Rheumatoid Arthritis

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The RA Diet: Anti-inflammatory and Nutritious
By John Henry Dreyfuss 
Published 8/12/2009 
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The food message for people with rheumatoid arthritis (RA) will no doubt sound familiar, because the recommendation is to eat a nutritious diet with plenty of intact carbohydrates (fresh fruits and vegetables, legumes, whole grains), nutritious fats, and high-quality protein sources.  

While losing weight is frequently recommended for people with other types of arthritis, people with rheumatoid arthritis frequently lose weight as a result of the illness. For this reason, it’s even more important to eat well, and to eat enough. Too much weight loss will put you at risk for nutrition-related diseases such as osteoporosis, malnutrition and — especially significant for people with RA — protein deficiency, which can affect muscle strength. While there is preliminary evidence that the elimination of processed foods may improve rheumatoid arthritis, there is still much that needs to be learned through carefully designed clinical trials. The bottom line is that dietary changes to bring about improvement in the condition may be important for people with RA.

Go Mediterranean
The Mediterranean diet, so-called because it is the preferred approach to eating in many of the countries that border the Mediterranean Sea, is a particularly good choice for people with RA.  The consumption of lots of fish, vegetables and olive oil, coupled with minimal amounts of red meat and little if any industrially processed fats or baked goods, provides a powerful anti-inflammatory effect for those who eat this way. According to a number of studies, nutrients such as omega-3 fatty acids, found in fish and green leafy vegetables, reduce the inflammatory activity of the immune system. In fact, clinical trials have shown that the arthritis-alleviating effects of omega-3s are amplified when consumed in combination with olive oil.

Beyond the Basics: Antioxidants, Omega-3s and Other Nutrients
In addition to maintaining a healthy diet and increasing your intake of omega-3 fatty acids, whether from foods or supplements, consuming more antioxidants can help, according to Rula Hajj-Ali, MD, a specialist in rheumatologic and immunologic disease at the Cleveland Clinic. 

Antioxidants such as vitamin C, vitamin E, beta-carotene and selenium, found especially in fruits and vegetables and certain nuts, may prevent tissue damage caused by free oxygen radicals. In fact, a study from the Netherlands reported that after just 10 weeks on an antioxidant-infused diet, study subjects experienced a significant decrease in the number of swollen and painful joints, and they reported significant improvements in their general health. You can certainly get plenty of antioxidants through your diet, by eating plenty of fresh fruits and vegetables and other whole foods, but some experts recommend that you take supplements as well, as a sort of insurance policy. Important antioxidants and their sources include:  

  • Vitamin A: chicken, turkey and fish liver; carrots, broccoli, pumpkin, sweet potatoes, kale, spinach, and other green leafy vegetables
  • Vitamin C: plums, rose hips, black currants, red peppers, parsley, guavas, kiwis, broccoli, Brussels sprouts, citrus fruits
  • Vitamin E: wheat germ oil, roasted almonds, sunflower seeds and oil, avocados, eggs, milk, spinach, whole grains and seeds, safflower oil, hazelnuts, peanut butter
  • Selenium: Brazil nuts, tuna, beef, cod, turkey, chicken, eggs, cottage cheese

Other important nutrients include vitamins B5 and B6, copper and zinc, all of which support the production and repair of cartilage, a smooth, firm, yet flexible type of tissue in our joints that to facilitate easy, pain-free movement. Since RA can affect the integrity of cartilage and cause it to break down, good nutrition is essential for preservation and ongoing repair. Good sources of these micronutrients include:

  • Vitamin B5: potatoes, bananas, lentils, chili peppers, tempeh, beans, liver oil, liver, turkey, tuna, nutritional yeast, brewer’s yeast
  • Vitamin B6: potatoes, bananas, chickpeas, chicken, pork, beef, trout, sunflower seeds, spinach, tomatoes
  • Copper: oysters, squid, lobster, mussels, crab, clams, beef liver, cashews, hazelnuts, macadamia nuts, pecans, soybeans, lentils, cocoa, tomatoes, potatoes, sweet potatoes, bananas, avocados
  • Zinc: oysters, crab, chicken, lobster, beans, cashews, raisins, chickpeas, yogurt, cheese

One more important nutrient is flavonoids, which have been shown to reduce joint inflammation in individuals with RA. Foods containing flavonoids are also part of a healthy diet, and good sources include berries (whether red, blue or purple), green and white teas, cocoa, apples, grapes and red wine, citrus fruits, broccoli, soybeans, tofu, and miso.

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