Diet and RA (rheumatoid arthritis)

Dia duit agus fáilte – that’s Irish for hello and welcome – to this blog about living and thriving with rheumatoid arthritis, autoimmune disease and other chronic illnesses naturally. So happy you decided to visit this post all about diet and RA ; I hope you find the support and encouragement you most need today.

The biggest factor in my RA fight was changing my diet. When my functional medicine doctor explained the correlation between diet and RA, I was flabbergasted (why is this information not common knowledge?) and also relieved; if my diet affected my RA so powerfully, I had much more control than I had thus far been led to believe.

My doctor explained there in no single best diet for RA and she also gave me a list of foods to avoid when you have rheumatoid arthritis and other autoimmune diseases, all of which are founded on chronic systemic inflammation. Her emphasis on diet and RA spurred me to action and, on her recommendation, I followed a combination elimination and rotation diet diligently for 24 weeks.

Over the course of six months, I completely shifted my eating habits, added a strong supplement protocol and my RA went into what felt to my body like complete remission. I had no joint pain or swelling and was once again able to enjoy a full yoga practice, weight lifting (including push-ups) and hiking. In just six months I came to believe and experience that living with RA was something I could manage, that I could maintain my active life and that thrilled and delighted me. Read Living with RA

Before we continue, please remember, I am not a doctor or a nutritionist; if you have questions and concerns about diet and RA or which is the best diet for rheumatoid arthritis, please talk to your medical provider.

A quick science lesson: the digestive system

I like this simple definition from a kids’ science site: “The digestive system consists of the parts of the body that work together to turn food and liquids into the building blocks and fuel that the body needs.”

The point of this brief lesson and diagram is to introduce:

What is Leaky Gut?

Leaky gut is also known as increased intestinal permeability and it is the subject of great debate between mainstream and functional or naturopathic medicine.

Mainstream medicine does not yet recognize Leaky Gut Syndrome as a diagnosis but “agrees that increased intestinal permeability, or intestinal hyperpermeability, exists in certain chronic diseases.”

Functional and naturopathic medicine practitioners point to leaky gut as being a primary cause of autoimmune disease. (Rheumatoid arthritis is an autoimmune disease.) My own experience leads me to agree with them. And this is good news because leaky gut is treatable.

Now you know what it is, you may be asking what heals leaky gut?

When healing leaky gut, we need to create the conditions for the damage to repair itself. Which means we need to:

• eliminate inflammatory ingredients from our diet
• eat healing and nurturing foods
• practice other self-care modalities that allow the gut to heal

My functional medicine practitioner warned me it could be a several-year process to heal a damaged small intestine but she told me what to eat to heal leaky gut, she gave me a list of foods to avoid for leaky gut and she advised me to deepen my yoga and meditation practice to support me on the journey back to full health. Read about yoga here.

The relationship between leaky gut and autoimmune disease

In the body, the immune system plays the role of protector, diligently ensuring peace and harmony, fighting any enemy that dares to invade. If it’s a one-time event (e.g. a cold), the immune system responds, does its job, retreats and rests.

If it’s a regular occurrence, the immune system remains on high alert, stressed and paranoid, and can begin attacking the body. Say, for example, you eat crusty French bread with a large glass of milk every morning for breakfast unaware that your body cannot tolerate gluten or dairy. Your immune system is under daily bombardment and cannot handle the pressure. Finally, the flood gates open and “all of a sudden” you are diagnosed with rheumatoid arthritis or another autoimmune disease.

To sum up:

A leaky gut allows toxins (invaders) into the body, the immune system attacks those ever-present invaders and never rests; is it any surprise that the immune system begins to malfunction?

And we already know that autoimmune disease is caused by a jacked-up, malfunctioning overactive immune system.

In order to calm down the paranoid immune system, we need to remove the invaders. In order to remove the invaders, we need to change out diet, and look at other habits we can improve and develop.

Foods to avoid if you have rheumatoid arthritis

Quick note: you will become an expert food label-reader which empowers and worries in equal measure. I mean, do we really want to put sodium diacetate (a fungicide in hot dogs) or potassium bromate (a carcinogen in bread) into our bodies?

• Gluten. Yup, I was bummed too; pasta is one of my favorite meals and I had just found the best pizza dough recipe when my doc told me that her number one recommendation is a gluten-free diet for RA, autoimmune diseases and any chronic illness stemming from inflammation. Gluten is found in the obvious places – breads, pastas, muffins etc… but it also hides in products like soy sauce, condiments, candy and even in French fries (because of the coating lots of places use). The great news is that there are tons of great gluten-free options available and they are getting more delicious every day. See here for more hiding places.
• Deli meats typically have high levels of sodium, preservatives and AGEs (advanced glycation end products) and myriad other mystery ingredients.
• Refined sugars. Look for words ending in -ose, high fructose corn syrup, cane sugar, and corn sweetener. Sugars often hide in “healthy” foods – plant-based milks, organic pasta sauces, granola bars and many more. Check out this list.
• Artificial preservatives and food coloring.
• Saturated fats, trans fats and vegetable oils like corn, safflower and soy. All are laden with Omega-6 fatty acids. (Those are the Omegas we’re trying to reduce.)
• Dairy and inflammation. Another real bummer for me; to say I love cheese and cream is an understatement. (Coffee is merely the vehicle whereby my body can legitimately ingest outrageous quantities of cream.) That said, it’s not certain if it’s the saturated fats in dairy that cause inflammation, in which case, eating non-fat options might not trigger inflammation in your body. The simplest way to find out how your body responds to dairy is an elimination diet and monitored reintroduction.
• Alcohol and rheumatoid arthritis. This is the perfect place for the axiom: “Less is more”. There is evidence that a glass of wine (actually it’s the resveratrol) can reduce inflammation. But, there is also evidence that alcohol can increase RA symptoms. To find out if alcohol in moderation might work for you; consider an elimination diet test.

What is the best diet for rheumatoid arthritis?

There is no one size fits all. The best way to eat is the one that best supports your body to full health, reduces autoimmune symptoms and chronic pain, prevents flare-ups and allows you to live your version of a fabulous life. The better acquainted you become with your body, the better you will know which foods support and nourish you and which deplete or trigger an RA flare up. Bottom line? Your best diet for rheumatoid arthritis will be the one that reduces inflammation, nourishes you completely and is a way of eating you both enjoy and can easily manage.

Over the past 4 years, my diet has evolved into strictly gluten-free, loaded with fresh veggies, greens and fruit, very little meat (organic, if possible, when I have to buy from the store rather than eat our own pasture-raised meat.) I also limit grains, alcohol and sugar. Except when I don’t!

The best diet for rheumatoid arthritis in YOUR body will:

• reduce your pain and RA symptoms
• leave you feeling energized and enthusiastic
• improve your digestive system including your bowel movements
• allow you to sleep better

The following is a list of possible diets when you are ready to treat your rheumatoid arthritis with diet and other holistic methods. Especially at the beginning of your healing process, many medical providers recommend following a strict rotation, elimination or anti-inflammatory diet for at least 60 days in order to give yourself time to remove any residual toxins and allow the body to begin the healing process without the presence of potentially inflammatory foods.

The rotation diet for RA

Foods belong to families and each family shares qualities and possible irritants. For example, brassicas include cabbage and broccoli while buckwheat and rhubarb are both members of the polygonaceae family.

The rotation diet is exactly what is sounds like – you rotate food families over four days so using the above examples, I could eat broccoli and cabbage on Monday and then, not again until Friday.

The rotation diet has several factors to recommend it:

1. It ensures a varied diet.
2. It prevents eating the same foods day after day, which can lead to food intolerances and inflammation.
3. Many food antigens disappear from the body within 72 hours.
4. The immune system is given the chance to rest.
5. It reduces inflammation.
6. The rotation diet improves digestion, resulting in better bowel movements.

I began my journey to full health with a strict doctor-recommended rotation diet while adhering to the list of foods to avoid with rheumatoid arthritis above. I rotated food over 4 days. It was very challenging and very rewarding. My RA symptoms completely disappeared and I could breathe, look around at my life and make decisions based on hope and joy rather than on fear and pain. I struggled in the early weeks to learn how to best group foods, after which I created my rotation diet meal plan with the best recipes or combinations that allowed me to feel satiated, physically, mentally and emotionally.

I learned some really cool things about food – like chicken and chicken eggs are in a different family to duck and duck eggs which allowed me to have eggs every other day – Yum!

And blueberries don’t belong to the same family as raspberries and strawberries – who knew?

Check back soon for more support materials around the rotation diet and RA. I am currently creating a four-day plan as well as a 28 day recipe book.

The AIP diet and RA

The anti-inflammatory protocol (AIP) diet is challenging and highly effective. It removes inflammatory foods, gut irritants, immune stimulants and high allergen foods and is recommended for a minimum of 30 days when beginning the diet for the first time.

What’s missing from the AIP diet?

So what is on the anti-inflammatory diet food list?

• All  fresh vegetables (except nightshades)
• Healthy animal proteins (except eggs)
• Seasonal fruit (in moderation)
• Healthy fats

The AIP diet is a challenging option for me but one I return to whenever I feel the need for a fresh start and I will do this anti-inflammatory protocol diet for 14-28 days. For example, after our 30^th anniversary trip to Paris!

My thoughts on the AIP diet

• It is perfect for a short time boost to the immune system. I struggle to maintain momentum after 3-4 weeks.
• Who doesn’t love a diet full of seasonal veggies?
• I don’t like to eat as much animal flesh as I need to eat to feel satiated.

The Paleo diet and RA (AKA the cave-man diet)

Proponents of the paleo diet sing its health benefits which may include reduced inflammation. Like the AIP diet, for me there is a heavier-than-I-like emphasis on animal flesh so I use the elements of paleo that I love and what best suits our lifestyle and values.

The paleo diet helped popularized zucchini noodles and cauliflower rice, both of which I have tried; I love the former! I have found tons of delicious paleo recipes that are delicious and work really well for me in my current RA diet.

The paleo meal plan is not as restrictive as the above AIP diet. What can I eat on the paleo diet?

• All  fresh vegetables (except nightshades)
• Healthy animal proteins
• Seasonal fruit (in moderation)
• Healthy fats
• Eggs
• Nuts and seeds

Some things I love about the paleo diet:

• It’s a great opportunity to explore new grain-free recipes, like delicious muffins and pancakes.
• There is a heavy emphasis on fresh veggies and healthy fats, including avocados and coconut oil.
• It avoids processed foods and promotes a mostly fresh-food approach to eating.

Things I don’t like about the paleo meal plan:

1. It doesn’t include legumes and not only do I love the flavor of most legumes, I also like their high fiber content.
2. The heavy emphasis on animal flesh.

A vegan or vegetarian diet and rheumatoid arthritis

A vegetarian diet is one that avoids animal flesh – no meat, chicken, fish but includes dairy, eggs and honey.

A vegan diet eschews all animal products.

There is so much information available about a meat-free diet and its benefits. Red meat is a known inflammatory food and reducing your intake has been proven to reduce inflammation as well as your risk for heart disease, stroke and diabetes.

I have been both vegan and vegetarian in the past and ultimately decided they were not the best fit for my health. (They negatively impacted my epilepsy, another chronic health condition.) That said, just because I don’t carry the label, doesn’t mean I don’t enjoy a vegan or vegetarian meal several times each week. There is so much to love about both of these diets – the heavy reliance on veggies, legumes and protein-packed grains (think quinoa and kamut) makes for yummy meals.

Elimination diet and RA

Just as it sounds, the elimination diet eliminates certain foods from your diet entirely. The AIP diet can be considered an elimination diet in that large groups of foods are removed from the diet. The biggest difference between both diets is that the anti-inflammatory protocol diet removes all potentially inflammatory foods at the same time while an elimination diet for rheumatoid arthritis may remove just one type of food at a time.

Typically, you will refrain from eating a specific food, dairy for example, for one month and record how you feel – pain levels, sleep patterns, energy levels etc… After the month, you will reintroduce the food during the “challenge period” and notice if there is a return to certain ill effects, for example, perhaps you feel more bloated, have more phlegm or feel sluggish.

The elimination diet challenge period consists of 4-5 days during which you reintroduce the recently eliminated food, at least once or twice each day. With close observation, you will likely notice any adverse effects this food has on the body during the 4-5 days but it is also possible reactions may take a week or more to manifest. Be sure to track all RA flare ups or any other symptoms you notice.

Things I like about an elimination diet for rheumatoid arthritis:

• It is a gentle approach to discovering food allergies and intolerances and not as demanding as the AIP.
• There is a built in testing process to learn how your body responds.
• When you only remove one food you can sometimes see instantly how it impacts your health. (When I stopped eating sugar in the evenings, I began to sleep better within days.)

Things I don’t like about the elimination diet for RA:

• It can take up to a year to work your way through all potential food intolerances and allergies.

Other diets to consider.

The below diets are not the right fit for me but you might be interested in exploring them further.

The Keto diet and rheumatoid arthritis

I first learned about the keto diet when I was researching ways to reduce the number of seizures I was having as the original primary purpose of this diet is to do just that, especially for hard-to-treat epilepsy in children.

Facts to know about the Keto diet:

• It relies heavily on animal proteins and fats and restricts carbohydrates.
• The body is forced into ketosis which means the body now burns fats rather than carbs.
• It may reduce inflammation in the brain though this does not necessarily translate to reducing the inflammation that causes RA.

The raw diet

Yes, it is exactly as it sounds – foods cannot be cooked above 105* to be considered raw. While I have tried several very delicious raw meals, I cannot speak to this way of eating from any real experience and will let the experts do the talking.

Final thoughts

There is oodles of information on this page and I hope I haven’t overwhelmed you. My intention is to show you the many options you have when looking for the best diet for RA or whichever autoimmune you are dealing with.

I would love to hear your thoughts and experiences; please share in the comments.

I hope this blog about rheumatoid arthritis and autoimmune disease has information that can support your journey to a live-out-loud kind of life, the one you had before the wind was knocked out of you with a life-changing diagnosis. I hope you find hope and strength in these pages and I look forward to travelling with you, my fellow autoimmune warrior.