For Rheumatoid Arthritis, Eat an Anti-Inflammatory Diet

I also recently found out that a good friend of mine has all of the factors for rheumatoid arthritis (RA), but so far she's physically asymptomatic (that is, no joint pain). Although she doesn't yet have the physical symptoms, she's concerned about her risk of developing all kinds of inflammation-related chronic disease, and how she can adjust her diet to combat inflammation.

Dr. Andrew Weill has a helpful visual anti-inflammatory diet tool - a new food pyramid:

And I found this really great site that someone who suffers from RA put together that has tons of resources. This particular individual has cut out wheat and dairy products and found that to be the most helpful.

It seems like the basic answer for RA is to eat a healthy, Mediterranean-style diet rich in whole foods (fruits, vegetables, legumes, and whole grains for vitamins, antioxidants, and fiber, cold water fish and certain nuts/seeds for omega-3s and protein, lots of olive oil) and low in sugar, meat, refined carbohydrates and saturated fat, and to figure out if you have any food sensitivities that cause inflammation.

A lot of folks with RA start out by eating a "Stone Age" or "hunter-gatherer" diet — only fruit, vegetables, seeds, meat, and fish for one month — and then they start keeping a journal while they reintroduce other types of foods, one at a time, to see if any particular type of food
is causing inflammation. The most common RA-exacerbating foods are wheat, milk and other dairy products, corn, beef and nightshade family foods (tomato, potato, eggplants, peppers and tobacco). The casein (milk protein) in dairy and gluten (wheat protein) seem to be very commonly cut out by RA sufferers.

Periodic fasting has also been studied and seems to help RA sufferers.

For RA, there is a lot of research showing that the following nutrients
help:

1. Omega-3 fatty acids, which you get from (4-6 servings/week) of cold water fish like salmon (choose wild pacific salmon), herring, mackerel, sardines, cod and halibut, also flaxseed and walnuts, and which are anti-inflammatory (human studies with marine omega-3 fatty acids show a direct relationship between increased consumption and diminished C-reactive protein levels);

2. Vitamin D, which you get in salmon, shrimp, sunflower seeds, eggs and vitamin-D fortified milk products (if you don't have any milk protein sensitivity), organically grown fruits and vegetables, and extra virgin olive oil (vitamin D is getting a lot of attention right now; the guidelines were just rewritten for daily recommended consumption, and most people who
are getting tested nowadays find out they're considered to be vitamin D-insufficient);

3. The Mediterranean diet as a whole (pioneer study on the effect for RA sufferers is published in the Annals of the Rheumatic Diseases), which is rich in fish, olives and olive oil, legumes, and fresh produce (and low in simple carbs, meat, and dairy fats). Extra virgin olive oil contains oleocanthal, which very similar chemically to ibuprofen, and this may explain why it is anti-inflammatory;

4. Vitamin E (high in kiwi, whole grains, collard greens, dark leafy lettuces, almonds, sunflower seeds);

5. Antioxidant-rich (whole) fruits and vegetables - the bioflavonoids (plant compounds) have anti-viral, anti-inflammatory, and anti-tumor activity (the more brightly colored and the greater the variety, the better; the ones with some bitter tasting compounds are also high in antioxidants; one trick I like to use is, on a weekly grocery shopping trip, buy the rainbow —
tomatoes, carrots, yellow bell peppers, dark green leafy vegetables like spinach, blueberries, beets...); and

6. Antioxidant-rich tea (white, green, and black).

Simple carbs, saturated fats, and vegetable oils that contain linoleic acid and are high in omega-6 fatty acids increase inflammation (corn oil, soybean oil, sunflower oil, wheat germ oil, and sesame oil).

Once people are on medication for RA there is a whole host of dietary guidelines, particularly concerning supplements, because certain of the RA medications make it harder to absorb certain nutrients.