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Foods To Avoid With Rheumatoid Arthritis

Updated on May 31, 2022
Medically reviewed by
Ariel D. Teitel, M.D., M.B.A.
Article written by
Victoria Menard

Rheumatoid arthritis (RA) is an inflammatory disorder. If you have RA, one way of managing inflammation alongside your prescribed treatments is through your diet. Although some foods may have benefits for people with RA, others have been found to increase inflammation, potentially worsening joint pain, stiffness, and other symptoms of rheumatoid arthritis.

Conversations about diet and which foods to avoid are a constant on myRAteam. “Diet is crucial for me and has helped me go into remission,” a myRAteam member commented. “If I cheat, I can feel it for days and sometimes weeks.”

Some members adopt a highly vigilant approach to their diets. “I get produce straight from the farm. I make all my food from scratch. I even make my own yogurt,” one member said. “This way, I know exactly what is in the food I eat.”

Others are more relaxed. As another member said, “I think everything in moderation is the way to go.”

Ultimately, there is no one right diet for everyone with rheumatoid arthritis. With this in mind, research has found that people with RA may be better off avoiding the following foods and ingredients.

Fats and Oils

Fats and oils have been found to heighten the body’s immune response, increasing inflammation and aggravating RA symptoms.

Saturated Fats

Saturated fats, frequently referred to as unhealthy fats, increase your low-density lipoproteins (LDL, or bad cholesterol). Aside from the risks to cardiovascular and overall health, saturated fats can cause inflammation in fat tissues when digested. These fats are found in high concentrations in foods such as cheese, red meat, palm oil, coconut oil, and butter.

Trans Fats

Trans fats are also considered unhealthy fats. They can harm cardiovascular health and stimulate or worsen systemic inflammation. Often labeled as “partially hydrogenated vegetable oils,” trans fats are frequently found in highly processed foods.

Hydrogenated Oils

Canola and vegetable oils are hydrogenated oils. These hydrogenated oils often contain omega-6 fatty acids, which are healthy in small amounts but can cause inflammation when consumed in excess.

Red Meats and Processed Meats

Aside from containing saturated fats, trans fats, or hydrogenated oils, many meat products also contain ingredients like hormones, preservatives, and artificial additives. These ingredients — often found in processed meats like pepperoni and bacon — can lead to systemic inflammation that may worsen rheumatoid arthritis.

Fried Foods

Fried foods, in general, have very little nutritional content. They also contain carcinogens (cancer-causing substances) and are often highly processed, all of which can set off the immune system and promote inflammatory reactions.

In particular, cooking meats at high temperatures (frying, grilling, or broiling) can result in increased amounts of advanced glycation end products (or AGEs) — toxins that damage the body’s tissues and trigger inflammation.

Gluten

Many myRAteam members have discussed reducing or cutting out gluten from their diets. For people with celiac disease (gluten allergy), the protein gluten causes allergic reactions and inflammation. However, many people with RA also experience inflammatory reactions after eating products that contain gluten. In fact, the protein is a known immunological trigger in rheumatoid arthritis.

Products that contain wheat, barley, and rye — such as pasta and bread — contain gluten. Although there is ongoing discussion about it in the medical community, some experts believe that eliminating gluten may be beneficial for people with rheumatoid arthritis.

Dairy Products

Some people with RA find that dairy can aggravate their symptoms. As one myRAteam member wrote, “I’m learning that gluten and dairy seem to make my symptoms worse.”

If you are sensitive to casein, a protein found in dairy products, you may find that eliminating dairy from your diet provides relief and helps reduce inflammation.

If you choose to consume dairy, use low-fat dairy products, which contain less saturated fat. They may be less aggravating than those made with whole-fat milk.

Sugars

Many people with RA find that sugars and refined carbohydrates trigger their symptoms. One myRAteam member reported that they “almost never eat sugary things” because eating high-sugar foods caused them to experience “dramatically increased pain and stiffness all over.”

Another member wrote, “Eating sugar and starch is my number one enemy,” while another echoed the sentiment: “Sugar is evil for arthritis, I have decided.”

The reason? The digestion of sugars and refined carbohydrates leads to the release of pro-inflammatory substances. When reading food labels, avoid foods with the ingredients glucose, fructose, sucrose, and others ending in “-ose.”

It’s also worth taking a look at what you drink. Research has suggested a connection between high-fructose corn syrup — found in many types of soda, fruit-flavored beverages, and other sweetened drinks — and arthritis risk. One study found that people who drank high-fructose beverages at least five times per week were three times more likely to develop arthritis than those who drank sugar-free options.

Artificial Sugar

Although sugar alternatives may help you avoid one trigger, products containing artificial sweeteners (sometimes marketed as “sugar-free” products) can also worsen RA symptoms. This is because some are made with a toxic chemical called aspartame. Aspartame cannot be processed by the body, leading to an inflammatory response.

Monosodium Glutamate

Monosodium glutamate (commonly known as MSG) is a substance used to preserve foods and enhance their flavors. Like aspartame, this ingredient cannot be digested naturally. For some people, eating MSG may lead to inflammation and worsened RA symptoms.

Alcohol

The relationship between alcohol and rheumatoid arthritis is a complex one. Although red wine has been found to have some anti-inflammatory properties, excessive alcohol consumption can actually increase inflammation. What’s more, alcohol can have negative interactions with certain medications for RA and symptom management — particularly methotrexate and nonsteroidal anti-inflammatory drugs (NSAIDs).

The decision to eliminate alcohol can be conflicting for some people. It can be even more challenging to make a decision about whether to drink if your health care team is not in agreement about how much alcohol is OK. One myRAteam member wrote that they “will go off methotrexate because my new rheumatologist does not want me to have any alcoholic beverages while on it.” They added, “My retired doctor allowed three drinks weekly. I like to have a glass of wine or a good margarita. Is anyone else concerned about alcohol use?”

Read more about alcohol and rheumatoid arthritis.

Foods and Rheumatoid Arthritis Medications

Research shows that certain foods and beverages may interact negatively with medications for rheumatoid arthritis or affect the way these drugs are metabolized by the body.

Methotrexate

As mentioned above, consuming alcohol while taking NSAIDs or methotrexate may lead to adverse side effects. The consumption of too much or too little folic acid (vitamin B9) can also affect the way the body metabolizes the methotrexate, potentially causing negative reactions. Some doctors may recommend supplementing your diet with folic acid to prevent possible toxicity.

Biologic Drugs

Biologics, such as tumor necrosis factor (TNF) inhibitors, suppress the immune system. Decreased immune activity can make you susceptible to developing severe infections (known as opportunistic infections). As a result, people taking certain biologic drugs may be at higher risk of developing food poisoning or other infections. Doctors recommend avoiding raw or undercooked meats, raw eggs, or unpasteurized dairy products, such as soft cheeses, to reduce the risk of infection.

Grapefruit and Calcineurin Inhibitors

Certain drugs known as calcineurin inhibitors — including cyclosporine and tacrolimus — may be prescribed if you are in an active flare-up or do not respond to other medications, such as methotrexate or disease-modifying antirheumatic drugs (DMARDs). Consuming grapefruit may affect the way these drugs are metabolized and increase their concentration in the blood.

Tips for Avoiding Inflammatory Foods With Rheumatoid Arthritis

If you’re looking to remove trigger foods from your diet, start by familiarizing yourself with what’s actually in the foods and drinks you consume. Take a close look at their ingredient labels — many products contain saturated fats, trans fats, and “hidden” potential triggers like gluten, casein, artificial sweeteners, and preservatives. The following tips may also help you avoid foods that may worsen your arthritis symptoms:

  • Opt for fresh foods over packaged and processed products.
  • Limit foods that are fried or cooked at high heat.
  • Increase your intake of omega-3 fatty acids and avoid omega-6 fatty acids (found in cooking oils).
  • Use natural cooking oils, like avocado oil or olive oil.

Find Alternatives

If you’re having difficulty avoiding certain triggers, such as sugar, you might try some alternatives. As one member shared, “Sugar is my worst enemy with my RA. Every time I go to eat anything with sugar, I have a flare. I have started replacing that craving with fruit.”

Another member took a similar approach: “I have frozen grapes in the freezer and pop them like candy when I get a craving,” they said.

If you have a sweet tooth or find it hard to eliminate sugar entirely from your diet, myRAteam members have suggested some sweet alternatives. One shared that they still consume coconut sugar and stevia — a sweetener derived from the leaves of the Stevia rebaudiana plant — while others report using honey and agave nectar instead of corn-derived sugars.

Rheumatoid Arthritis Diets

Sticking to a diet recommended for people with RA may help manage your symptoms. As always, talk to your rheumatologist or a dietitian before making any dietary changes.

Elimination Diet

While it’s not a particular diet you stick to in the long term, an elimination diet can help you get a better sense of what particular foods trigger your RA symptoms. This diet involves eliminating certain foods from your diet temporarily, then slowly reintroducing them during what’s known as a “challenge” period. This approach makes it easier to observe which foods may, in fact, be causing your symptoms to flare.

Although many myRAteam members report that gluten aggravates their symptoms, everyone with RA is different. You may even find that some common trigger foods don’t affect you. As one member wrote, “Sugar is a big trigger for me. Never had a problem with gluten.”

Some sources also recommend eliminating alcohol temporarily and observing how your symptoms change. For some people, eliminating alcohol for four to six weeks may help decrease inflammation and pain and improve your sleep, which can indirectly improve RA symptoms.

Anti-Inflammatory Diet

There is no conclusive research that a specific diet can prevent, cure, or improve the symptoms of RA, but eating certain foods associated with an anti-inflammatory diet may help. An anti-inflammatory diet is technically any diet that reduces inflammation in the body. The most popular forms of these diets are the Mediterranean diet, a high-fiber diet, and a plant-based (or vegan) diet.

Many myRAteam members have reported following an anti-inflammatory diet as they seek to manage their condition. “Started the Mediterranean diet on Monday, hoping for relief!” one member posted.

“I feel like my body responded very well to eating a totally plant-based diet,'' another member wrote, adding, “I just can say the only REAL thing that helps is FOOD, and totally plant-based is the only way to keep our bodies clean.”

“I, too, have been paying close attention to the anti-inflammatory food list,” shared a third.

Read more about the anti-inflammatory diet for rheumatoid arthritis.

Find Your Team

Navigating life with rheumatoid arthritis can be a challenge. The good news? You don’t have to go it alone. When you join myRAteam, you become a part of the social network for people diagnosed with rheumatoid arthritis and their loved ones. Here, more than 190,000 members from across the world come together to ask questions, offer support and advice, and share stories of life with RA.

What foods have you found trigger symptoms of rheumatoid arthritis? Have you made any dietary changes that help you feel better? Share your thoughts in the comments below or by posting on myRAteam.

All updates must be accompanied by text or a picture.
Ariel D. Teitel, M.D., M.B.A. is the clinical associate professor of medicine at the NYU Langone Medical Center in New York. Review provided by VeriMed Healthcare Network. Learn more about him here.
Victoria Menard is a writer at MyHealthTeam. Learn more about her here.

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