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NMU 73 – Diet for Patients with Rheumatoid Arthritis

Nutrition / Natural Medicine Update No. 73 (November 22, 2017)

with Dr. James Meschino


Research Topic: Diet for Patients with Rheumatoid Arthritis

Source: Journal Frontiers in Nutrition – Clinical Nutrition (November 2017)


The research review paper I am citing today was published in the journal Frontiers in Nutrition on Nov 8, 2017.  It’s a fabulous review article with concluding recommendations by the researchers that address the role of dietary practices in the management of rheumatoid arthritis. But the recommendations also apply to other autoimmune diseases that affect the joints, as well as osteoarthritis. The researchers review the different dietary approaches used over the years to help manage Rheumatoid Arthritis and cite some impressive outcomes.

First Up is the 7-Day Supervised Fast, followed by an on-going Vegan Diet – this is where patients are allowed to have limited vitamin and mineral supplementation, carbohydrates, and energy in the form of vegetable juice for 7 days. Results show that this approach decreases the activation of CD4 cells to inflammatory TH1 and Th17 inflammatory cells, which are known to produce significant inflammation and joint destruction rheumatoid arthritis. This approach also decreased other inflammatory joint chemicals (LTB4) from neutrophils). This diet also put patients into ketosis (a low-blood sugar state) and one of the ketone bodies (beta-hydroxybutyric acid) was shown to decrease secretion of various inflammatory chemicals (cytokines) that are commonly seen in rheumatoid arthritis. There is convincing evidence that this form of medically-supervised 7-day fast, followed by a Vegan-style diet can reduce inflammation, pain and joint destruction in rheumatoid arthritis patients. It seems a bit drastic, so there are dietary practices you may want to test out first.

One of them is the Mediterranean Diet – this diet is rich in oleic acid, omega-3 fatty acids, unrefined carbohydrates, and phytochemicals. It involves high consumption of olive oil, cereals, fruits, vegetables, fish, and legumes; less red meat; and the inclusion of moderate amount of red wine in the diet. The olive oil and fish components are shown to exert anti-inflammatory effects and studies show that people eating in this way are much less prone to developing rheumatoid arthritis.

Then there is the more drastic Elemental Diet – this diet consists mostly of liquid formula drink that has specific amino acids, a low amount of glucose, some vitamin and trace elements. A large study showed that 72% of patients on the Elemental Diet had more than 20% improvement in pain and early morning stiffness. The formula is described as hypoallergenic to help tone-down any immune system overactivity.

There is also the Elimination Diet- this diet attempts to eliminate any foods to which an individual may be sensitive. Studies show that in rheumatoid arthritis some food-based antigens can leak across the gut into the bloodstream and trigger and immune-inflammatory response that exacerbates rheumatoid arthritis symptoms.

After reviewing all the available data here is what the researcher suggest rheumatoid arthritis patients should do to help reduce their symptoms and disease progression using daily dietary practices:

“We believe that an ideal meal can include raw or moderately cooked vegetables (lots of greens, legumes), with the addition of spices like turmeric and ginger, seasonal fruits, probiotic yogurt; all of which are good sources of natural antioxidants and deliver anti-inflammatory effects. The patient should avoid any processed food, high salt, oils, butter, sugar, and animal products (meat, cheese etc.). Dietary supplements like vitamin D, cod liver oil, and multivitamins can also help in managing RA. This diet therapy with low impact aerobic exercises can be used for a better degree of self-management of RA with minimal financial burden”.

They cite studies showing the anti-inflammatory effects of:

  • Green tea catechins (EGCG)
  • Ginger, Curcumin (from Turmeric), Boswellia, Ashwagandha and Cinnamon bark
  • The anti-inflammatory properties of grapes, oranges, apples, tomatoes, spinach, and potatoes, which contain p-Coumaric acid
  • The anti-inflammatory properties of soybeans, which contain the isoflavone genistein
  • The anti-inflammatory effects produced by Omega-3 fats as well as borage seed oil (rich in gamma-linolenic acid)
  • The anti-inflammatory and antioxidant effects of prebiotics and probiotics, helping to improve the gut microflora and immune system modulation


In my view, this dietary approach is not only good for patients with rheumatoid arthritis but is also a good approach to prevent and help manage many various degenerative diseases, from heart disease to Alzheimer’s disease. The review paper is a very worthwhile read in its entirety for those diagnosed with rheumatoid arthritis, any autoimmune disease or osteoarthritis.

I have included a link to the complete text article in the text below

Reference: Khanna S, Jaiswal KS and Gupta B. Managing rheumatoid arthritis with dietary interventions. Frontiers in Nutrition- Clinical Nutrition. Nov 8, 2017


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Dr. Meschino

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