How What I Eat Affects My Rheumatoid Arthritis

There is no specific diet for rheumatoid arthritis (RA). However, certain foods can make inflammation worse. If you have RA, you’ve probably heard this many times. This is a common introduction in many articles, books, and other educational materials about RA.

If you have RA, like me, you have likely read a lot about anti-inflammatory diets and various versions from self-proclaimed experts. And, if you’re also like me, you have probably tried countless diet plans, only to feel frustrated and still hungry! I admit, I’ve tried more diets promising to control inflammation than I can even remember. It’s been quite an adventure, and I’ve learned a lot about myself along the way. Most importantly, none of them worked.

However, I discovered that I can eat some foods without any issues, while others can trigger a flare just by tasting or smelling them. Most foods fall somewhere in between.

In my opinion, when considering a diet good for your RA, there are two things to consider:

• Foods to avoid because they make you feel bad or cause flares.
• Foods to regularly consume because they make you feel good or reduce flares.

Foods to Avoid

Let’s start with my foods to avoid:

Nightshades

There’s a lot of talk about nightshades and their connection to inflammation. Nightshades include vegetables like white potatoes, tomatoes, bell peppers, eggplant, cayenne pepper, and paprika.

Nightshade vegetables contain many health-promoting compounds, such as lycopene and beta carotene found in tomatoes, and anatabine, an alkaloid compound found in peppers, potatoes, tomatoes, and eggplant. Anatabine can actually help reduce inflammation, as shown in studies on irritable bowel disease.

However, nightshade vegetables also contain a compound called solanine, which has been suggested to increase intestinal permeability and potentially worsen arthritis symptoms. (It’s important to note that very high concentrations of solanine can be toxic.)

In my personal experience, not all nightshade vegetables affect me the same way. The preparation, cooking method, and preservation of these vegetables matter a lot. For example, I can eat unlimited amounts of fresh tomatoes and feel great, but if I eat canned or processed versions, like marinara sauce or jarred salsa, I’m down for days. Just 1-2 hours after eating these processed foods, my left thumb becomes stiff, and I end up needing an extended nap. This is especially inconvenient during a busy workday or when I have many commitments.

Peppers are hit-or-miss for me, so I avoid seasonings that contain pepper or paprika. On the other hand, I can tolerate almost any amount of eggplant and enjoy it in certain dishes. I’ve found that replacing nightshade foods with sweet potatoes, yams, cauliflower, and mushrooms has been very beneficial to my overall health.

It took me several years to figure out why my joint pain and swelling fluctuated so much until I started reading ingredient lists more closely. I discovered that my favorite Mexican restaurant’s seasoning was full of these ingredients, and I had to stop eating their food cold turkey. It was sad at first, but once I started feeling better, I realized it was worth it.

If you think nightshades are worsening your arthritis, I strongly recommend keeping a food log and a symptom tracker to identify which specific nightshades affect you the most.

Foods High in Fat

Diets high in fat are known to increase systemic inflammation by raising the levels of circulating free fatty acids. High-fat diets are also linked to many diseases and even some types of cancer. I love traditional American comfort meals like fried chicken, mozzarella sticks, and chicken wings, but I can only indulge in these a few times a year and in small amounts. Otherwise, I suffer from pain and inflammation for weeks.

Finding an effective diet took me over a year to fine-tune. During that year, we had a birthday party for my son and served southern-style food — fried chicken, macaroni salad, mashed potatoes, gravy. I indulged, and as a result, I felt lethargic, swollen, and sickly for nearly two weeks after the party. Looking back, it was directly related to my high-fat intake that day. Hindsight really is 20-20.

Sugary Foods

Sugar is considered an accomplice to inflammation, and can also interfere with the gut microbiome’s balance by decreasing the capacity to regulate the epithelial integrity and mucosal immunity. I love snacking on sugar-filled, all-American treats like licorice, gummy candies, and especially enjoy frozen, sugary drinks (Slurpees and Frazil are my weakness!) in the summer. I have to limit my intake, or my hand swelling gets bad really quickly.

There is a lot of discussion about artificial sweeteners and inflammation, too. I find this to be a very personal one. In my experience, artificial sweeteners don’t interfere with my health unless I consume them in a large amount —  i.e. an entire gallon of artificially sweetened lemonade. Consuming any one of the many options available on the market is a personal choice, and to be determined on a personal level. If you don’t want to consume them, they’re easy enough to avoid (unless you’re also diabetic, this does not apply to you).

Too Many Carbohydrates

For me, high carbohydrate intake is directly related to increased inflammation. Studies support this connection. For instance, a study involving 360 women with a body mass index of (BMI) of 25 or higher (overweight) concluded that high carbohydrate intake was associated with higher levels of inflammation, while high fat intake was not.

Foods to Enjoy

Let’s talk about foods that help me feel my best. These food items are nutrient dense, high fiber, and high protein.

Fish Oil and Omega-3s

The most important nutrient I have found to benefit my RA is fish oil, which is high in anti-inflammatory omega-3s. Not only does this powerful nutrient decrease inflammation, but it helps lower triglycerides, which in turn lowers the risk of cardiovascular disease. Cold-water fatty fish like salmon, mackerel, and sardines, as well as flaxseeds, chia seeds, and walnuts, are excellent sources. Additionally, some brands of eggs, yogurt, milk, and juice offer fortified products.

There are many omega-3 dietary supplements available, and even a few that are vegetarian. Once I started consuming more of this, in a combination of foods and supplements, my mobility improved and I generally felt better overall.

High-Fiber Foods

Recent research suggests a very strong role of the gut microbiota and immune system as it relates to RA. Without getting into the nitty-gritty details, a daily bowel movement seems to keep most people feeling healthier and lighter.

I try to get enough fiber in my foods, but if I don’t, psyllium supplement options are effective for me. Although indirectly related to RA, when I feel lighter, I can move better, and this is always less painful for my joints.

Protein-Rich Foods

RA is often associated with diminished muscle mass, which is a reflection of an imbalance between protein synthesis and protein breakdown. This study found that with adequate protein intake and physical activity, someone with RA can still build muscle the same as one without RA.

I always supplement my protein with shakes. I drink one or even two per day and it has made a big difference in my ability to stay physically active. I feel fuller longer and feel stronger day-to-day, especially in my efforts to exercise regularly.

Finding What Works for You

This is what works for me, and I hope this helps. As I said, it’s taken me years to fine-tune. If you’re just starting your RA-diet journey, I wish you the best of luck. Trial and error along with food logs and symptom tracking are the key to success with this.

It’s essential to work closely with your doctor when managing your diet, especially if you have RA or other health conditions. Make sure to share any supplements or special diets you are following. Your doctor can help ensure there are no interactions with your medications or adverse effects on your health. Together, you can create a balanced plan that supports your overall well-being.