Among environmental factors, diet has often been cited as a modifiable risk factor that can affect the severity of symptoms associated with rheumatoid arthritis (RA). In a recent study, Shweta Khanna, Disease Biology Laboratory, School of Biotechnology, KIIT University, Odisha, India, and colleagues determined that early signs of RA can potentially be impeded in patients who implement certain dietary interventions, including eating more vegetables, reducing intake of potentially allergic food components, and introducing more polyunsaturated fatty acids, oleic acids, and synbiotics into his or her diet plan (Khanna S, et al. Front Nutr. 2017;4:1-16).
Because of the growing breadth of literature supporting the positive affect dietary interventions can have on decreasing disease activity in patients with RA, as well as the notion that patients are always keen to find out about alternative methods for relieving their symptoms, Ms Khanna and colleagues analyzed data from various clinical trials that evaluated the effect of various dietary interventions (eg, elemental diets, Mediterranean diets, fruits, alcohol consumption) on patients with RA, with the goal of identifying foods that clearly show evidence-based, long-term benefits in this patient population.
Based on their findings, Ms Khanna and colleagues suggest that patients with RA should consider the benefits of adopting a vegetarian or vegan diet, eliminate any foods that could potentially cause an allergic reaction, and introduce more polyunsaturated fatty acids—found in oily fish, plant-based oils, and walnuts—into their diet.
“We believe that an ideal meal can include raw or moderately cooked vegetables (lots of greens, legumes), with addition of spices like turmeric and ginger, seasonal fruits, probiotic yogurt; all of which are good sources of natural antioxidants and deliver anti-inflammatory effects. The patient should avoid any processed food, high salt, oils, butter, sugar, and animal products,” said Ms Khanna and colleagues.
Foods listed as having the potential to reduce the progression and symptoms of RA included:
- cereals (eg, whole oatmeal, wheat bread, or flattened rice)
- fruits (eg, dried plums, grapes, grapefruits, mangoes, or pomegranates)
- spices (eg, ginger or turmeric)
- herbs (eg, sallaki or ashwagandha)
- essential fatty acids (eg, olive oil, fish oil, or borage seed oil)
- green and basil teas
- whole grains (eg, wheat, rice, oat, and sorghum)
- legumes (eg, black soybeans or black grams).
Overall, these foods were included based on their ability to reduce inflammation, alleviate joint stiffness, and protect against bone destruction. Ms Khanna and colleagues also stressed the importance of incorporating probiotics into the diet, as well as the use of dietary supplements (eg, vitamin D, cod liver oil, and multivitamins), to reduce the progression and symptoms of RA.
They stated that the dietary interventions they recommend—which most patients can adopt with limited financial burden—may actually reduce the need for antirheumatic drugs, which are often expensive and associated with numerous side effects.
“This may not cure the patients; however, an effective incorporation of these food items in the daily food plan may help to reduce their disease activity, delay disease progression, and reduce joint damage, and eventually a decreased dose of drugs administered for therapeutic treatment of patients,” Ms Khanna and colleagues concluded.