from a rheumatoid arthritis registry. Arthritis care & r&search, 69(12), 1920-192 

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