If you’ve been diagnosed with an inflammatory kind of arthritis, such as rheumatoid arthritis or psoriatic arthritis, you’ve probably thought about how you should change your diet to help manage your disease.
You’ve read about the benefits of eating an anti-inflammatory diet. Perhaps your doctor’s been talking about the importance of losing weight. Or maybe you’ve been considering a stricter elimination diet, such as the autoimmune protocol.
Figuring out what to eat — and what not to eat — with rheumatoid arthritis is admittedly tricky. Scientific research is often limited and conflicting. There’s a lot of unproven information on the internet. Following the diet tips one patient swears by might sound like your worst nightmare.
Heck, what to eat when you have arthritis is even hard for experts who know the ins and outs of nutrition science, according to two nutritionists who have rheumatoid arthritis themselves. We talked to them to learn not just what they eat, but how they landed on the diets for rheumatoid arthritis that work best for them. Here’s what we learned from their stories:
1. Go mostly Mediterranean
While there’s no specific best diet recommended for people with rheumatoid arthritis, research does link a Mediterranean diet pattern with decreased inflammation in people with RA. Lisa Andrews, a dietitian in with a practice in Cincinnati, Ohio, follows a mostly Mediterranean diet focused on veggies and fruit, dairy, beans and lentils, and nuts. Cristina Montoya, a public health dietitian in Ontario, Canada enjoys mostly plant-based meals, with chicken and fish mixed in a couple of times each per week. “I am from Colombia, so I eat beans, lentils, and garbanzos quite often,” she says. Here are some common anti-inflammatory foods you eat on a Mediterranean diet.
2. Find your individual triggers
There’s no “one-size-fits-all” diet when it comes to what foods NOT to eat when you have rheumatoid arthritis. Can some foods cause flares for certain people? Yes, but this can be very individualized. For example, both Andrews and Montoya find that red meat can be a trigger food for them — so they both avoid it, among certain other foods. You can try an elimination diet to determine if any foods trigger symptoms for you. The best way to do this is to work with a dietitian who can help you identify triggers safely and reliably.
3. Learn what you can live with
Your trigger foods may include some of your favorite things to eat. But that doesn’t have to mean they’re completely forbidden. You may find that small servings or every-once-in-a-while treats are fine for you, and can satisfy your cravings. “I love dairy products; however, I limit it to very small amounts of lactose-free milk, cheese, and yogurt,” says Montoya.
4. Make sure your diet can really fit with your lifestyle
While lots of people with rheumatoid arthritis say they have found relief from eating a gluten-free diet, following one may not be right for everyone, or for the long run. “Being gluten-free full time is difficult,” says Andrews. Her Italian family tradition is to make pizza with her teenage daughters every Friday night — and that’s a pleasure Andrews is not about to give up. She does, however, limit her intake of wheat-based foods to the extent that helps her manage RA symptoms and feels doable.
5. Go ahead — be skeptical
It’s fine if you’re even questioning the role that diet may or may not have in managing symptoms of RA. For example, some people report that while making healthy diet changes may help related issues, such as energy levels or digestive distress, they don’t necessarily see a difference in their RA symptoms.
Even professionals can have these doubts. “As a dietitian who used to work on programs to nourish low-income communities, I never thought of food as being harmful,” says Montoya.
When she had success using a low-FODMAP diet to identify triggers for her irritable bowel syndrome, she began to open up to the possibilities that diet changes could help with RA as well. (A low-FODMAP diet eliminates certain types of carbohydrates, which includes specific sweeteners, fruits, vegetables, grains, legumes, and dairy, because they’re thought to aggravate digestive problems in certain people.)
So if you’re not convinced that what you eat really helps with your RA symptoms, don’t worry. You can experiment with your diet if and when you feel ready.
6. Stick with your treatment plan
While there is evidence that food can help you manage symptoms, it should be thought of as complementary to the medication you and your doctor have determined is right for you. “The changes I had made a positive impact on my health, but should not be a substitute for the treatment,” says Montoya. Prescription medications that target inflammation are often at the core of treatment for rheumatoid arthritis due to the strong evidence supporting their success.
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