I work as a registered nutritionist with the National Rheumatoid Arthritis Society and this is my article that they have published. See below for full article link.
Evidence suggests that nutrition can play an important role in the management of Rheumatoid Arthritis (RA) and Juvenile Idiopathic Arthritis JIA.
There is a lot of nutrition information out there and with that comes misinformation. Altering your diet to help your RA/JIA symptoms is very individual. Auto-immune conditions are complex. The effects they have on the body vary from person to person.
In this series of blogs I will cut through the noise and concentrate on good, evidence-based information. Read on for more detailed information on how each of these changes could help you to manage your RA/JIA. This article includes tips that are sensible, practical and evidence-based. Here I will show that the following changes could improve your RA/JIA:·
Maintaining a healthy weight
Exercising
Adopting a Mediterranean diet
Being mindful of what you eat
Eat for a healthy gut·
Including omega 3 fatty acids (and lowering omega 6)
Increasing colourful vegetables and fruit
Optimising Vitamin D intake
Consider excluding gluten
Decreasing red meat and salt
Nobody expects you to change your dietary habits overnight. Remember, any small changes you make from these suggestions are progress. You are more likely to stick to a good diet long term if you make gradual changes that suit your lifestyle.
Some quick changes you can make right now include:
Weight loss – if you are over your ideal weight
Exercise – it all counts – gardening, walking, swimming – do only what you love/enjoy
Mediterranean diet – this is a wholefood and colourful way to eat and live as well as being good for your RA/JIA
Increase the amount of colourful fruit and vegetables you consume
Reduce the amount of processed and high sugar food and drink you consume
Keep a food and symptom diary, monitoring what you eat the symptoms you have. This may help to identify any foods that might worsen your symptoms
Boost Omega 3 levels by eating oily fish or taking supplements. Make sure that any supplement you take is safe with your medication. Omega 3 can reduce the number of tender and swollen joints in people with RA/JIA
Eat for gut health, by consuming foods such as:·
natural or Greek yoghurt
bone broth·
sauerkraut·
garlic·
onions·
bananas·
apples and oats
Watch your Weight
Keeping to a healthy weight is important in managing RA. Excess weight can worsen disease activity and increase flares, as shown below.
Carrying too much weight is not good for joint health and mobility. Pressure on weight-bearing joints such as knees is around 5-6 times that of body weight.
What’s more important is the way that fat acts within the body. Fat plays an important role in the body’s endocrine (meaning hormonal) system. Excess fat can increase inflammation by further activating your already over-active immune system. In particular, ‘visceral fat’ (fat around the abdominal area) can cause inflammation. If you are overweight, small amounts of weight loss can have a big impact.
Being underweight can also cause problems, as you may be low in muscle mass needed to support the joints. Please see your GP should you feel like this is an issue.
What to do
If you are overweight, follow the concepts in the Mediterranean Diet section below. Focus on whole foods and limit processed and refined carbohydrate foods. This can help you to maintain a healthy weight.
Exercise
Exercise plays an important role in managing RA and JIA. A good exercise routine can improve joint function and reduce stiffness and inflammation. It is also good for your health more generally.
Exercise can increase the function of synovial fluid, which sits inside the joint. Synovial fluid helps protect joint and reduces friction between bones. In RA and JIA, the quality and quantity of synovial fluid can be reduced by inflammation.
Exercise can also lower pro-inflammatory proteins called cytokines. which play an important role in your immune system. In RA and JIA, where the immune system is over-active, cytokines target healthy joints.
Doing little or no exercise also increases the risk of weight gain, especially if diet is not altered. This risk increased with age.
How?
The best exercise is the one that you do. It could be walking, swimming, dancing, tai-chi or yoga for example. Find something you enjoy that is within your limits and be consistent. It may be worth speaking to a fitness professional with some understanding of RA and JIA. The added bonus is the improvement in mood often experienced with regular exercise.
Benefits of the Mediterranean, anti-inflammatory diet
The Mediterranean diet (MD) is rich in fruits, vegetables, whole grains, olive oil, and fish.
Many studies of this diet have shown a positive impact on all areas of health with research suggesting that a MD can improve RA/JIA. A MD diet can reduce disease activity and improve physical function. This may be due to high levels of antioxidants and polyphenols (plant chemicals). These can help regulate systems in the body. Left unchecked, these systems can cause the immune system to over-react, increasing inflammation. This is why we refer to the MD diet as an ‘anti-inflammatory’ diet.
Research has shown that following a Mediterranean diet can improve symptoms of RA. This included reduced swollen and tender joints and duration of morning stiffness. General wellbeing was also seen to improve.
The MD is a healthy way to eat in general and will have positive impacts above and beyond arthritis, benefitting the whole family. A MD diet can increase weight loss and lower the risk of diabetes and cardiovascular disease. It can also lower the risk of certain cancers. It’s no wonder it has gained such significant and well-deserved attention.
What is the Mediterranean diet?
There is often confusion about what MD is. This is because there isn’t one, specific MD diet. MD is a way of dietary lifestyle change, adopted with other healthy habits. Research shows that these changes to your diet and lifestyle can help you to manage symptoms. To follow a MD diet, do the following:
Base meals and lifestyle on:
Increased colourful fruit and vegetables in each meal. Aim for one half to two thirds of the plate to be non-starch vegetables. This includes greens, mushrooms, squashes, beets, cauliflower or broccoli. Don’t forget to add them to breakfast too.
Fibrous foods such as wholegrains, lentils, beans and vegetables
Simple protein sources such as lean cuts of meat, lots of sea food, eggs and tofu
Consume plenty of healthy fats – Extra virgin olive oils, nuts and seeds, avocado and oily fish
Eat fish, especially oily fish (important enough to have its own section). Research shows that Omega 3 is important for brain development and function. It can also improve RA/JIA joint symptoms.
Don’t eat on-the-go. Life can be busy sometimes, but food is better digested when eaten at a slower pace. At mealtimes, try to relax and sit down to eat at a table.
Lots of outdoor activity and gentle exercise
Social connection
Consume less and limit:
Processed foods (especially ultra processed foods) & take aways
Sugary drinks – not only the big brand sodas but also fruit juices. People with high sugar intakes have much higher levels of haptoglobin in their blood. High levels of haptoglobin increase risks of diabetes, heart attacks, stroke and obesity.
Omega 6 fats such as vegetable and seed oils. Use only extra virgin olive oil, avocado oil or small amounts of coconut oil.
Red meat can increase inflammation. This is especially true for processed meats (e.g. sausages or bacon). Public Health England suggests eating these meats in moderation. Instead, choose leaner meats such as fish and poultry.
Added sugars
Refined grains such as white flour, white rice and flour based foods. Focus on whole grains like quinoa, brown rice and bulgur wheat. White flour spikes blood sugar and adds to the inflammatory load.
Confectionary
Alcohol – Drinking too much alcohol puts strain on your liver. It may be best avoided or drunk in moderation with certain medications. If you do drink alcohol, it is better to avoid drinking too much in one sitting. Binge drinking put more strain on your liver. Alcohol also has a high calorie content and can contribute to weight gain. Your rheumatologist can discuss with you whether alcohol intake will affect your medications. Government guidelines can give you an idea of the number of recommended units.
Build your plate around lean protein, healthy fats and non-starchy vegetables. Add to this a small portion of wholegrains.
If this is a way of eating that is very far removed from where you are now, then make small and sustainable changes. You can start by adding protein, colour and whole grains to each breakfast and work from there.
Eat for your gut
Increase fish oils and omega 3 fatty acids
Increase colourful vegetables
Increase vitamins and minerals
Consider a gluten exclusion
Consider supplementation (safely checked against any medications)
Keep a food and symptom diary
I am delighted to be the nutritionist for, and have an article published with, the National Rheumatoid Arthritis Society (NRAS), who endlessly look for the latest research in how to support RA. My full article is here in my blog, spread out in bitesize chunks!
How I can help with Nutritional Therapy
Using the functional medicine approach, I work to understand why you have RA and to see what factors are contributing to it. Growing up, my lovely Mum suffered quite severely and I am very passionate about helping others.
You can expect from me:
A personalised nutrition plan rich in nourishing foods to assist your joint function and inflammation
Test recommendations and full interpretation either privately or through your GP
Personalised supplement protocol - meticulously checked against medications
Regular consultations and coaching to support new choices
I am currently taking clients for next month. To find out about my 12 week programmes, please contact me here and book a free 20 minute Reboot your Health call.
Note: as a Nutritional Therapist, I do not diagnose or prescribe, however I do use functional nutrition testing to help find the best way to support my client’s health.
My programmes are designed with people like you in mind. I see many clients with auto-immunity and they all have different symptoms, family health histories, lifestyles, work and family life which may may have contributed to where they are. This is why a personalised nutrition and lifestyle rather than a 'one size fits all' gets such good results. Book your free Reboot your Health 20 minute call to discuss your health goals and if working with me would benefit you.
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