Food Can your diet help arthritis? “Some foods may trigger symptoms in some people, but not others” Mediterranean, vegan, elimination – the amount of information about diets and arthritis can be overwhelming. We look at the science behind the claims and find out whether eating or avoiding certain foods can be beneficial for arthritis Words: Louise Parfitt My mum, Jacqueline, doesn’t put vinegar on her chips. She limits the amount of tomatoes she eats, and steers clear of oranges. It’s not that she doesn’t like these foods, but she says they affect the symptoms of her rheumatoid arthritis (RA). She is not alone; many people say their arthritis pain can be increased or lessened by what they eat. It seems as if every week there is a claim that eating this or avoiding that will ease your symptoms – but what you read today can contradict what you heard on the radio last week. The Mediterranean diet This includes poultry, fish, plenty of vegetables, fresh fruit, olive oil, wholegrain cereals, peas, beans, nuts and seeds, and less red meat than a typical UK diet. Some studies have indicated that this type of diet may improve the symptoms of RA, but the results are not conclusive. For example, one study showed that only men benefited and, in another, the diet was combined with an exercise programme, so it is difficult to say how much the diet contributed. “Following a Mediterranean diet might improve your arthritis, but, importantly, it will benefit your overall health, as it is well balanced,” says Clare Thornton-Wood, paediatric and adult dietitian, and British Dietetic Association spokesperson. The UK government also recommends it. The veggie diet Some people have found that a plant-based diet (vegan) or cutting out meat and fish (vegetarian) helps reduce inflammation and ease joint pain. In September 2019, a US investigation into studies that indicated a plant-based diet could ease arthritis symptoms concluded that more research was needed. “Diets rich in fruit and vegetables will be rich in natural antioxidants”, says Alex White, assistant nutrition scientist at the British Nutrition Foundation. “However, there is no definitive evidence of a link between specific foods and a reduction in the severity of arthritis symptoms.” If you decide to choose a vegetarian or vegan diet, speak to your GP to make sure you’re not missing out on essential nutrients that are important for arthritis and healthy bones, such as calcium. Elimination diets Some people avoid certain ‘trigger foods’ because they say they make their arthritis worse. Common foods they avoid include citrus fruits, because the acidity exacerbates inflammation; and nightshade-family vegetables (tomatoes, peppers and aubergines) because they contain solanine, which some fear may cause pain and inflammation. But research has shown no link between inflammation and such vegetables. “There is no conclusive evidence,” says Thornton-Wood. “Solanine is also found in foods not in the nightshade family, such as blueberries, apples and cherries.” A study by KIIT University in India found that blueberries may reduce joint stiffness – and citrus fruits contain inflammation-fighting antioxidants, which may help those with RA. “Some foods may trigger symptoms in some people but not others,” says White. What should you do? The science isn’t conclusive on the benefits of following a specific diet, but eating a balanced diet will help you to maintain a healthy body and weight. “There are a number of concerns to being overweight if you have arthritis, including an increase in disease activity, medication working less effectively, and strain on joints,” says Thornton-Wood, who agrees with White that following the principles of the Mediterranean diet is good for you. “While the evidence for it reducing arthritis symptoms is inconsistent, this dietary pattern is likely to be generally beneficial for our wellbeing,” says White. Feeling tired is a common symptom of RA and, if you are anaemic, this will be made worse. “Make sure your diet contains iron-rich foods, such as green leafy vegetables, fortified breakfast cereals, red meat and eggs,” says Thornton-Wood. “Also, oily fish is an excellent source of omega-3, so eat at least one portion a week or take a fish-oil supplement.” She also recommends a daily 10 microgram vitamin D supplement, because low levels of this have been linked to faster disease progression (see Inspire, Winter 2019). Before taking any supplements or trying a new diet, however, do seek professional advice. “Consult your GP or pharmacist before supplementing, especially if you are on other medication,” says White. “Following a Mediterranean diet will benefit your overall health, as it is well balanced” read More Food “Some foods may trigger symptoms in some people, but not others” Mediterranean, vegan, elimination – the amount of information about diets and arthritis can be overwhelming. We look at the science behind the claims and find out whether eating or avoiding certain foods can be beneficial for arthritis Words: Louise Parfitt My mum, Jacqueline, doesn’t put vinegar on her chips. She limits the amount of tomatoes she eats, and steers clear of oranges. It’s not that she doesn’t like these foods, but she says they affect the symptoms of her rheumatoid arthritis (RA). She is not alone; many people say their arthritis pain can be increased or lessened by what they eat. It seems as if every week there is a claim that eating this or avoiding that will ease your symptoms – but what you read today can contradict what you heard on the radio last week. The Mediterranean diet This includes poultry, fish, plenty of vegetables, fresh fruit, olive oil, wholegrain cereals, peas, beans, nuts and seeds, and less red meat than a typical UK diet. Some studies have indicated that this type of diet may improve the symptoms of RA, but the results are not conclusive. For example, one study showed that only men benefited and, in another, the diet was combined with an exercise programme, so it is difficult to say how much the diet contributed. “Following a Mediterranean diet might improve your arthritis, but, importantly, it will benefit your overall health, as it is well balanced,” says Clare Thornton-Wood, paediatric and adult dietitian, and British Dietetic Association spokesperson. The UK government also recommends it. The veggie diet Some people have found that a plant-based diet (vegan) or cutting out meat and fish (vegetarian) helps reduce inflammation and ease joint pain. In September 2019, a US investigation into studies that indicated a plant-based diet could ease arthritis symptoms concluded that more research was needed. “Diets rich in fruit and vegetables will be rich in natural antioxidants”, says Alex White, assistant nutrition scientist at the British Nutrition Foundation. “However, there is no definitive evidence of a link between specific foods and a reduction in the severity of arthritis symptoms.” If you decide to choose a vegetarian or vegan diet, speak to your GP to make sure you’re not missing out on essential nutrients that are important for arthritis and healthy bones, such as calcium. Elimination diets Some people avoid certain ‘trigger foods’ because they say they make their arthritis worse. Common foods they avoid include citrus fruits, because the acidity exacerbates inflammation; and nightshade-family vegetables (tomatoes, peppers and aubergines) because they contain solanine, which some fear may cause pain and inflammation. But research has shown no link between inflammation and such vegetables. “There is no conclusive evidence,” says Thornton-Wood. “Solanine is also found in foods not in the nightshade family, such as blueberries, apples and cherries.” A study by KIIT University in India found that blueberries may reduce joint stiffness – and citrus fruits contain inflammation-fighting antioxidants, which may help those with RA. “Some foods may trigger symptoms in some people but not others,” says White. What should you do? The science isn’t conclusive on the benefits of following a specific diet, but eating a balanced diet will help you to maintain a healthy body and weight. “There are a number of concerns to being overweight if you have arthritis, including an increase in disease activity, medication working less effectively, and strain on joints,” says Thornton-Wood, who agrees with White that following the principles of the Mediterranean diet is good for you. “While the evidence for it reducing arthritis symptoms is inconsistent, this dietary pattern is likely to be generally beneficial for our wellbeing,” says White. Feeling tired is a common symptom of RA and, if you are anaemic, this will be made worse. “Make sure your diet contains iron-rich foods, such as green leafy vegetables, fortified breakfast cereals, red meat and eggs,” says Thornton-Wood. “Also, oily fish is an excellent source of omega-3, so eat at least one portion a week or take a fish-oil supplement.” She also recommends a daily 10 microgram vitamin D supplement, because low levels of this have been linked to faster disease progression (see Inspire, Winter 2019). Before taking any supplements or trying a new diet, however, do seek professional advice. “Consult your GP or pharmacist before supplementing, especially if you are on other medication,” says White. “Following a Mediterranean diet will benefit your overall health, as it is well balanced” read More Can your diet help arthritis? you are what you eat Jacqueline Parfitt was diagnosed with rheumatoid arthritis in her early 50s. Her mother had lived with the condition for many years, so Jacqueline had had experience of it. She did some research, started adjusting her diet, and found that – for her – foods containing acids seemed to be triggers. “My body does not react well to these foods now that I have arthritis, so I cut back on them,” she says. “That was more than 20 years ago and, although the condition has progressed, my diet has helped me to manage my symptoms and keep active.”