Dr. Zashin’s experience with gluten and RA patients is similar to what Sandon has seen. “It’s possible that some patients will have gluten intolerance, in which case removing those foods would be beneficial, but it’s probably not the case for everyone who has rheumatoid arthritis.”
Dr. Zashin also talks of the value of omega-3 supplements and the use of CherryFlex, a fruit supplement he has worked with that contains antioxidants and anthocyanins.
Sandon advocates with patients the use of 2,000 mg daily of omega-3 supplements containing both docosahexaenoic acid and eicosapentaenoic acid. These supplements might help RA symptoms and heart disease, as well. A study published last year in the journal Nutrition with 37 RA patients found that intake of omega-3 acids seemed to affect disease activity and have beneficial effects on RA by decreasing inflammation.4
Omega-3 supplements may also enable someone with RA to use fewer antiinflammatory medications. However, Sandon will caution patients that higher-than-average doses of omega-3 supplements can cause belching, body odor, and blood thinning—the latter of which could be a concern because other RA medications are already thinning the blood.
As someone living with RA herself, Sandon uses a fish oil capsule, calcium, and vitamin D supplements for better bone health, and folate to counteract methotrexate effects.
Taking the Next Steps to Ensure a Healthy Diet
Sandon encourages rheumatologists to refer their patients to registered dietitians. However, in her 20 years as an RA patient, she has rarely heard her physicians discuss this option. Dr. Crilly agrees. “Diet is probably something clinicians don’t take much interest in. It can be a struggle for patients to get a straight answer about diet because of the lack of research,” he says.
Still, a dietitian can not only help a patient focus on healthier eating, he or she can also make sure the patient does not follow a program that is too restrictive, says Dr. Smedslund.
In addition, the Arthritis Foundation has various articles and resources on its website (www.arthritis.org) that discuss diet and arthritis.
Still, all of the emphasis on diet doesn’t mean one should ignore medications. A balanced approach is best, says Sandon. “You need medical treatment to help control symptoms and pain and help the disease from progressing, but you also need to maintain the body through physical activity and diet. When you pair all three elements, I think you get a better outcome,” she says.
