Indulge in These Healthy Eating Habits to Keep Rheumatoid Arthritis (RA) at Bay!

Medications are a mainstay of treatment, but an appropriate diet might help in the management of RA.

Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disease, affects roughly 1% of the world’s population. RA pathogenesis remains unclear, but genetic factors account for 50–60% of the risk while the remainder might be linked to modifiable factors, such as infectious diseases, Tobacco smoking, gut bacteria, and nutrition. Dietary triggers may play an inciting role in the autoimmune process, and a compromised intestinal barrier may allow food components or microorganisms to enter the bloodstream, triggering inflammation. In addition, excessive body weight may affect pharmacotherapy response and the likelihood of disease remission, as well as the risk of disease mortality. Medications are a mainstay of treatment, but an appropriate diet might help in the management of RA.

Excessive body weight increases the risk of RA. Excessive fatty tissue secretes pro-inflammatory cytokines and increases tissue inflammation. Increased body weight further exacerbates joint damage in these patients. Canadian Early Arthritis Cohort (CATCH) study (n = 982) showed that being overweight or obese were independently associated with a decreased chance for achieving sustained RA remission. Diets high in fat and processed meat increase inflammatory markers, while diets high in whole grains and fruit reduce these.

• Processed carbohydrates like white flour and white sugar, saturated and trans fats, like those found in fried foods, red & processed meats, dairy, eggs might increase inflammatory response. Studies show that a Mediterranean diet, with lots of fruits and vegetables, whole grains and healthy fats is a good choice for people with RA.
• Omega-3 Fatty Acids in fish may help control inflammation. Unfortunately, there have been few experiments with fish oils in patients with RA that have shown favourable results and consequently practical and safe doses are still unknown for this dietary therapy. Excessive fish oil supplements may interfere with blood clotting and increase the risk for Stroke, especially when consumed in conjunction with Aspirin or other nonsteroidal anti-inflammatory drugs. Taking excess fish oils has also been linked to changes in bowel habits such as diarrhoea and may also cause an upset stomach.
• Peas and beans are a good source of vegetable protein helping muscle health, are nearly fat free with and a source of antioxidants.
• Nuts are full of healthful monounsaturated fat. Walnuts are good in moderation for people with RA because they’re high in Omega-3 Fatty Acids but high in calories.
• Olive oil contains healthy monounsaturated fat and a compound called Oleocanthal that reduces inflammation but eat it in moderation; as with all oils, it’s a fat that can lead to weight gain. Results show that dietary changes are hard to maintain long term and the elimination of one or more food groups (such as in a strict vegan diet) may lead to deficiencies. The patient should be willing and able to make the change. Such patients are already vulnerable to nutritional risk and hence patients should be encouraged to follow a healthy, balanced diet and maintain a healthy weight instead of aggressive dietary manipulation expecting a miracle cure.

Nutritional Guidelines:

• Eat a variety of foods
• Balance the food you eat with physical activity; maintain or improve your weight
• Choose a diet with plenty of grain products, vegetables, and fruits
• Choose a diet low in fat, saturated fat, and cholesterol
• Get more fibres in your diet
• Choose a diet moderate in sugars
• Avoid Alcoholic beverages
• Supplementation of Calcium and vitamin D to decrease the risk of Osteoporosis
• Supplement with Vitamin C, B6, B12, E, Folic acid, Magnesium, Zinc and Selenium supplements as food alone may not provide enough

(Inputs by Dr Kaushal Malhan, Director-Orthopaedics & Joint Replacement Surgery, Fortis Hospital, Mulund)