The Impact of Food on RA

The role of food on the expression of Rheumatoid Arthritis has been known for, probably, centuries to those with the disorder.  It was the common knowledge among those with the condition that finally led researchers to look into it. Below is some of the recent research showing the impact of diet on inflammation and RA.

You will note that little of it has been conducted in the United States where so much health related research is subsidized by drug companies and therefore involves only sophisticated and dangerous pharmaceuticals instead of more benign and less toxic dietary measures.

These articles deal with the effects of diet on inflammation, the immediate cause of arthritis destruction; with the impact of a Mediterranean diet – high in olive oil and vegetables; with the effect of omega-3 fatty acids like those found in olive oil and fish; with the role of gluten in inflammatory disease; and with the impact of a vegetarian diet, all pointing to a connection between Rheumatoid Arthritis, inflammation and food.

One article notes that chronic fatigue can be improved by an anti-inflammatory diet and another concludes that a person’s psychological sense of empowerment plays a role in the course of the disease.

Several mention that fasting is a way to immediately calm the inflammatory disease process. The only possible conclusion, if avoiding food eliminates the symptoms, is that foods are the immediate cause of the disorder.

There is an article about the improvement some had with a vegetarian diet, even though the diet included foods that would be, for some, an immune system trigger for inflammation.

The almost universal problem with dietary research into RA and other autoimmune diseases is the rigidity of the study design and the lack of understanding that autoimmune disease processes are uniquely personal. A one-size-fits-all approach, where the diet for everyone is controlled for specific foods, will result in a study that lacks the power to show clear and definitive improvement.

Nevertheless, many of these did just that, and those that produced results that were not scientifically significant still managed to show that diet could improve not only arthritis, but according to several included below, also chronic fatigue, heart disease and other inflammatory conditions.


1. [Short-term therapeutic fasting in the treatment of chronic pain and fatigue syndromes–well-being and side effects with and without mineral supplements] Michalsen A, Weidenhammer W, Melchart D, Langhorst J, Saha J, Dobos G. Forsch Komplementarmed Klass Naturheilkd. 2002 Aug;9(4):221-7;Abteilung für Innere Medizin V, Naturheilkunde und Integrative Medizin, Kliniken Essen Mitte, Essen. [Article in German]

CONCLUSIONS: Fasting followed by vegetarian diet has shown to be an effective treatment for rheumatoid arthritis, moreover fasting is frequently used as an [added] treatment in chronic pain and stress/exhaustion syndromes. …. Short-term fasting in patients …. is safe and well tolerated….


2. Vegetarian diet for patients with rheumatoid arthritis–status: two years after introduction of the diet. Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Førre O.; Clin Rheumatol. 1994 Sep;13(3):475-82;Department of General Practice, University of Oslo, Norway.

CONCLUSION: Our findings indicate that a group of patients with rheumatoid arthritis benefit from dietary manipulations and that the improvement can be sustained through a two-year period.

*************************************************************3. [Role of omega-3 polyunsaturated fatty acids in diet of patients with rheumatic diseases] Sales C, Oliviero F, Spinella P.;Reumatismo. 2008 Apr-Jun;60(2):95-101 Servizio di Dietetica e Nutrizione Clinica, Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Via Giustiniani 2, Padua, Italy. [Article in Italian]

CONCLUSION: Nutritional therapy based on food rich in omega-3 or on supplementation with fish oil capsules, proved to be a valid support to the treatment of chronic inflammatory rheumatic diseases including …[RA. systemic lupus erythematosus and ankylosing spondylitis.]


4. Dietary fatty acids and arthritis. Hurst S, Zainal Z, Caterson B, Hughes CE, Harwood JL.; Prostaglandins Leukot Essent Fatty Acids. 2010 Apr-Jun;82(4-6):315-8. Epub 2010 Mar.;School of Biosciences, Cardiff University, Cardiff, UK.

CONCLUSION: The data provide a scientific rationale for the consumption of n-3 fatty acids [olive oil) as part of a healthy diet and perhaps in treating arthritis.


5. Arterial stiffness and cumulative inflammatory burden in rheumatoid arthritis: a dose-response relationship independent of established cardiovascular risk factors. Crilly MA, Kumar V, Clark HJ, Scott NW, Macdonald AG, Williams DJ.; Rheumatology (Oxford). 2009 Dec;48(12):1606-12. Epub 2009 Oct 25; Section of Population Health, Institute of Applied Health Sciences, Aberdeen University Medical School, Aberdeen AB25 2ZD, UK.

CONCLUSIONS: In RA patients free of overt arterial disease, a dose-response relationship exists between cumulative inflammation and arterial stiffness. This relationship is independent of established CV risk factors.


6. Effects of the Mediterranean diet on longevity and age-related morbid conditions. Pérez-López FR, Chedraui P, Haya J, Cuadros JL.Department of Obstetrics and Gynecology, Facultad de Medicina, Universidad de Zaragoza, Hospital Clínico de Zaragoza, 50009 Zaragoza, Spain.

CONCLUSIONS: Individuals who adhere to the principles of the traditional Mediteranean Diet tend to have a longer life-span. Both men and women who report eating foods closest to the MD are about 10-20% less likely to die over the course of a study of heart disease, cancer or any other cause. … The MD also has a preventive effect on cancer, … mostly due to the components of virgin olive oil and vegetables. There is some evidence of the benefits of the MD in relation to bone metabolism, rheumatoid arthritis, and neurodegenerative age-related diseases (cognitive deficit, Alzheimer’s disease, Parkinson’s disease).


7.  Gluten-free vegan diet induces decreased LDL and oxidized LDL levels and raised atheroprotective natural antibodies against phosphorylcholine in patients with rheumatoid arthritis: a randomized study Elkan AC, Sjöberg B, Kolsrud B, Ringertz B, Hafström I, Frostegård J; Arthritis Res Ther. 2008;10(2):R34. Epub 2008 Mar 18;Rheumatology Unit, Karolinska Institutet at Karolinska University Hospital Huddinge,141 86 Stockholm, Sweden;

CONCLUSION: A gluten-free vegan diet in RA induces changes that are potentially [heart] protective and anti-inflammatory, including decreased LDL and oxLDL levels and raised anti-PC IgM and IgA levels.


8. A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Hafström I, Ringertz B, Spångberg A, von Zweigbergk L, Brannemark S, Nylander I, Rönnelid J, Laasonen L, Klareskog L.; Rheumatology (Oxford). 2001 Oct;40(10):1175-9;Department of Rheumatology, Karolinska Institutet at Huddinge University Hospital, Stockholm, Sweden.

CONCLUSION: The data provide evidence that dietary modification may be of clinical benefit for … RA patients, and that this benefit may be related to a reduction in immune [system reaction] to foods … eliminated by the change in diet.


9. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Laerum E, Eek M, Mowinkel P, Hovi K, Førre O.; Lancet. 1991 Oct 12;338(8772):899-902;Department of General Practice, University of Oslo, Norway.

CONCLUSION: Fasting is an effective treatment for rheumatoid arthritis.…The effect of fasting followed by one year of a vegetarian diet was assessed … The diet group showed a significant improvement in number of tender joints, Ritchie’s articular index, number of swollen joints, pain score, duration of morning stiffness, grip strength, …sedimentation rate, C-reactive protein, white blood cell count, …. The benefits in the diet group were still present after one year, ….


10. Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Adam O, Beringer C, Kless T, Lemmen C, Adam A, Wiseman M, Adam P, Klimmek R, Forth W. Rheumatol Int. 2003 Jan;23(1):27-36. Epub 2002 Sep 6.Medizinische Klinik Innenstadt der LMU, Ziemssenstrasse 1, 80336 Munich, Germany.

CONCLUSION: … In patients on the Anti-Inflammatory Diet, but not those on the Western Diet, the numbers of tender and swollen joints decreased by 14%…. In AID patients, as compared to WD patients, fish oil led to a significant reduction in [disease activity] …. A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation.


11. Effects of fish oil supplementation on non-steroidal anti-inflammatory drug requirement in patients with mild rheumatoid arthritis–a double-blind placebo controlled study. Lau CS, Morley KD, Belch JJ.;Department of Medicine, Ninewells Hospital, Dundee, Scotland. Br J Rheumatol. 1993 Nov;32(11):982-9.

CONCLUSION: …. There was a significant reduction in NSAID (aspirin, etc.) usage in patients on (fish oil supplements) when compared with placebo …. … patients were able to reduce their NSAID requirement without experiencing any deterioration in the clinical and laboratory parameters of RA activity.

*******************************************************************12. Vegetarian diet for patients with rheumatoid arthritis: can the clinical effects be explained by the psychological characteristics of the patients? Kjeldsen-Kragh J, Haugen M, Førre O, Laache H, Malt UF.; Br J Rheumatol. 1994 Jun;33(6):569-75;Department of General Practice, University of Oslo, Norway.

CONCLUSION: … patients with certain psychological characteristics self-selected into the clinical trial and benefited most. [a sense of self-efficacy, the ability to affect their own lives, played a role in their clinical improvement.]


13. [The Mediterranean diet model in inflammatory rheumatic diseases] Sales C, Oliviero F, Spinella P.; Reumatismo. 2009 Jan-Mar;61(1):10-4.;Servizio di Dietetica e Nutrizione Clinica, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Padova, Padova, Italia. [Article in Italian]

CONCLUSION: It has been shown that the Mediterranean diet can reduce disease activity, pain and stiffness in patients with inflammatory arthritis and may thus constitute a valuable support for patients suffering from these diseases.


5 comments to Diet and RA: The Research

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