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Everyone feels their best when they consistently eat a healthy, balanced diet. For people with rheumatoid arthritis (RA), nutrition can help you combat inflammation, manage your weight, and avoid developing osteoporosis and other complications.

Some popular diets may contain toxic levels of some nutrients or dangerously low levels of others. Always consult your doctor before adding dietary supplements or making significant changes to your diet.

What does it involve?
A nutritious diet for someone with rheumatoid arthritis is not very different from a healthy diet for other people. In general, focus your diet on fresh vegetables and fruit, whole grains, legumes, fish, low-fat dairy products, and sources of healthy unsaturated fats such as nuts.

Antioxidants are nutrients that may help reduce inflammation. Fresh fruits and vegetables are packed with antioxidants, including vitamin C. Foods such as cantaloupe, citrus, tomatoes, broccoli, mango, pineapple, and berries are especially rich in vitamin C. Fresh produce is also often high in fiber, vitamins, and minerals, and lower in calories. Eat as many vegetables as possible, and eat fruit in balance with other carbohydrates.

Some types of fat raise cholesterol and may contribute to inflammation, while other types may help reduce inflammation. Researchers have tied saturated fats to increased inflammation. Saturated fats include fatty meat, full-fat dairy, fried foods, and baked goods made with tropical oils. Reduce your saturated fat intake by limiting your consumption of foods such as beef, pork, chicken with skin, lard, cream, butter, cheese, full-fat or 2 percent milk or yogurt. Instead, choose skim milk, fat-free yogurt, skin-free chicken or fish, and vegetarian meat substitutes.

Conversely, the type of fat found in walnuts, pecans, flaxseed, canola and olive oil, and fatty fish such as salmon, tuna, mackerel, lake trout, and sardines may help fight inflammation as well as heart disease. These foods are rich in omega-3 fatty acids.

Other foods found to increase inflammation include sugar, refined carbohydrates such as white bread and pastries, red meat, and many processed, pre-prepared products.

Dietary fiber keeps your heart healthy and your bowels working properly. You can eat more high-fiber foods including vegetables, dried or fresh fruits, legumes such as peas or beans, some nuts including almonds and pistachios, and whole-grain products. Making the switch from white bread to whole-grain, from white rice to brown rice, or from regular pasta to whole-grain pasta will also add fiber to your diet while avoiding refined carbohydrates. Oats and quinoa are other examples of whole grains. Always check labels to make sure products are whole-grain.

People with rheumatoid arthritis need more of some nutrients than other people. Osteoporosis is a serious concern for people with rheumatoid arthritis, who are at higher risk for losing bone mineral density even in early stages of the disease. Make sure to eat plenty of foods with calcium and vitamin D to fight osteoporosis. Foods rich in vitamin D include tuna, mackerel, salmon, egg yolks, and fortified products such as some milk, soy milk, orange juice, and cereal. Vitamin D may also help lower the risk of RA in older women by helping to regulate the immune system. Calcium is present in dairy, dark leafy greens such as kale and spinach, sardines, and fortified soy milk and orange juice.

As a result of treatment with corticosteroid medications such as Prednisone and Medrol (Methylprednisolone), some people with RA may need more of certain vitamins and minerals, including folic acid. Good sources of folic acid include leafy green vegetables, citrus fruits, asparagus, beets, Brussels sprouts, eggs, legumes, and fortified grains. Other medications may raise your sodium levels or deplete your body of potassium and other vitamins and minerals. Ask your doctor about the drugs you are taking, and whether you might need a test to check your nutrient levels. If one or more of your nutrient levels are low, your doctor may recommend dietary supplements.

Maintaining a healthy weight is important for people with rheumatoid arthritis. Keeping your weight to a healthy level can help reduce RA symptoms and improve mobility. Ask your doctor about setting a healthy weight goal. Eating a healthy diet is an important part of reaching that goal.

Alcohol poses several problems for people with rheumatoid arthritis. Consuming more than two alcoholic drinks per day can lower your calcium levels and raise your risk for developing osteoporosis. If, like many people with rheumatoid arthritis, you take non-steroidal anti-inflammatory drugs (NSAIDs) such as Ibuprofen or Celebrex (Celecoxib), drinking alcohol may also increase your risk for gastrointestinal bleeding, ulcers, and liver or kidney damage. Alcohol can also interfere with the effects of certain drugs, including Methotrexate. Finally, although alcohol labels never list calories, alcohol can add significant calories to your diet without adding any nutrients. According to the U.S. Department of Agriculture, a can of beer is about 154 calories; a glass of wine has about 123 calories; and a mixed drink has around 103 calories. Those calories can add up.

Drinking eight to 10 glasses of water each day will flush toxins from your system and may help reduce inflammation.

Consider consulting a dietitian or nutritionist to help plan a diet designed to meet your specific needs and goals. On your own, you can experiment by cutting out certain foods for a few weeks, then adding them back in. Keep a diary that tracks what you eat and drink and how you feel, and watch for foods that cause flares.

Intended outcomes
Eating a nutritious, balanced diet can help improve your rheumatoid arthritis symptoms by reducing inflammation and maintaining a healthy weight. A healthy diet can also lower your risk for osteoporosis and other serious complications.

There have not been any rigorous clinical studies examining the effect of diet specifically on rheumatoid arthritis. However, multiple studies have established that certain foods promote or reduce inflammation.

Side effects of some medications, which can include nausea, upset stomach, fatigue, and dizziness, may make it difficult to eat regular meals or focus on a healthy diet.

Fatigue, depression, or physical disabilities may make it more difficult to find the energy to prepare fresh, healthy meals. Making large batches of food in advance and freezing several portions for the future can help conserve energy.

You may feel disappointed to give up favorite high-sugar, deep-fried, or full-fat foods. However, think of diet changes as a chance to explore unfamiliar foods and find new favorites. Many recipe books focus on low-fat, high-fiber cooking and provide a wealth of exciting ideas.

Depending on where you live, it may be harder to get to a grocery store with a good selection of produce and other healthy foods.

For more details about this treatment, visit:
Foods that fight inflammation – Harvard Women’s Health Watch

Nutrition and pain – Mayo Clinic

Nutrition Guidelines for People with Rheumatoid Arthritis - Arthritis Foundation

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