Posted on February 24 2022
Doctors call rheumatoid arthritis or RA an autoimmune condition. The condition starts when our immune system (supposed to protect us) goes awry and begins to attack our body’s tissues. Nearly 1% of the Indian population suffers from RA, so much so, that it is considered a natural part of ageing.
But as we read though this blog, you will realise that this is far from the truth. Rheumatoid arthritis can be managed with lifestyle and nutritional changes alone, to an extent that you do not have any symptoms of the same.
What is Rheumatoid arthritis?
Rheumatoid arthritis leads to inflammation in the lining of our joints (the synovium), and as a result, our joints may get warm, red, swollen, and painful.
It is an autoimmune disease that causes joint pain, inflammation, and damage in your body. The joint damage that RA causes mostly happens on both sides of the body.
So, when a joint is affected in one of your legs or arms or similar joint existing in the other arm or leg will most likely be affected as well. This is the most common way doctors distinguish RA from other forms of arthritis, like osteoarthritis or OA.
It is extremely important to learn the signs and symptoms of RA because treatments work best when diagnosed early.
Rheumatoid arthritis symptoms.
RA is a chronic disease with symptoms of inflammation and pain in the joints. These signs and symptoms can increase during periods known as flares or exacerbations. They are also known as periods of remission (when symptoms can disappear completely).
RA symptoms most commonly affect joints in the wrists, hands, and knees. However, it can also affect tissues and organs throughout the body, including the heart, lungs, and eyes.
Following are the most common symptoms of RA:
- Pains or acute ache in one or more joints
- Stiffness that occurs in one or more joint
- Swelling and tenderness in more than one joint
- Similar symptoms of joints on both sides of the body
- Deformities and loss of joint function
- Low-grade fever
- Loss of appetite
Causes and Risk Factors of Rheumatoid Arthritis
Numerous lifestyle, nutritional, genetic and environmental factors can increase the risk of developing rheumatoid arthritis.
As already mentioned, RA is an autoimmune disorder. It results from our body’s immune system attacking healthy body tissues. But, the specific causes or triggers of RA still remain unknown.
If you are diagnosed with RA, your immune system will transport the antibodies towards the joint lining as a part of the disease process. These antibodies will attack the tissues lining your joints, cause the lining cells (synovial cells) to divide and add to inflammation.
During this process, chemicals are released to damage nearby cartilage, bones, tendons, and ligaments. If RA is not treated, the joint will become damaged and lose its shape and alignment. It will eventually become destroyed.
- Diet: Inflammatory foods such as dairy, meat and oil's are the main cause of RA. Eating a highly inflammatory diet has been associated with RA and multiple other lifestyle diseases.
- Age: The onset of RA is most commonly found among adults in their 50s. The risk of RA continues to increase with age for people who are assigned male at birth. RA is however also commonly seen among women in their child- bearing age.
- Genetics: People born with certain genes known as HLA class II genotypes are more likely to develop RA. The risk of RA is highest when people with these genes are obese or are exposed to environmental factors such as smoking. However, genetics does not determine your health alone. Genetics just load the gun. It is your nutrition and lifestyle that pulls the trigger.
- Early life exposure: As per the Centers for Disease Control and Prevention, children with mothers who smoked doubled the risk of developing RA as adults.
- Smoking: Studies show that people who smoke stand at highest risk of getting RA.
Obesity: Having obesity or being obese can increase the risk of developing RA.
Types of rheumatoid arthritis
There are different types of RA. Knowing which type you have will help the healthcare provider choose the most appropriate treatment for you.
- Seropositive RA: If you are seropositive RA, you have an anti-CCP blood test result or a positive rheumatoid factor meaning the antibodies cause your immune system to attack joints.
- Seronegative RA: You may have seronegative RA if you possess a negative RF blood test result and a negative anti-CCP result, but you still have RA symptoms. Ultimately, you may develop antibodies that change your diagnosis of seropositive RA.
Juvenile idiopathic arthritis (JIA): Juvenile idiopathic arthritis denotes RA in children aged 17 years old and younger. Previously the condition was known as juvenile rheumatoid arthritis (JRA). Symptoms for the condition are the same as those of other types of RA. However, they may include eye inflammation and issues with physical development.
Complications associated with Rheumatoid arthritis.
My common statement to all my clients always is to treat the problem you are dealing with rather that learning to live with the same. Untreated, RA could lead to complications that are beyond a fix.
Having RA can put you at risk of developing other health complications. Some people can develop complications from medications used to treat RA.
The complications may include the following:
- Premature heart disease: People with RA are almost twice as likely to develop heart disease than people without it. People who have obesity and RA stand at a highest risk. The number one cause of death for RA is coronary artery disease.
- Carpal tunnel syndrome: Carpal tunnel syndrome is quite a common occurring with RA. It causes numbness, aching, or tingling in the fingers and hands. It occurs due to a nerve compression in hand known as the median nerve.
- Interstitial lung disease: Inflammation of the lungs is also seen as a common side effect to RA treatment drugs.
- Pulmonary fibrosis: Pulmonary fibrosis is a condition that leads to lung scarring and stiffness and makes it difficult to breathe. Another painful lung condition is pleurisy, a complication of RA due to inflammation of the lung lining (known as pleura).
- Chest pain: Inflammation of tissues around your heart can lead to pericarditis. It is a condition that causes chest pain.
- Eyes conditions: Inflammation in the eyes due to RA causes uveitis and scleritis, which causes eye redness and pain. It can create Sjögren’s syndrome, or dry eyes.
- Vasculitis: Inflammation of the blood vessels (also known as vasculitis) can lead the vessels to thicken, narrow, weaken, and scar. It can also affect blood flow to our body’s organs in serious cases and be life-threatening.
- Joint damage: Permanent joint damage can occur if RA is not managed or treated early. Joints can become severely deformed, and nearby bones, tendons, and cartilage damage. In some cases, surgery is essential to prevent the loss of any joint function.
- Cervical myelopathy: If you have RA, it increases your risk of developing cervical myelopathy. This condition may result from compression of the spinal cord in our neck. Further, it can lead to dislocation of joints at the top of the spinal cord, seriously affect mobility, and permanent spinal cord damage.
- Pneumonia: The most frequently encountered infection in people with RA is Pneumonia.
- Renal failure: The third most common cause of death in people with RA is renal failure. People with RA are at an increased risk of glomerulonephritis and chronic kidney disease (CKD).
- Gastrointestinal haemorrhage: Gastrointestinal haemorrhage is a condition where heavy bleeding can occur in the upper parts of the digestive tract. It is the most common GI complication for people with RA. Further, it is also associated with nonsteroidal anti-inflammatory drugs (NSAIDs).
- Pancytopenia: Pancytopenia is a condition in which a person has lesser than normal number of white blood cells, red blood cells, and platelets. It can cause three blood diseases: anaemia, leukopenia, and thrombocytopenia. The severity of anaemia is connected with the severity of RA.
- Lymphoma: People with RA are at an increased risk of developing Hodgkin’s lymphoma (HL) and non-Hodgkin’s lymphoma (NHL).
Subcutaneous nodules: Subcutaneous nodules are lesions located deep in the dermis and subcutis layers of the skin. They can be commonly found in 30 to 40 per cent of patients with RA and are associated with more severe diseases.
Why does a plant-based diet help with RA?
Rheumatoid arthritis is an autoimmune illness in which the body damages its own joint lining. While genetics have a part, we now have more than enough research showing that a plant- centric diet can be a game changer.
Multiple researchers looked at clinical studies and case reports and discovered significant and positive evidence that a plant-based diet can reduce inflammation and improve RA symptoms.
But it is not just inflammation. Animal protein is toxic to the human body and when humans consume animal cartilage, the body responds to it by producing anti- cartilage proteins to help get rid of the animal cartilage from the body. This anti- cartilage protein in turn confuses our own cartilage as being a foreign body and starts attacking it.
This concept is called a friendly fire or molecular mimicry, where the body wants to attack a foreign protein, but instead ends of attacking itself.
Participants in study groups who switch to a plant centric diet experience lack of morning stiffness, better grip strength, reduced severity of joint pains etc within just a few weeks of dropping meat and dairy from their diet.
Gut- microbiome health is also a determining factor to rheumatoid arthritis. Read this blog to understand more:
Gut health is determined by plant- diversity. The more colourful and diverse your plate looks, the better your gut health. By filling your plate in inflammatory meat and dairy, you leave little room for vegetables, fruits, lentils, pulses, nuts and seeds.
People on a plant based diet also have a lower BMI (body mass index) and waist to hip ratio. Body weight is also a key risk factor associated with rheumatoid arthritis.
One key study showing a positive association between plant- based diets and RA symptom management was conducted by Hana Kahleova. She said:
“A plant-based diet comprised of fruits, vegetables, grains, and legumes may be tremendously helpful for those with rheumatoid arthritis. This study offers hope that with a simple menu change, joint pain, swelling, and other painful symptoms may improve or even disappear.” -Hana Kahleova, MD, PhD, director of clinical research for the Physicians Committee.
If you could just change your diet for the next month and instantly start feeling better, shouldn't it atleast be worth a try?
Does fasting help with Rheumatoid Arthritis?
Data supports that fasting might very well positively impact metabolic disorders, pain symptoms, hypertension, persistent inflammatory illnesses, and even psychosomatic disorders. But the maximum body of scientific proof supporting the benefits of fasting is in rheumatic diseases, such as rheumatoid arthritis.
Dr. Goldhaner, who pioneers in disease management through fasting only quotes:
If you treat high blood pressure medically, they tell you, “You must take these drugs the rest of your life.” If you have diabetes, they’ll tell you, “You’ll be on these medications the rest of your life.” If you have autoimmune disease, like lupus, rheumatoid arthritis, ulcerative colitis, ankylosing spondylitis, psoriasis, or eczema, you will be told, “You must be on medications the rest of your life,” because medicine guarantees you will never recover. They promise you, if you follow their advice explicitly, you will be sick the rest of your life.
This approach (fasting) offers people an option to make lifestyle changes, eliminate the cause of the problem, and stabilize their conditions, to the point where the medication is no longer needed. So it is a very different approach to managing these diseases of dietary excess—the diseases of kings, if you will—than conventional medicine, which is more about the suppression of the symptoms associated with the disease, rather than removing the underlying mechanisms by which they are caused.
Fasting followed by a vegetarian diet may aid individuals with rheumatoid arthritis, according to research evidence (RA).
The findings of a controlled trial with at least three months of follow-up data after fasting were objectively integrated. The combination of a period of water- only fasting under medical supervision followed by a year long switch to a vegetarian diet works together.
Following fasting and a subsequently meat and egg-free diet, ten distinct markers of inflammation dropped dramatically, however none of the parameters changed in illness sufferers who continued to eat their usual meals.
It's possible that this is linked to modifications in the gut micro-biome. The reduction in symptoms was accompanied with a huge change in intestinal micro-flora, which might be useful in some way, possibly by boosting the gut barrier. As a result, this diet approach i.e. fasting appears to be a beneficial addition to standard medical treatment for rheumatoid arthritis.
I cannot insist enough here that there is a very thin line between fasting and starving. You want to only introduce fasting under the presence of a medical doctor and certified nutritionist. Please do not try this on your own.
Intermittent fasting ironically is not as effective as a complete water only fast. The period of the fast varies vastly depending on the severity of your condition.
Spices that help manage Rheumatoid Arthritis.
Spices have been the groundwork on which modern medicines is developed. It is no surprise that traditional Chinese medicines and Ayurveda both have relied heavily on the use of herbs and spices to treat diseases.
One particular spice vastly studies for inflammation management is turmeric. Curcumin, an orange-yellow ingredient found in turmeric, is what gives it its yellow color. Thousands of publications on the health advantages of Curcumin have been published in medical journals.
In a study, 45 patients with rheumatoid arthritis were randomly assigned to one of three groups: Curcumin, the standard of care medication, or both. The primary outcome was a decrease in disease activity, as well as reduced joint discomfort and swelling.
Although all three groups improved, the Curcumin groups demonstrated the greatest improvement, outperforming the medication group by a substantial margin. As a result, it was proved that Curcumin alone was indeed healthy and beneficial, and also shockingly more successful in reducing pain than the main medicine of choice, all while causing no obvious side effects.
Turmeric is best absorbed by the body in the presence of black pepper. Consider adding a pinch of turmeric and black pepper to your morning drink daily for the most benefits.
The quantity of turmeric used in Indian curries and regular cooking is bare minimum and often shared by the entire family. If you are struggling with RA, consider a pinch of turmeric and black pepper mixed in warm water twice a day. This is more than enough as turmeric is very potent.
8 Food Ingredients That Can Cause Inflammation
Your body is in an inflammatory state when you have arthritis. Inflammation is basically the bodies defence cells attacking itself.
It can trigger pain, among other symptoms. What you consume may increase inflammation and set you up for other chronic conditions like obesity, heart disease, and diabetes. Eliminate or limit these eight pro-inflammatory foods and ingredients:
- Sugar: It may be hard to resist pastries, chocolate bars, desserts, sodas, even fruit juices. But according to the American Journal of Clinical Nutrition, processed sugars can trigger the release of inflammatory messengers known as cytokines. Artificial sweeteners do the same and must also be avoided.
Saturated Fats (Dairy and Meat): Several studies have shown that saturated fats trigger the development of adipose (fat tissue). It is an indicator of heart disease and worsens arthritis inflammation. Dairy and meat are the biggest sources of saturated fats.
Trans Fats: Trans-fat is known to trigger systemic inflammation. It can be found in fast foods and other fried products, frozen breakfast products, cookies, processed snack foods, doughnuts, crackers and most stick margarine.
Omega 6 Fatty Acids: The body needs Omega 6 fatty acids, an essential fatty acid for normal growth and development. But more importantly, the body requires a healthy balance of omega-6 and omega-3 fatty acids. However, excess consumption of omega-6s will trigger the body to produce pro-inflammatory chemicals. These fatty acids can be found in oils like corn, sunflower, safflower, grapeseed soy, peanut, vegetable, mayonnaise, and many salad dressings.
Refined Carbohydrates: White flour products such as bread, rolls, crackers; white rice, white potatoes such as instant mashed potatoes, french fries and bowls of sugary breakfast cereal are refined carbohydrates. Processed carbohydrates trump fats as the main driver of escalating obesity and other chronic conditions. These high-glycemic index foods accelerate the production of advanced glycation end (AGE) products that further stimulate inflammation.
MSG: Mono-sodium glutamate (or MSG) is a flavour-enhancing food additive. It is most commonly found in Asian food and soy sauce. It can be added to fast foods or while preparing soups and soup mixes, salad dressings, and deli meats. MSG is known to trigger two important pathways of chronic inflammation and affect liver health.
Gluten and Casein: People having joint pain could be sensitive to gluten (found in wheat, barley and rye), and casein (found in dairy products). People diagnosed with celiac disease (where gluten sets off an autoimmune response and damages the small intestine and sometimes causes joint pain) will find relief when they adopt a gluten-free diet. Casein, found in dairy products should be avoided under all circumstances as it is highly carcinogenic.
Alcohol: Alcohol is a problem for the liver. Excessive alcohol use can weaken liver function, disrupt other multi-organ interactions, and cause inflammation. Therefore it is best to eliminate or use in moderation.
Healthy Foods to Include for Rheumatoid Arthritis:
A well- balanced diet will help manage inflammation, prevent the body from attacking itself via molecular mimicry and provide relief from symptoms. A healthy diet also helps one stay in an ideal BMI range, thus, preventing the complications that come from Rheumatoid Arthritis.
A whole- food plant- based diet is considered thee best option for people with RA. This diet primarily focuses on inflammation-fighting foods, like:
- Plenty of fresh fruits and vegetables: These are rich in antioxidants
- Flax and chia seeds: It has heart-healthy monounsaturated fat
- Nuts: These are a great source of monounsaturated fats and other nutrients
- Whole grains: Whole grains fight inflammation.
Legumes (including peas and beans): They are a healthy source of protein and help improve gut health.
Additionally, people with RA should eat calcium-rich foods to support strong bones because some RA medications can increase the risk of osteoporosis. Good sources include dark leafy green vegetables.
Since anaemia can occur during RA flare-ups, resulting in fatigue, it is also a good idea to incorporate iron-rich foods into their diet, like:
- Leafy greens
- Fortified breakfast cereals
Further, antioxidants like vitamins A, C, and E and selenium can help in reducing inflammation. Foods high in antioxidants are:
- Berries (blueberries, cranberries, goji berries, and strawberries)
- Dark chocolate
- Kidney beans
Read this to know more:
Foods containing flavonoids can also help with pain management. They include:
- Soy products (including tofu and miso)
- Green tea
What you don’t eat is equally as important as what you do eat. So, make sure that you avoid trigger foods. These will particularly include processed carbohydrates and saturated or trans-fats.
Lifestyle Changes For rheumatoid arthritis management.
When it comes to managing any auto- immune diseases, lifestyle changes play a crucial part. Unless you are able to change your lifestyle you cannot sustain changes to last permanently. Here are some changes I suggest my clients make:
Take Care of yourself: Make time for your health. This might include time for your mental health through non- doing or spiritual practices, time spend on a hobby of your choice and on your physical health.
Exercise: Work with a professional who knows about your condition and is trained to help people with RA specifically. The solution for RA is not ceasing all forms of activity, but rather finding a fitness plan that works to increase joint mobility, body balance and flexibility, and increase muscle mass.
Here are a few forms of exercises I recommend my clients:
- Low-impact aerobic exercise: These exercises keep your heart strong without hurting your joints. Walking, swimming, and riding a bike are good choices for people with RA.
- Yin- Yoga/ Vinyasa flow: Vinyasa flows are gentle flows aimed at improving coordination, balance and challenge the muscle fibres. Yin- yoga on the other hand works on improving the range of motion of your joints.
- Floor pilates: Slow, gentle, flowing exercises such as Pilates, tai chi, and yoga helps in boosting your balance and flexibility. They even ease your pain.
- Resistance training: Resistance training can be your greatest strength or a burden. Make sure to work with a certified expert who understands your condition and guides you accordingly.
- Watch your nutrition: Switch to a whole- food plant- centric diet and include foods that heal your body.
Keep a Healthy Weight: Almost two-thirds of people with RA are overweight or obese. Getting to a healthier weight can lead to fewer complications and promote a better chance of remission. Fat cells release cytokines. More fat cells will mean more cytokines, and more cytokines will mean more inflammation.
Further extra weight can make some medications that treat RA less effective. And whether you have RA or not, adding pounds to your frame will put more pressure on your joints. The ones that bear weight feel the most strain, such as:
- Low back
- Lower Stress: Dealing with RA can be stressful. However, there are many ways to lower your stress level:
- Seek help from a professional counsellor. Every person is different and you want someone who understands you and suggests accordingly.
- Take time to rest during the day since balancing activity and rest is a crucial part of self-care for RA.
- Introduce some form of breathing practices to your daily routine. This could be pranayama or Wim Hoff method etc.
- Reach out for support from family, friends, and co-workers.
- Join a support group or a class. You may also connect with others who have RA online or social media.
Sample Vegetarian Diet Plan for RA.
Here is a list of foods to include in your daily diet:
High in Omega 3 Fatty Acids: Omega-3 fatty acids found in Walnuts, Flax Seeds, and Chia Seeds are great sources of omega-3 fatty acids, which help in reducing inflammation.
How much to eat: Two to three tablespoons of seeds and four to five walnuts daily.
Antioxidant-rich fruits and vegetables: Lutein and vitamin A in Broccoli, Vitamin C in Amla and fruits like Oranges, Grapefruit, Strawberry etc., bromelain in Pineapple, papain in Papaya, quercetin in Kale and anthocyanins in Cherries are all the fruits and veggies that benefits to ease the arthritic pain.
The deeper the colour of fruits and vegetables, the higher the antioxidants it carries. These antioxidants help strengthen your immune system and reduce the inflammation and pain experienced in arthritis.
How much to eat: At least two to three servings of fruits and four to five servings of vegetables per day.
Grains: Eating a lot of whole grains will toss High Fiber into your diet and help maintain a healthy weight. Obesity is one of the causes of osteoarthritis. So include Oats, Buckwheat, Barley, Jowar, Bajra and Quinoa in your diet.
How much to eat: Aim for four to five servings daily. A slice of bread will be one serving. So a sandwich for lunch with two slices of whole wheat bread will be two servings.
Sulphur rich foods: Sulphur rich foods such as Cabbage, Brussels Sprouts, Broccoli, and Cauliflower are loaded with sulforaphane compounds. These foods help heal auto- immune diseases.
How much to eat: Have at least 100- 150 grams of cruciferous vegetables per day.
Pulses/ Legumes: Pulses such as Rajma is a good source of fibre and other nutrients such as Magnesium, Iron, Zinc, Potassium, folic acid. Together they work to stabilise blood glucose levels and keep your waistline tiny.
How much to eat: At least two to three servings per day.
RA is a chronic disease that does not currently have a cure. Most people with RA do not have constant symptoms. Instead, they have flare-ups followed by relatively symptom-free periods known as remissions. The course of the disease varies from person to person, and the symptoms range from mild to severe.
Though the symptoms can stop for extended periods, the joint problems caused by RA usually get worse over time. That is why nutritional and lifestyle changes adopted early can prevent further complications.
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