What should people with RA eat?
What we eat plays a big role in our health, whether we have rheumatoid arthritis or not. With healthy eating habits and active movement in everyday life, it is also easier to get enough energy and all the nutrients the body needs (1).
Many people with RA wonder if there are any special dietary guidelines. In fact, some people find that dieting and choosing certain foods and avoiding others affects how they feel. Maybe it's eating vegetarian, opting out of gluten, red meat or something else. It is important to remember to focus on your whole diet. It's what you put on the plate every day that counts, not that cake we take every now and then. What does the research say? Can you influence your RA with diet?
It’s difficult to carry out research about diets
Wouldn't it be great if it was possible to find out what exactly what foods are best? There are difficulties with research into diet. When studies are done on a drug, a group is given a drug that is the "right one" and a control group is given a placebo pill. The results are often clear when none of the groups know whether they have eaten the "right" pill or not. The researchers can see with good certainty whether the drug worked or not. In dietary studies, it is more complicated. It is more difficult, for example, to compare different diets against each other as so much else can come into play. It is also difficult to get the participants to stick to a certain type of "strict" diet for a long time. However, research is being done and the more research that is done the more we will, hopefully, discover the link between diet and RA. (2)
Food recommendations for RA
Today, dietary advice for people with RA is based on the Nordic Nutrition Recommendations (NNR), which have been developed by over a hundred experts. This is because it is the dietary guidelines that have the greatest scientific support. These are also the dietary guidelines that are recommended for the entire population. In summary, the recommendations look like this:
Legumes such as beans, peas and lentils
Fruit & berries
Fish and seafood
Nuts & seeds
Cereal products made from white / sifted flour → Cereal products from whole grains
Butter, butter-based fats → vegetable oils, oil-based fats
Fatty dairy products → lean dairy products
Eat and drink less
Meat products, red meat
Drinks and foods with added sugar
(1) Do you want to read more about the Nordic nutritional recommendations? (Swe)
Nordiet - a Nordic alternative to the Mediterranean diet
Maybe you've heard of Mediterranean food? Collected research shows that it is a healthy way to eat. The word "Mediterranean food" can be a little misleading. Therefore, many people instead use the term Mediterranean-like diet. It does not have to be food from the Mediterranean, but the same type of healthy food pattern can be achieved with Swedish ingredients!
Choosing locally produced foods can be important to many people, for both environmental and economic reasons. Studies have been carried out based on the Mediterranean diet but with Nordic produce, with foods such as whole grains, fruit, vegetables, fish and skimmed milk products. It is called Nordiet. A Swedish study showed that after only six weeks, the subjects' weight, blood pressure, blood fats, blood sugar and insulin levels were affected. The diet included oatmeal, crispbread, salmon, herring, berries and Swedish apples, rapeseed oil and sunflower oil. (5.6)
There is great interest in investigating in more detail whether the most important foods in a healthy Nordic diet have positive health effects. (4)
There is still too little research on whether there is a diet that causes lower inflammation and what is an anti-inflammatory diet. The diet which is today considered to have the most research-based basis and could include a diet that results in lower inflammation is also the so-called Mediterranean diet, or if you prefer, the Mediterranean-like diet. There are studies yet on individual foods and inflammation as the research base is not large enough. (2) Do you eat anything special that you think affects inflammation?
Research on the intestinal part of the immune system
Studies show that the bacterial flora in the gut can change in diseases linked to the immune system, such as RA and inflammatory bowel disease. Researchers thus believe that immunological processes in the gut can both initiate and accelerate the development of rheumatic disease. Very little is still known, which has led to researchers and doctors at the Department of Rheumatology, Skåne University Hospital in Lund, to study this in people with RA and systemic sclerosis. The idea is to be able to gain more understanding through research of the intestine's influence on the immune system in rheumatic disease. (3)
Livsmedelsverket (2012). Nordiska näringsrekommendationer - Rekommendationer om näring och fysisk aktivitet.
Reumapodden (2019). Gluten, kött eller laktos? Om kost vid RA. Helen Lindqvist nutrionist PHD och lektor Göteborgs universitet.
Reumatikerförbundet (2018). Forskningsrapport s.11-13. https://static-reumatikerforbundet.s3-eu-west-1.amazonaws.com/uploads/attachments/Forskningsrapport-2018.pdf
Nutritionsfakta (2017) Hälsofrämjande nordiska kostvanor – senaste framstegen och framtida forskningsutmaningar https://nutritionsfakta.se/2017/06/13/halsoframjande-nordiska-kostvanor-senaste-framstegen-och-framtida-forskningsutmaningar/
Sundkurs (2019) Webbvägen till en sundare folkhälsa. http://www.sundkurs.se/kurser/mat/
Adamsson V, Reumark A, Fredriksson I‐B, Hammarström E, Vessby B, Johansson G, Risérus U (Uppsala University, Uppsala; Lantmännen R&D, Stockholm; Bollnäs Heart Clinic, Mitt Hjärta, Bollnäs; Halmstad University, Halmstad, Sweden). Effects of a healthy Nordic diet on cardiovascular risk factors in hypercholesterolaemic subjects: a randomized controlled trial (NORDIET). J Intern Med 2011; 269: 150–159.