Features August 2010 Issue

Diet and RA: A Questionable Link

Instead of manipulating your diet, eat wholesomely and maintain a healthy weight.

Can your diet affect your rheumatoid arthritis (RA) symptoms? A recent review of scientific literature confirms what previous studies and reviews have shown—namely, no conclusive evidence exists to show that particular foods make rheumatoid arthritis symptoms flare up or decrease. Published in the May 2010 issue of the Journal of the American Dietetic Association, the review looked at evidence from studies of the following diets aimed at reducing RA


• Fast (7-10 days) followed by a lacto (includes milk products)-vegetarian eating plan.

• Vegan eating plan (gluten-free, animal product-free): mainly vegetables, nuts, fruits, buckwheat, millet, corn, rice, and sunflower seeds.

• Mediterranean-style eating plan.

• Elimination diet: Only foods known to be tolerated; reintroduce other foods one at a time.

• Elemental diet: A meal replacement supplement plus foods like chicken, fish, rice, carrots, beans, and bananas, followed by reintroduction of other foods.

Only the Mediterranean diet and fasting followed by lacto-vegetarian eating seemed to reduce pain associated with RA, but not stiffness or physical function, when compared with an ordinary diet. Results from the other diets were "unclear." The review also pointed out that it is difficult to manipulate a diet, people who do so don’t normally do so for long periods, and that the safety of any diet requiring the elimination of whole groups of food is "questionable."

"In light of the limited data, individuals with RA should try to eat healthfully, including foods from all food groups for a variety of nutrients," says Andrea Dunn, RD, LD, CDE, a dietitian in the Nutrition Therapy Section of Cleveland Clinic’s Digestive Disease Institute.


Anti-Inflammatory Eating

Some foods can act as allergens. The most common food allergies are to peanuts, tree nuts (walnuts, pecans, almonds), fish, and shellfish, milk, eggs, soy products, and wheat, according to Dunn. "An allergy is an immune response—it is the body rejecting the food, creating antibodies to fight it. This fighting can cause inflammation."

That said, food allergies are unlikely to be causing your RA symptoms, though it’s possible they might make symptoms more severe. The answer, again: eat like a Greek.

"The Mediter-ranean-style eating plan is a style of eating that’s lower in saturated fat and contains plenty of fruits and vegetables. That style is considered anti-inflammatory in nature," Dunn explains.

The Mediter-ranean diet also includes foods rich in omega-3 fatty acids, which are also linked to reduced inflammation. Omega-3s are found in foods such as cold-water fish (tuna, salmon, herring, sardines, mackerel), as well as soybeans, flax, green leafy vegetables, and olive oil. Other beneficial nutrients in the Mediterranean diet include fiber, antioxidants, vitamins E and C, selenium, and various phytochemicals, such as beta-carotene.

Food intolerance—for example, intolerance to lactose in milk—"is an irritation or the body’s inability to properly break down the food," says Dunn. "So it is more of a digestive issue then a whole-body issue.

"If you truly have RA, then your joint pain is probably not from food," Dunn emphasizes. "See your doctor to make sure you’re symptoms are due to RA. Don’t try to self-diagnose—or self-treat."

Finally, don’t try to get your nutrients through supplements instead of food, says Dunn. The balance of nutrients in real foods provide the right mixture of vitamins, minerals, and micronutrients to maintain health. There are enough different kinds of foods that provide essential nutrients that you can select the ones you like most and tolerate best.