People with chronic illnesses often search for alternative ways to help their condition, and rheumatoid arthritis patients are no different. Some insist that following an anti-inflammatory diet can help with symptoms of the autoimmune disease.
Rheumatoid arthritis causes pain, swelling, stiffness, and loss of function in the joints, according to the U.S. National Library of Medicine. It differs from osteoarthritis — the more common arthritis that people develop as they age. With rheumatoid arthritis, however, the immune system attacks the body’s own tissues.
What are anti-inflammatory diets, exactly?
These diets promise to help combat inflammation in the body and there may be something to them, Alissa Rumsey, New York City-based dietitian and nutrition therapist, tells Yahoo Lifestyle. “Chronic low-level inflammation has been linked to many diseases including type 2 diabetes, allergies, autoimmune conditions, heart disease, cancer, and stroke,” she says. “Diet, exercise, stress, and smoking all contribute to chronic inflammation.”
But while many anti-inflammatory diets have similar food restrictions, they’re not typically a one-size-fits-all approach to wellness. “Everyone reacts to different foods and chemicals,” registered dietitian Sonya Angelone, a spokeswoman for the Academy of Nutrition and Dietetics, tells Yahoo Lifestyle. “One food that might cause inflammation for one person may not be a problem for another person.”
In general, though, “a diet that includes plenty of vegetables, fruits, whole grains, omega-3 fats, and antioxidants is your best defense against inflammation,” Rumsey says.
How do these diets work?
Overall, anti-inflammatory diets focus on reducing inflammation in the body, through eliminating foods that are thought to be inflammatory, as well as adding in foods that have anti-inflammatory properties. “It is best for people to add foods that are high in antioxidant compounds and can reduce inflammation, while reducing excess refined oils, sugar, and trans fats,” Angelone says.
Specifically, “omega-3 fats decrease the production of pro-inflammatory molecules in the body and stimulate the production of anti-inflammatory compounds called eicosanoids,” Rumsey says. Fruits and vegetables are also anti-inflammatory, especially green leafy vegetables, sweet potatoes, berries and cherries, and tomatoes, she says. Whole grains are a good source of fiber, which is linked with lower levels of inflammatory biomarkers in the body, notes Rumey.
Anti-inflammatory diets have been researched before. A review article published in the journal Frontiers specifically listed foods that scientists believe can help reduce the progression and symptoms of rheumatoid arthritis, including dried plums, blueberries, pomegranates, whole grains, spices like ginger and turmeric, and specific oils and teas. The researchers say these foods can provide many benefits, including lowering inflammatory cytokines (chemicals released by the immune system that can cause rheumatoid arthritis symptoms), reducing joint stiffness and pain, and lowering oxidative stress — aka your body’s ability to fight harmful chemicals.
There is also a diet followed by some patients with rheumatoid arthritis and other autoimmune conditions known as the Autoimmune Protocol (AIP), which is an extension of the paleo diet that also focuses on reducing inflammation. The AIP has an initial elimination phase of food groups including grains, legumes, nightshade vegetables (e.g. tomatoes, eggplants), dairy, eggs, coffee, alcohol, nuts and seeds, refined/processed sugars, oils, and food additives, according to a 2017 study on the diet.
It also stresses eating and preparing fresh, nutrient-dense foods, bone broth, and fermented foods while encouraging followers to get better sleep, reduce stress, and exercise regularly. After the elimination phase, followers are asked to maintain the diet for a bit before gradually reintroducing food groups in stages to help see if any one in particular aggravates their symptoms.
Given that rheumatoid arthritis causes bodily inflammation, it seems that an anti-inflammatory diet would be a good treatment option. But doctors still say it still shouldn’t replace conventional medications.
“This is very difficult to study and there are no clinical data to help tell us about whether this works,” arthritis expert Joshua Baker, MD, assistant professor of medicine at the Hospital of the University of Pennsylvania, tells Yahoo Lifestyle. “What is known is that patients with rheumatoid arthritis do report a correlation between their diet and symptoms, suggesting there might be a link. There are also some reasons to believe that your diet may affect your immune system. However, it’s difficult to predict which dietary approach would have the best effect on arthritis.”
There is some anecdotal evidence, at least, that anti-inflammatory diets help. “I have patients who have told me that these diets have been helpful for them,” Orrin Troum, MD, a rheumatologist at Providence Saint John’s Health Center in Santa Monica, Calif., tells Yahoo Lifestyle, noting that includes patients who follow the AIP. The AIP in particular, though, “is a very restrictive diet and there’s not much literature to suggest that it is of merit,” Troum notes.
When patients say they want to try an anti-inflammatory diet, “my approach is to not discourage those who would like to try,” Baker says. “However, I typically do not make dietary recommendations. My opinion is that the effects are likely to be small (if any) and I don’t want to distract my patients from the proven benefits of medications that are available for the disease.”
Both Baker and Troum say they wouldn’t recommend using any diet as the sole response to rheumatoid arthritis. “Rheumatoid arthritis may be so aggressive at times that unless you get it under control quickly, there may be damage within weeks that’s irreversible,” Troum says. “I recommend to patients that they try to avoid refined sugars and greasy, fatty meats, but that they also take medications that have been proven to be effective for rheumatoid arthritis.”
Baker agrees: “I think diet might end up being a helpful adjunctive therapy, but it is unlikely that people will be able to stop all other treatments as a result.”
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