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Can changing my diet ease my rheumatoid arthritis pain?

The question: I have rheumatoid arthritis. Should I avoid certain foods? And can certain foods reduce my symptoms?

The answer: Yes, certain types of diets, foods and supplements may help ease the symptoms of rheumatoid arthritis as well as the side of effects of certain medications used to treat the autoimmune disease. The diet and nutrition strategies I am about to describe, however, should not be considered a replacement for any medication you might be taking.

You might have heard that people with arthritis should avoid nightshade vegetables such as bell peppers, eggplant, tomatoes and potatoes. These foods were once thought to aggravate joint pain. However, not one study has proven this connection and it's no longer believed to be true.

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Studies have found, however, that adopting a Mediterranean-style diet – one that's rich in fruits, vegetables, legumes, extra virgin olive oil and contains little red meat – can help reduce inflamed joints and improve physical functioning. The characteristic foods of a Mediterranean diet deliver monounsaturated fat, antioxidants, vitamins and minerals which can help reduce inflammation in the body.

A number of studies have also demonstrated that a low-fat vegan diet can bring about long-term improvements in symptoms. (A vegan diet eliminates all animal foods – meat, poultry, fish, eggs and dairy.) A plant-based diet plentiful in fruit, vegetables, whole grains, beans and soy is thought to reduce inflammation and promote the growth of friendly bacteria in the gut that enhance the body's immune system. (If you're considering going vegan, I strongly recommend you consult a dietitian to help you design a nutritionally complete meal plan.)

If you don't want to overhaul your diet, start by adding plenty of antioxidant-rich foods to your diet each day. During the process of inflammation, immune cells generate free radicals, compounds that may damage tissues in people with rheumatoid arthritis. In fact, researchers have noticed increased free radical activity and lower levels of antioxidants (vitamins C and E, beta carotene, selenium) in the blood and joint fluid of arthritis suffers.

The best food sources of vitamin C are citrus fruit, cantaloupe, kiwi, mango, strawberries, broccoli, Brussels sprouts, cauliflower, and red pepper. Vitamin E rich foods include wheat germ, nuts, seeds, whole grains and kale. Beta-carotene rich foods include dark green and orange produce in your daily diet such as carrots, sweet potato, winter squash, kale, spinach, apricots, peaches, mango and papaya. Selenium is found in seafood, chicken, whole grains, nuts, onions, garlic and mushrooms.

When it comes to supplements, fish oil might help reduce the number of tender joints and morning stiffness, and reduce pain. The omega-3 fatty acids in fish oil (called docosahexaenoic acid and eicosapentaenoic acid, or DHA and EPA) hinder the body's production of inflammatory immune compounds. Most studies have used a dose of fish oil that provides 3.8 grams EPA and 2 grams DHA per day, an amount that's easier to get from a liquid fish-oil supplement than a capsule.

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The content provided in The Globe and Mail's Ask a Health Expert centre is for information purposes only and is neither intended to be relied upon nor to be a substitute for professional medical advice, diagnosis or treatment.

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