Survey Shows Diet Works for Some People with Rheumatoid Arthritis

Lene Andersen | May 3, 2017

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Managing rheumatoid address (RA) includes a lot of tools, such as medication, physical therapy, pacing yourself, acupuncture, and more. Some people also use diet to manage their symptoms. Most evidence about the role of diet with RA is anecdotal reports from individuals living with the condition, although studies do indicate certain foods may be helpful. A new survey sheds light on how many people with RA experience an impact of food on their condition.

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Can food control RA?

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At present, there is no research showing that a particular diet can control RA. However, studies do show that certain foods can play a role in managing symptoms. In particular, the Mediterranean diet (also known as the anti-inflammatory diet), which emphasizes fish, olive oil, and vegetables, has been shown to have some impact on inflammation, likely due to omega-3 fatty acids in certain fish. A number of small studies also indicate that a vegan or vegetarian diet may be helpful.

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Surveying people with RA about diet

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In research from 2017, researchers from Boston distributed a diet survey to 300 individuals with RA. Participants were asked to review a list of 20 different foods often called inflammatory or anti-inflammatory and indicate if they had an impact on their symptoms: positive, negative, or no effect. Study participants were found through an RA registry, which also included information about demographics, medications, and disease activity scores.

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Who took the survey

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A large number of individuals who received the survey returned it to the researchers (217 or 72 percent). The majority were female (83 percent), and almost two-thirds were using a biologic medication. The median duration of having lived with RA was 17 years. In other words, these were people who had lived with RA for a long time.

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Survey shows food can improve or worsen symptoms

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Twenty-four percent of survey participants reported that food had an impact on their RA. Fifteen percent experienced an improvement of symptoms from certain foods, while 19 percent experienced flaring in connection to what they ate. The foods most associated with an improvement were blueberries and spinach, while desserts and sugared soda were most often connected to worsening of symptoms.

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Other factors connected to food and RA

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The researchers also looked at whether other factors were associated with participants reporting that certain foods affected their condition. They found that younger participants were more likely to report that food affected their symptoms, as well as individuals who said that sleep, warm room temperatures, and supplements led to improvements. Factors not associated with reporting the food and RA link included gender, use medication, disease duration, disease activity scores, and weight.

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Limitations of the survey

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There are some limitations of this research, primarily that it is based on a survey, rather than a randomized double-blind study design. Participants self-reported the connection between food and RA symptoms, rather than a study using a more objective measurement. Studies that utilize survey design result in association between two factors, in this case food and RA symptoms. This means that we can’t reliably draw a cause-and-effect conclusion.

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Strengths and future research

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The high response rate in this survey confirmed that many people who live with RA are interested in getting more information about the effect of foods on the condition. The results indicate that further research into the impact of food could be a valuable tool for managing symptoms in some. Further research could also attempt to confirm the percentage of the RA population sensitive to food, as well as explore the reason behind the sensitivity.

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What does this mean for you?

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Living with RA is very often a challenge in finding one more thing that can chip away at your symptoms of pain and fatigue. Trying different foods to see if you respond either positively or negatively can be one way to feel more in control. It is important to keep in mind that according to the survey, 76 percent of those who live with RA do not respond to food, either in terms of their symptoms worsening or the symptoms improving.

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Inflammatory food triggers reported by the RA community

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Members of the RA community report some commonalities in foods that they feel trigger their symptoms. Echoing the study, sugar and desserts are frequent mentions. Vegetables in the nightshade family (tomatoes, potatoes, eggplant, peppers) are also commonly mentioned, although there is no evidence in the literature for this. Processed foods, as well as fried foods, are also frequently reported. You may want to experiment with some of these foods to see if you react, as well.

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How to find out if your RA responds to food

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If you are interested in exploring whether your symptoms respond to food, you can do so through an elimination diet. Talk to your doctor about how to do this. You can also ask for a referral to a dietitian who can assist throughout the process, as well as help you assess which foods you may be responding to. You can also track your symptoms and what you eat with a tracking app or a symptom diary.