Rheumatoid disease (RD) is a condition aggravated by inflammation that not only affects the joints but the entire body. It can be very painful and debilitating. It is common for people who have RD to have tried elimination, mediterranean, vegan, vegetarian, and elemental diets. There are dietary modifications a dietitian can recommend to assist with reducing inflammation in the body but there is not one diet that has been clinically proven or researched long enough to be marketed as the therapeutic diet for rheumatoid disease that would provide patients with black and white recommendations. However, dietitians can utilize what information that is known about inflammation in the body and foods that may help prevent inflammation to try to prevent and manage symptoms, pain, and comorbidities that often occur. Keep in mind, it can take time to see changes in how patients feel from dietary modifications and they may not feel any different. However, they are preventing further inflammation from becoming more aggravated and thus feeling worse.

Omega 3 fatty-acids and omega-6 fatty acids are beneficial when they exist in the proper ratio in the body.  An abundance of omega-6 fatty acids can have the opposite effect of protection from inflammation. Americans typically are not lacking in omega-6 fatty acids but rather they are typically lacking in omega-3 fatty acids. The plant form of omega-3 fatty acids can be converted in the body in small amounts to the biological form we utilize but not efficiently so it is important to consume the animal form in greater abundance (ALA → plant form, EPA, DHA → biological forms). Omega-6 fatty acids can be found in foods like red meat, poultry, eggs, dairy, corn oil, and walnuts. Omega-3 fatty acids can be found in foods like cold-water fish such as salmon, tuna, mackerel herring, sardines, anchovies, walnuts, flax seeds, chia seeds, hemp seeds, soybeans, algae, and Brussels sprouts.

Incorporate extra-virgin olive oil into regular cooking practices. Extra-virgin olive oil is abundant in healthy monounsaturated plant fats but it also has antimicrobial, anti-inflammatory, and antioxidant like properties. Research has shown there is a possibility that RD could stem from a microbial exposure of some kind. Antioxidants protect our cells from damage from free radicals.  Oleocanthal is a component in olive oil that inhibits the same inflammatory pathway that ibuprofen does… so think of consuming olive oil regularly as potentially nature’s ibuprofen, a common drug used for pain in RD.

Eat the rainbow. Consume more fruits and vegetables because they are rich in antioxidants and micronutrients that help stop free-radicals in the body that can trigger inflammation and damage cells. It is recommended to consume 2 cups of fruit per day and  2 to 3 cups of non-starchy vegetables per day. Lastly, incorporate less refined sugar, grains, and fried foods. Choosing whole grains increases fiber and micronutrient intake which aids in avoiding blood sugar spikes, inflammation, and helps us feel fuller for longer. Refined sugar and fried foods with high saturated fat content also increase inflammation in the body. Limit refined, added sugar to less than 25 g/day for women and 30 g/day for men. Alcohol should also be avoided.

RD patients are not all built the same. Overweight and obese patients may benefit from weight loss to reduce added stress on joints and rid themselves of excess body fat which creates inflammation. Incorporating these dietary modifications into a patient’s lifestyle may help better manage their weight as well as reduce inflammation. Cachexia exists in patients with RD likely due to medication side-effects, physical limitations, and psychological stress. Pharmacological interventions, like methotrexate, can cause vitamin deficiencies. Supplementation is not recommended unless proven deficient or prescribed by a doctor.  Self -supplementation should be avoided due to risky side-effects, lack of evidence, and null safety oversight. There is some research that is promising on ginger, green tea, and turmeric consumption for inflammation. It is recommended to incorporate these potential anti-inflammatory options into the diet instead of supplements.