Diet and Gut Health May Impact Rheumatoid Arthritis, Study Suggests

Oksana_Slepko/Shutterstock

Millions of people globally are grappling with the debilitating symptoms of rheumatoid arthritis, an autoimmune disorder characterized by painful joint inflammation. While the precise origins of this condition remain elusive, a growing body of research highlights the potential link between gut health and rheumatoid arthritis.

According to 2020 data, nearly 18 million people worldwide were living with rheumatoid arthritis, a form of autoimmune disease that causes painful swelling and inflammation in our joints.

While scientists still don’t know the exact cause of this potentially disabling condition, recent research suggests it could be linked to certain changes in our gut microbiome, and there is evidence that specific dietary changes may relieve the painful symptoms.

Microbiome Effects

A recent review of studies published in Nutrients explores how diet and gut health may play important roles in rheumatoid arthritis.

Rheumatoid arthritis is an autoimmune disease that causes painful swelling in the joints, especially in the hands and feet, leading to difficulties in movement and a lower quality of life. Besides joint pain, rheumatoid arthritis can cause health issues, including skin nodules and lung problems.

The review findings suggest a connection between our gut bacteria, or gut microbiome, and the development of rheumatoid arthritis. It’s already established that the microbiome helps regulate our immune system. Still, an imbalance in gut dysbiosis can lead to chronic inflammation, a key feature of rheumatoid arthritis.

The findings highlight that people with rheumatoid arthritis often have fewer types of certain gut bacteria, and higher levels of a bacteria called Prevotella that have been linked to new cases of the disease.

Increases in another bacteria called Collinsella could lead to problems in the gut’s protective barrier, allowing harmful substances to enter the bloodstream and trigger inflammation.

However, too few beneficial bacteria can also exacerbate symptoms. The review found that beneficial bacteria like Faecalibacterium prausnitzii (F. prausnitzii) are often found in lower amounts in those with rheumatoid arthritis and treated with disease-modifying antirheumatic drugs. These drugs calm the body’s overactive immune system, decrease inflammation, and slow damage to the joints.

F. prausnitzii can help reduce inflammation in other inflammatory conditions, according to a study published in PNAS.

Diets to Treat Autoimmune Disease

A diet high in fiber can help reduce inflammation by supporting healthy gut bacteria. Foods rich in omega-3 fatty acids, such as fish, may also help lower inflammation, while vitamin E may improve gut health and immune function. 

Conversely, diets high in saturated fats and red meat can worsen rheumatoid arthritis symptoms due to their ability to increase inflammation. The Mediterranean diet, full of fruits, vegetables, fish, and healthy fats like olive oil while limiting red meat and processed foods, has been suggested as a beneficial way to manage the condition.

Other diets, such as vegan and anti-inflammatory diets, also show potential in reducing joint inflammation. However, there’s another eating pattern that shows promise to address the problem of inflammation.

The autoimmune protocol diet (AIP) is a way of eating that can significantly reduce the amount of inflammation in the body related to foods you eat.

Stephanie Schiff, a registered dietitian nutritionist at Huntington Hospital, a part of Northwell Health in New York, told The Epoch Times that with the AIP diet, “you eliminate foods that have a higher chance of causing inflammation or irritating the gut.”

She explained that after a while, these foods are slowly introduced back into the diet, one by one.  This process can identify foods that cause problems within the individual and show what should be avoided.

Some of the foods eliminated are grains, especially those that contain gluten, such as wheat, barley, rye, and gluten-contaminated oats, and legumes like beans, peas, lentils, dairy products, eggs, nuts, and seeds, Schiff explained.

She pointed out that this can include nightshade vegetables such as potatoes (excluding sweet potatoes), tomatoes, eggplant, bell and other peppers, red spices, and seasonings. Even alcohol and sugar can be problematic for some people.

“Remember that some foods not on [the] elimination list are inflammatory to some people,” Schiff continued. “And not all nightshade vegetables and other elimination foods cause inflammation in everyone.”

She emphasized that this is why the elimination diet is important as a way to determine what an individual is sensitive to.

AIP vs. Mediterranean Diet

Schiff pointed out that there are many autoimmune diseases that affect the population—including rheumatoid and psoriatic arthritis, celiac disease, lupus, and polycystic ovary syndrome.

“Some of these chronic conditions may be aggravated by eating certain foods,” she continued. “They may cause the immune system to attack a person’s own healthy tissue and cause further inflammation.”

Schiff noted that the Mediterranean is a great, general diet that is anti-inflammatory and tends to work well for the general population, but for people with an autoimmune disease—or more than one—the AIP diet can specifically determine which food or foods are causing issues for them.

However, removing whole categories of food from the diet can put individuals at risk for vitamin and mineral deficiencies.

Schiff emphasized that working with a registered dietitian is important because they can help you substitute certain foods for ones that you’ve eliminated so that you can maintain diversity in your diet, which is important for gut health.