If you have rheumatoid arthritis (RA), one way of managing inflammation alongside your prescribed treatments is through your diet. Although some foods may have benefits for people with this inflammatory disorder, others have been found to increase inflammation, potentially worsening joint pain, stiffness, and other symptoms of RA.
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. Another member said, “I think everything in moderation is the way to go.”
Ultimately, there is no one right diet for everyone with RA. With this in mind, research has found that people with RA may be better off avoiding some of the following foods and drinks, especially those that might affect certain RA treatments.
Fats and oils have been found to heighten the body’s immune response, increasing inflammation and aggravating RA symptoms.
Saturated fats, frequently referred to as unhealthy fats, increase low-density lipoprotein (LDL, or bad cholesterol). Aside from increasing risks related 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 are also considered unhealthy fats. They can harm cardiovascular health and stimulate or worsen systemic (throughout the body) inflammation. Often labeled as “partially hydrogenated vegetable oils,” trans fats are frequently found in highly processed foods.
Canola and vegetable oils are hydrogenated oils and often contain omega-6 fatty acids, which are healthy in small amounts but can cause inflammation when consumed in excess.
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 RA.
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 — toxins that damage the body’s tissues and trigger inflammation.
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 — the protein is a known immunological trigger in RA.
Gluten shows up in products that contain wheat, barley, and rye, such as pasta and bread. Although there is ongoing discussion about it in the medical community, some experts believe that eliminating gluten may be beneficial for some people with RA.
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.
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.” 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.
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 chemical called aspartame.
Monosodium glutamate (MSG) is a substance used to preserve foods and enhance their flavors. For some people, eating MSG may lead to inflammation and worsened RA symptoms.
The relationship between alcohol and RA is complex. Although red wine has 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 RA.
If your doctor prescribes methotrexate to treat your RA symptoms, they may also recommend supplementing your diet with folic acid to prevent possible side effects from the medication. Consuming too much or too little folic acid (vitamin B9) can affect the way the body metabolizes the methotrexate, potentially causing negative reactions. Some researchers have suggested that — in rare cases — eating too many foods rich in folate (the natural form of vitamin B9), such as dark leafy greens, when taking folic acid supplements could tip the balance and interfere with methotrexate. Talk to your doctor if you’re concerned about how your diet affects your treatment plan.
Biologics, such as tumor necrosis factor 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, and unpasteurized dairy products, such as soft cheeses, to reduce the risk of infection.
Certain drugs known as calcineurin inhibitors — including cyclosporine (sold as Neoral and Sandimmune) 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.
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 worsen your arthritis symptoms:
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.”
If you have a sweet tooth or find it hard to eliminate sugar 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.
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.
Although it’s not a diet that you follow for the long term, an elimination diet can help you get a better sense of what particular foods trigger your RA symptoms. This diet involves removing 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 be causing your symptoms to flare.
Many myRAteam members report that gluten aggravates their symptoms, but 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 sleep, which can indirectly improve RA symptoms.
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 are Mediterranean, high-fiber, and plant-based (or vegan) diets.
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. “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 RA.
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 197,000 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.