Anti-Inflammatory Diet for Arthritis

While there is no special diet for arthritis, researchers have identified certain foods and supplements that may be helpful. One group of foods that reduce inflammation, called anti-inflammatory foods, has shown promise in some studies. Anti-inflammatory foods contain compounds that help control inflammation in the body, which is a hallmark of RA. These foods comprise what is known as the anti-inflammatory diet, sometimes also referred to as the Mediterranean diet.

Before beginning any new dietary or supplement regimen, it’s important to talk to your doctor.

What’s in the Mediterranean Diet?

• Fruits and Vegetables – Fruits and vegetables contain antioxidants that can help reduce inflammation. Specifically, green leafy vegetables rich in vitamin K like spinach, kale and broccoli dramatically reduce markers in the blood that indicate inflammation. Research has also shown that cherries, strawberries and other red and purple fruits have an anti-inflammatory effect.
• Whole grains – There is some evidence that whole grains, such as brown rice and quinoa, may help lower an indi­cator of inflammation in the body called C-reactive protein (CRP), which sometimes goes up during an RA flare. CRP can be measured through a blood test. Whole wheat pastas and breads offer the additional benefit of the antioxidant selenium, which can be low in some people with RA.
• Beans – Beans are helpful in two ways. First, they are loaded with beneficial protein that helps preserve muscle health. This is important for people with RA and osteoarthritis because muscles help support the joints. Beans are also loaded with fiber and phytonutrients, which help lower CRP.
• Nuts and Seeds –There are many studies that confirm the anti-inflammatory properties of nuts and seeds. One study published in The American Journal of Clinical Nutrition in 2011 found that men and women who consumed the most nuts over a 15-year period had a 51 percent lower risk of dying from an inflammatory disease like RA compared with those who ate the fewest nuts.
• Olive oil – Olive oil, particularly extra virgin olive oil, has been shown to lower the amount of chemicals in the body that cause inflammation, in much the same way that ibuprofen does. Drizzle it over salads or use as a low-fat alternative to other cooking oils and butter. Extra virgin olive oil is best because it is less processed compared to other types, and thus has more nutrients.
• Oily fish and fish oil (from cold water fish such as salmon, herring, cod, trout and sardines)

Why Fish Oil?

Fish oil is an excellent source of omega-3 fatty acids, which the body converts to powerful anti-inflammatory chemicals.  Fish oil has been studied extensively in RA and other inflammatory conditions. Studies have shown that fish oil can relieve joint tenderness and morning stiffness, reduce the duration of morning stiffness and reduce disease activity in people with RA.  For some people, it has allowed them to lower the amount of conventional medicine they take for their RA.  Early studies show that fish oil may have similar effects in people with osteoarthritis.
Some evidence suggests that the positive effects of fish oil supplements are enhanced when fish oil is consumed in combination with olive oil. Since it is difficult to get enough fish oil from food alone, people with RA should consider fish oil capsules with at least 30 percent EPA/DHA.
It’s important to talk to your doctor about the right dosage of fish oil for you if you choose to start taking it. Higher doses of fish oil may interact with certain drugs, including those for high blood pressure.

Foods to Avoid with Arthritis
Some foods have been found to increase inflammation and should be avoided as much as possible if you have arthritis. These include:

• Meats grilled or fried at high temperature – Although a direct link to arthritis is not firmly established, studies have shown that frying, roasting, searing or grilling meat at high temperatures can raise the amount of advanced glycation end products (AGEs) in the blood. AGEs have been found in people with inflammation and are believed to increase inflammation in the body.The highest levels of dietary AGEs are found in beef, pork and fish; however, even leaner meats like chicken produce high levels of AGEs when they are cooked with dry heat. Try lowering the cooking temperature of the meats that you eat. Some good alternatives include steaming fish and seafood, simmering chicken in a sauce and braising red meat in cooking liquid.
• Omega-6 Fatty Acids – Omega-6 fatty acids are found in corn, sunflower, safflower, soybean and cottonseed oils as well as many common snack foods like cookies, crackers and cake mix. When you take in more omega-6 fatty acids than omega-3s, it raises your risk of joint inflammation and obesity.
• Sugar – A diet high in sugar increases inflammation and contributes to obesity, so it’s best to limit the amount of deserts, pastries and sweet drinks, such as sodas and fruit juices in your diet. The American Journal of Clinical Nutrition has said that sugar triggers the release of inflammatory messengers in the body called cytokines. In addition to “sugar” look out for any word ending in “ose” on labels, such as fructose and sucrose.
• Trans fats – Typically seen as “partially hydrogenated” oil in packaged goods and margarine, trans fats are vegetable oils that have been processed to reduce the chance of spoilage and increase the shelf life of processed foods, particularly snack foods. These fats have been shown to increase inflammation.Trans fats can also raise bad cholesterol and lower good cholesterol, which increases the risk of heart disease. Be sure to read labels and substitute trans fat-free liquid oils, such as olive and canola oils instead of margarine or shortening. It’s also a good idea to limit the amount of fried foods you order at restaurants, as these are often fried in trans fat.

• Mono-Sodium Glutamate (MSG) – This chemical ingredient is added to many foods as a flavor enhancer, most commonly in Asian foods like soy sauce, and has been shown to trigger inflammation. Look for it on food labels.

What about Gluten?
While some people believe gluten can worsen RA, there is no evidence to support this. However, those who are sensitive to gluten (found in wheat, barley and rye) should avoid eating it in order to avoid bowel inflammation.

Alcohol and Tobacco – Call it Quits
Cigarette smoking is bad for everyone, but in people with RA it has been shown to increase the severity of the disease. Smoking can also make it harder to manage RA. Studies show that people with RA who smoke are less likely to achieve remission and tend to have a worse prognosis.
Smoking can also increase painful rheumatoid nodules, which form in the joints, and can lead to heart disease, the leading cause of death in people with RA. People with RA are at greater risk for heart disease compared to the general population.

Drink Alcohol in Moderation
Studies are mixed on the effects of alcohol on RA. While alcohol does not contribute to or worsen RA like smoking does, experts say it’s best to have one or two glasses of wine, beer or spirits occasionally, but not more than that.  If you are taking non-steroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, alcohol can increase your risk of stomach bleeding and liver problems, respectively. Drinking more than two glasses per day can also increase your risk of certain cancers.