Rheumatoid Arthritis Not Helped by Dietary Changes

Reviewers Find Special Diets Are Not Beneficial or Inconclusive

Fish Oil Capsules & Salmon
Rheumatoid arthritis and diet.. Denise Bush / Getty Images

Patients Want to Know -- What Dietary Changes Stop Rheumatoid Arthritis?

It's one of the first questions someone with rheumatoid arthritis asks: "What dietary changes should I make to stop this disease?" Not only are people who ask the question looking for a quick fix -- they want a fix that will keep their rheumatoid arthritis symptoms in some form of remission. They want to stop the pain and stiffness that come with having rheumatoid arthritis.

If they could find out one or more dietary changes that would make a difference, they would be committed to at least trying it.

Most of what I have read over the years on the subject of diet and arthritis suggested that, at most, some people may have food allergies or food sensitivities that make their arthritis worse. People are not the same, though, so there is only the process of elimination that will help determine which food is causing the sensitivity. That's a pretty daunting task -- to eliminate foods one by one to see if they change how you feel.

Some patients swear that a dietary change helped them, while others are equally emphatic that dietary changes made no difference in their arthritis symptoms. Similarly, there have been clinical trials performed with mixed results.

Cochrane Review Analyzes 15 Studies

The 15 studies included in the Cochrane Review involved 837 patients. Here's what researchers found:

  • Fasting followed by 13 months of a vegetarian diet (no meat but allows eggs and milk) reduced pain by 1.89 on a scale of 0 to 10 -- but had no effect on physical function or morning stiffness.
  • A 12-week Mediterranean diet (high in fruits, vegetables, cereals, legumes, fish, olive oil -- low in red meat) reduced pain by 14% but had no effect on physical function or morning stiffness.
    • Two studies assessed an elemental diet (hypoallergenic, easy-to-digest food -- usually a liquid diet) and there were no significant differences in pain, function and stiffness among rheumatoid arthritis patients.
    • Studies of vegan diets (no meat, fish, eggs, or milk products) and elimination diets (where foods are removed from the diet to see if improvement in symptoms occurs) were deemed inconclusive.

    Other Study Findings

    Interestingly, of the study participants who were placed on a diet, twice as many dropped out as participants not put on a diet suggesting that, even if helpful, these diets are hard to stick to. Also, study participants who did change their diet had unintentional weight loss -- up to 6 1/2 pounds. That may sound good to you, but researchers were concerned about vitamin and mineral deficiencies that may have resulted from dietary changes.

    There may be "side benefits" for rheumatoid arthritis patients who attempt certain dietary changes, though. Consider common comorbid conditions that are associated with rheumatoid arthritis, such as cardiovascular disease and osteoporosis.

    Some of the diets may lower the risk of those and other comorbid conditions in rheumatoid arthritis patients. Researchers concluded that the Mediterranean diet, for example, is heart-healthy and would do little harm to a rheumatoid arthritis patient even though its direct effect on rheumatoid arthritis would likely be insignificant.


    Dietary interventions for rheumatoid arthritis. Hagen KB, et al. The Cochrane Database of Systematic Reviews 2009.

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