If you have rheumatoid arthritis (RA), your healthcare provider may recommend an anti-inflammatory diet, which is very similar to a Mediterranean diet. It emphasizes vegetables, fish, legumes, fruits, and olive oil to help fight inflammation, which can help relieve joint pain.
Some studies suggest intermittent fasting, which involves restricting food intake for specific periods, may improve joint pain and other RA symptoms. However, it isn’t right for everyone.
This article will explore the latest research surrounding intermittent fasting for rheumatoid arthritis and provide general nutrition advice to help you manage your condition.
The Link Between Diet and RA
Rheumatoid arthritis is an inflammatory, autoimmune disease. It happens when a person’s immune system mistakenly attacks healthy cells in the body. RA primarily attacks the joints, where it causes the lining of the joint to become inflamed, resulting in joint tissue damage.
Although diet alone cannot cure RA, certain foods can improve or worsen joint pain and other symptoms. One study found that nearly 25% of individuals with RA reported that certain foods either positively or negatively impacted their RA symptoms.
For example, typical Western diet patterns rich in processed foods, red meat, and sugar can cause chronic inflammation and immune dysfunction. This may worsen symptoms for a person with RA. In contrast, eating healthful foods can reduce body-wide inflammation, improve joint pain and promote a healthy weight.
In addition to eating an anti-inflammatory diet, some research suggests intermittent fasting (IF) can be beneficial in managing symptoms of RA.
What Is Intermittent Fasting?
Intermittent fasting (IF) is a pattern that involves eating and fasting in time blocks. During periods of fasting, a person eats very little or nothing at all. This allows the body to use up its sugar (glucose) stores and switch to burning fat stored in cells for energy.
Some experts believe IF can benefit a person with RA because it may reduce inflammation. Studies suggest that IF reduces the release of monocytes (a type of white blood cell). During fasting, monocytes go into what researchers consider a “sleep mode” and exhibit less inflammation than fed monocytes.
Other studies suggest fasting can “reset” the immune system by eliminating old or damaged cells and regenerating new ones.
One study looked at 35 people with RA who observed fasting during Ramadan (a 30-day fast from dawn to dusk, about 12 hours). Participants were assessed six months before, during, and three months after. Researchers found significant decreases in disease activity during fasting, with the effects fading by the third month. Fasting for one month every three months may improve symptoms in those with RA.
IF and weight loss
IF may also support weight loss, which lessens the pressure on the joints and knees. One review of 40 studies found that people who practice IF can lose 7 to 11 pounds over 10 weeks.
A few studies suggest IF may also provide additional benefits, including:
- Improvements in memory
- Reduce blood pressure
- Lower heart rate
- Weight loss
- Fat loss
- Better physical performance
- Prevention of age-related neurodegenerative disorders (e.g., Alzheimer’s disease)
- Decreasing fasting glucose
Types of IF
The most common types of intermittent fasting include:
- Alternate-day fasting involves alternating between eating what you want one day and fasting or eating around 25% of your calorie needs the following day. For example, you may choose to fast Tuesday, Thursday, and Saturday and normally eat on the other days.
- Whole-day fasting is fasting or eating less than 25% of your daily calorie needs for an entire 24-hour period. It consists of eating normally with no food restriction for five days of the week and severely restricting intake to 400-500 calories the other two days.
- Time-restricted feeding involves fasting during a specific time frame. An example would be fasting for 16 hours and eating as desired for eight hours. You may eat during a window of 8 a.m.-3 p.m. and fast during the day’s remaining hours.
Although IF may be a good option to aid in weight loss and manage chronic conditions like RA, it is not appropriate for everyone. Groups who should likely avoid intermittent fasting include:
Medication and Mealtime
Some medications commonly prescribed for RA have to be taken with meals. For example, hydroxychloroquine should be taken with food to minimize nausea.
However, some IF plans allow for some food intake during fasting periods. If you choose to fast without food intake, you can probably adjust meal timing to fit your medication needs.
Consult With Your Healthcare Provider
As with all eating plans, the quality of your food matters. Before adjusting medication timing or starting intermittent fasting, you should always consult your healthcare provider. Not all diets are a good fit for everyone.
IF Alternatives for RA
If intermittent fasting is not a fit for you, following a Mediterranean-style diet may be helpful. A Mediterranean diet is filled with anti-inflammatory foods to reduce inflammation and improve symptoms. People with RA should follow a Mediterranean style diet and aim to:
- Consume 3-4 ounces of salmon, tuna, or sardines twice a week
- Eat 6 ounces of grains per day, with 3 ounces coming from whole grains
- Have at least nine servings of colorful fruits and vegetables per day
- Eat 1.5 ounces of walnuts, pine nuts, pistachios, or almonds each day
- Eat at least 1 cup of beans twice a week
- Use 2-3 tablespoons of olive oil for cooking or blended in salad dressing each day
- Get at least 25-35 grams of fiber each day
Certain foods may increase inflammation and pain. If you have RA, avoid the following list of inflammatory foods to help manage your condition.
- White bread
- Canned goods
- Processed meat (hot dogs and sausage)
- Fried foods
- Sugary beverages
- Red meat
- Processed foods
Can Nightshades Trigger RA Flare-Ups?
Some people believe nightshade veggies, including eggplant, tomatoes, peppers, and potatoes, may trigger arthritis flare-ups. While there’s no strong scientific evidence to support this, you may consider eliminating nightshades from your diet for a week or two to see if you notice symptom improvement.
Starting With Small Changes
Once you decide to make diet and lifestyle changes, start with small changes instead of big, drastic ones. Incorporating colorful fruits and veggies, swapping white bread for wheat bread, or replacing beef with salmon are great ways to make small changes.
If you are considering IF, start with larger time windows, such as 12 hours of fasting and 12 hours of eating normally. This allows you to ease into your goal time frame slowly.
While there is no specific diet for rheumatoid arthritis, following an anti-inflammatory diet, such as the Mediterranean diet, can reduce inflammation and improve joint pain. Additionally, there’s growing evidence that intermittent fasting can also provide short-term symptom relief. Eating a diet rich in fish, healthy fats, fruits, and veggies can fight inflammation and benefit your overall health.
A Word From Verywell
Living with RA can be difficult because it often makes simple, everyday tasks challenging. Although there isn’t a specific meal plan proven to alleviate RA symptoms, it’s essential to follow a healthy diet rich in foods that fight inflammation and avoid processed and fried foods that can cause inflammation.
Frequently Asked Questions
Why does intermittent fasting improve RA inflammation?
Intermittent fasting may reduce inflammation by reducing the release of monocytes in the blood. During periods of fasting, monocytes go into a “sleep mode” and have less inflammation compared to fed monocytes. This can lead to short-term improvements in symptoms of RA.
Can you drink liquids while intermittent fasting?
During strict periods of fasting, you should only drink water, black coffee, tea, or another zero-calorie beverage.
Who shouldn’t do intermittent fasting for rheumatoid arthritis?
People who are breastfeeding or pregnant, children under the age of 18, and people with a history of an eating disorder should avoid intermittent fasting.