Diet can play an important role in arthritis. This fact sheet from the Physicians Committee for Responsible Medicine explains how a low-fat plant-based diet, weight loss and identifying personal trigger foods may ease the pain and stiffness of rheumatoid arthritis and osteoarthritis.
Millions of people live with painful, swollen joints, yet health care providers rarely discuss diet with arthritis patients. Earlier studies tested diets that still included dairy, oils, poultry or meat and found little benefit, but newer research shows that food matters.
Types of Arthritis
Osteoarthritis is the gradual breakdown of joint cartilage with bone overgrowth, especially in the knees, hips, spine and fingertips. More than 32.5 million Americans have it, and the risk rises with age.
Rheumatoid arthritis (RA) affects more than 1.3 million Americans and is more aggressive. It is an autoimmune disease that causes joint pain and inflammation and can lead to permanent damage. Its cause is still unclear: some suspect viruses or bacteria trigger an autoimmune response, and certain genes may make people more susceptible.
The Role of Diet
Diet and Rheumatoid Arthritis
Not every study has found a link, but several show that changing diet can ease RA symptoms. In one study, patients on a very low-fat vegan diet had less morning stiffness, pain, joint tenderness and swelling after only 4 weeks. A recent study in the American Journal of Lifestyle Medicine confirmed that a low-fat plant-based diet improves joint pain in people with RA. The Plants for Joints randomized controlled trial found that a 16-week program built on a whole-food plant-based diet, physical activity and stress management improved RA symptoms, with more weight loss and lower cholesterol than the control group.
Weight loss also helps. In one study, people with RA who lost 11 pounds (about 5 kilograms) or more were three times as likely to improve as those who lost less. Some foods can trigger RA symptoms. Meat, eggs and dairy are common triggers, but healthy foods such as citrus, tomatoes and corn can be triggers too, and the specific foods differ from person to person.
Diet and Osteoarthritis
A study of more than 6,000 people found that those who ate more fiber were less likely to have osteoarthritis symptoms. In a 2015 study, a whole-food plant-based diet significantly reduced osteoarthritis pain within two weeks, and by the end of the six-week study participants reported more energy and better physical function. The Plants for Joints study confirmed these findings, with less pain and stiffness among participants with osteoarthritis.
How a Plant-Based Diet May Help
Vegan diets are usually low in fat and saturated fat, have a healthy balance of omega-6 and omega-3 fats, and are rich in antioxidants and phytochemicals that help control inflammation. Meat can also supply too much iron, which encourages free radicals that can damage joints. Iron from vegetables and beans is absorbed only when the body needs it, and fruits and vegetables provide antioxidant vitamins C and E.
Finding Your Food Triggers
To find out whether a food triggers your joint pain, try this for two weeks: eat plenty of foods from the safe list, avoid the common triggers completely, and eat other foods freely. If your pain improves, reintroduce one eliminated food every other day and watch for symptoms. If a food brings symptoms back, wait until they settle before testing the next one. Avoiding animal products for the long term is best.
Safe Foods
These foods almost never cause arthritis or other pain: buckwheat, rice, quinoa, millet, lentils, cooked green vegetables such as artichokes, asparagus, broccoli, Brussels sprouts, spinach and kale, cooked yellow and orange vegetables such as carrots, zucchini and pumpkin, and cooked or dried non-citrus fruits such as pears, apricots, blueberries and plums.
Common Pain Triggers
Common trigger foods include meat, dairy and eggs; wheat, barley and rye; corn; nuts and peanuts; soy; citrus fruits; chocolate; nightshade vegetables such as tomatoes, potatoes, peppers and eggplant; sugar; apples; onions; celery; chickpeas; bananas; sweet potatoes; and nutritional yeast. Alcohol (especially red wine), caffeinated drinks, MSG, aspartame and nitrites in processed meats are also common triggers. If you suspect wheat or gluten, ask your health care provider about celiac disease screening before cutting gluten from your diet.
Other Approaches
The first line of defense is a low-fat plant-based diet rich in fruits and vegetables, a vitamin B12 supplement, and any medication your health care provider prescribes. Some research suggests the omega-3 fats DHA and EPA may help people with RA. If you try them, choose an algae-based vegan supplement with no more than 2 grams of DHA/EPA combined, and check with your provider first, since high intakes raise bleeding risk and can interact with medications. Small studies suggest curcumin, found in turmeric, may ease osteoarthritis pain. Use turmeric to season foods such as chili, soups and curries, with a little black pepper to help absorb more curcumin.
This fact sheet is not a complete treatment plan. If you have arthritis, talk with your health care provider about which approaches are right for you.
The Chinese version of this page includes the full fact sheet with references. For the original English fact sheet, visit: Foods and Arthritis