Rheumatoid Arthritis

Rheumatoid arthritis affects millions of people in the US. Almost half of the risk factors for rheumatoid arthritis are modifiable and can be addressed with the right diet and lifestyle changes, and many patients report significant benefits as a result of a plant-based diet.

Cases per year

1.5 million people in the US have rheumatoid arthritis.

General frequency

It affects roughly 1% of the world’s population (around 79 million people).

Risk

Debilitating pain that can make daily tasks difficult, and cause falls, sleep problems, anxiety, and depression.

Managing rheumatoid arthritis with a plant-based diet and lifestyle medicine

Joint pain and other symptoms of RA can be modified using diet. Diets that include animal products such as dairy and red meat exacerbate RA symptoms likely due to their pro-inflammatory effects. In contrast, diets rich in vegetables, fruits, and fiber are associated with lower BMI, have anti-inflammatory properties and help reduce pain and inflammation in these patients."

Dr Yashoda knows the power that lifestyle medicine can have on rheumatoid arthritis.

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Here are some top scientific studies that support the results our clinicians have seen first-hand:

Treating arthritis with a plant-based diet

Rheumatoid arthritis treated with vegetarian diets 

This study tested the effects of fasting for 7-10 days, followed by consuming a plant-based diet for 3.5 months, and compared the results to an omnivorous diet. After just one month, participants in the plant-based diet group experienced a dramatic reduction in pain, morning stiffness, and fewer tender and swollen joints compared to the omnivorous group 1.

Plant-based diet alleviates many rheumatoid arthritis symptoms 

Effects of a Very Low-Fat, Vegan Diet in Subjects with Rheumatoid Arthritis 

Patients suffering with rheumatoid arthritis were given 4-weeks on a low-fat plant-based diet. In response, all measures of RA symptoms significantly alleviated, including less joint pain, less stiffness, less swelling, and improvements in limited function 2.

Plant based diets for the treatment of rheumatoid arthritis 

Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review 

A 2019 paper published in the journal Frontiers in Nutrition reviewed the evidence for plant-based diets in relieving symptoms of RA. The authors propose that a plant based diet improves gut health, reduces inflammation, and promotes a healthy weight which can alleviate the symptoms of rheumatoid arthritis 3.

Exercise improves outcomes of rheumatoid arthritis

Effects of high-intensity resistance training in patients with rheumatoid arthritis: a randomized controlled trial 

This is one of many exercise intervention trials that show exercise is fundamentally beneficial for patients with rheumatoid arthritis. In this trial, resistance training was able to significantly restore muscle mass and improve function in patients with rheumatoid arthritis. Patients gained a significant amount of strength and physical function due to increasing exercise 4.

Find more information about rheumatoid arthritis below

What is rheumatoid arthritis?

Arthritis is painful inflammation of the joints. It can span decades of a patient's life and make daily tasks challenging and painful, as well as increase rates of depression, anxiety, sleep problems, and falls 5. It is a leading cause of disability among older adults around the world 6

Rheumatoid arthritis (RA) is a common form of arthritis, and is a chronic inflammatory autoimmune disease 3. An autoimmune disease is where our immune system, which usually attacks foreign invaders like bacteria and viruses, attacks part of our own body. In RA, the immune system attacks a tissue called the synovium, which lines the inner surface of joints. This leads to chronic inflammation and eventual erosion of the cartilage and bone 7

Whilst genetic factors account for 50-60% of the risk of developing RA, that leaves almost half the risk linked to modifiable lifestyle factors, many of which are within our control. These include infectious diseases, tobacco smoking, gut health, sedentary lifestyle, and diet 8. Because of this, many patients have more control over their rheumatoid arthritis than they may be aware of. 

part a shows normal joint compared to joint with rheumatoid arthritis which is swollen with degraded cartilage and part b shows the presentation of rheumatoid arthritis in the hand
a) normal joint compared to joint with rheumatoid arthritis, b) presentation of rheumatoid arthritis in the hand, images credit: SMART-Servier Medical Art

Symptoms

In the early stages of rheumatoid arthritis people are likely to experience tenderness and pain, and as the condition progresses there may be redness and swelling of the joints. The signs and symptoms to look out for include: 

  • Pain, tenderness, swelling or stiffness around the joints that lasts for six weeks or longer.
  • Morning stiffness that lasts for 30 minutes or longer.
  • Fatigue (feeling very tired)
  • Low grade fever 
  • Loss of appetite 

The symptoms of rheumatoid arthritis may come and go in what is known as ‘flare ups’ of the condition, where individuals suddenly get lots of inflammation and symptoms. 

Usually small joints such as the wrists and certain joints in the hands and feet are affected first, and as the condition progresses it can affect knees, ankles, elbows, hips and shoulders. 

Diagnosis 

Diagnosing rheumatoid arthritis early on is an important step in managing the condition. Your healthcare provider may refer you to a rheumatologist who can diagnose the condition best. Diagnosis will typically consist of your symptoms, medical history, a physical exam, blood tests and imaging tests. 

The specific blood tests used for rheumatoid arthritis include: 

  • Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels: these tests are markers of systemic inflammation that is seen in patients with RA
  • Rheumatoid factor (RF): an antibody found in around 80% of people with rheumatoid arthritis so is very useful in the diagnosis process 

Treatment 

For years, physicians and patients alike have been intrigued with the idea that some foods aggravate whilst others ameliorate the symptoms of RA. Science now provides much truth behind these ideas. 

Diets rich in vegetables, fruits, and fiber are associated with lower BMI, have anti-inflammatory properties and help reduce pain and inflammation in patients with rheumatoid arthritis. Plant foods also have beneficial effects on gut health which is linked to both autoimmunity and inflammation. Studies have shown that dietary fiber found in these plant-based foods can improve the gut bacteria composition and increase the bacterial diversity in RA patients, which also helps to reduce inflammation and joint pain 3

Lifestyle interventions including stress management, improved sleep, and exercise are also associated with maintaining a healthy body weight which improves management of RA and alleviates symptoms of rheumatoid arthritis.  

Combined, dietary changes and exercise are key in the management of rheumatoid arthritis. 

They can prevent the need for lots of pain-management medications which are fraught with negative side effects, and make life with rheumatoid arthritis much more enjoyable.

Make food your medicine and improve your health for the long run. 

Think you may be suffering with this and need help? Join us today to make a change. 

Useful links

Incredible success stories:

References

1. Kjeldsen-Kragh, J. Rheumatoid arthritis treated with vegetarian diets. Am. J. Clin. Nutr. 70, 594s–600s (1999).

2. McDougall, J., Bruce, B., Spiller, G., Westerdahl, J. & McDougall, M. Effects of a Very Low-Fat, Vegan Diet in Subjects with Rheumatoid Arthritis. J. Altern. Complement. Med. 8, 71–75 (2002).

3. Alwarith, J. et al. Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review. Front. Nutr. 6, 141 (2019).

4. Lemmey, A. B. et al. Effects of high-intensity resistance training in patients with rheumatoid arthritis: A randomized controlled trial. Arthritis Rheum. 61, 1726–1734 (2009).

5. Cutolo, M., Kitas, G. D. & van Riel, P. L. C. M. Burden of disease in treated rheumatoid arthritis patients: Going beyond the joint. Semin. Arthritis Rheum. 43, 479–488 (2014).

6. Long, H. et al. Prevalence Trends of Site‐Specific Osteoarthritis From 1990 to 2019: Findings From the Global Burden of Disease Study 2019. Arthritis Rheumatol. 74, 1172–1183 (2022).

7. Huber, L. C. et al. Synovial fibroblasts: key players in rheumatoid arthritis. Rheumatology 45, 669–675 (2006).

8. Maeda, Y. & Takeda, K. Role of Gut Microbiota in Rheumatoid Arthritis. J. Clin. Med. 6, 60 (2017).

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