Diet for rheumatism

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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Little animal, a lot of herbal: this is what the diet should look like for rheumatism. Here you can find out why meat, eggs & Co. are rather unfavorable for inflammatory rheumatic diseases, why this does not apply to fish and what other recommendations there are for rheumatism nutrition!

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. M05M06

The role of diet in rheumatism

Diet for rheumatism (like rheumatoid arthritis) plays an important role. It cannot replace treatment with medication, physiotherapy and / or surgery. With what you eat and drink every day, you as the person affected can have a positive influence on the course of the disease and your well-being. There are mutliple reasons for this:

Anti-inflammatory food

Some food ingredients have an anti-inflammatory effect, others an anti-inflammatory one. This explains why the choice of food and the composition of meals should be carefully considered in inflammatory rheumatic diseases such as rheumatoid arthritis. In rheumatism, the right diet can help reduce inflammatory processes and relieve pain.

Antioxidants protect cells

When there is inflammation, a lot of "free radicals" are created. These are aggressive oxygen compounds that damage the tissue of joints and neighboring structures, for example. Antioxidants such as vitamin C, vitamin E, zinc and selenium help against this: They can neutralize oxygen radicals and thus render them harmless. Vegetable foods in particular contain large amounts of these "radical scavengers".

Antioxidants also help the body against "free radicals", which arise or are supplied to the body, for example, as a result of overload, environmental toxins, alcohol and tobacco smoke.

Minerals and vitamins for strong bones

Bone loss (osteoporosis) is a common chronic bone disease. Like many diseases, it also belongs to the rheumatic group of forms. It is also a frequent concomitant and secondary disease of other rheumatic diseases. The diet should therefore provide sufficient minerals and vitamins that the body needs for strong bones right from the start.

Most people know that calcium and vitamin D are of particular importance here. But there are other minerals and vitamins that are important for bone health. These include, for example, magnesium, potassium, zinc, folic acid, vitamin B12 and vitamin K.

The need for vitamin D is only partially covered by food (herring, salmon, egg yolk, mushrooms, etc.). The main contribution is made by the skin's own production using sunlight.

Changed energy demand

In order to be able to perform all of its tasks well, the body must be able to absorb a wide variety of nutrients in sufficient quantities from food. This is especially true for rheumatoid diseases such as rheumatoid arthritis - the chronic ailment puts additional demands on the body:

Due to the constant inflammatory processes that occur in rheumatism, the sick organism needs around 20 percent more energy than a healthy one. Rheumatism patients should therefore eat more. At the same time, however, many are not very physically active due to the constant pain and consequently have little muscle mass. As a result, your body has a lower basal metabolic rate (energy consumption at rest) than that of "more muscular" people. The energy from food is therefore converted more quickly into fat tissue.

With the right diet in combination with appropriate physical activity - here, joint protection is particularly important - patients can counteract growing fat deposits.

Is there a special rheumatism diet?

There are a number of studies that deal with the possible influence of different diets and strategies on rheumatism - starting with fasting cures and vegetarian diet (in different forms) to Mediterranean or Crete diets to exclusion diets. In the case of the latter, individual foods that are suspected to be the cause of ailments are experimentally avoided.

In summary, the effectiveness of special rheumatism diets has not yet been conclusively assessed. Nonetheless, some general diet recommendations can be made for rheumatism. They can help alleviate inflammation-related symptoms, prevent comorbidities such as osteoporosis, and improve general health.

The general rule is: Regardless of the rheumatism diet, it cannot replace medicinal or surgical treatments, but rather provide useful support!

In addition, a wholesome, balanced diet is generally recommended for rheumatism. The chances are good that the body will get all the nutrients it needs in sufficient quantities - after all, no food contains all the relevant carbohydrates, proteins, fats, vitamins and minerals (bulk and trace elements), including antioxidants. So variety on the plate is healthy - by the way, also for people who do not suffer from rheumatism.

Which foods should you avoid with rheumatism?

Only eat animal foods in moderation! This advice applies to all inflammatory rheumatic diseases, not just rheumatoid arthritis. The reason: a diet that consists largely of meat and sausage products, milk and dairy products and eggs can fuel inflammatory processes. This is because animal foods contain arachidonic acid. From this omega-6 fatty acid, inflammatory messenger substances, so-called eicosanoids, are formed in the body.

Therefore, especially as a rheumatism patient, do not consume meat, sausage, eggs etc. too often and only in moderation. The following table, which lists the arachidonic acid content of selected animal products, will help you plan your "rheumatic diet":

Food	Arachidonic acid content
Food	per serving	per 100 g
Chicken ragout	1600 mg (per 400 g)	400 mg
Soup chicken	1095 mg (per 150 g)	730 mg
roast chicken	851 mg (per 370 g)	230 mg
croissant	749 mg (per 70 g)	1070 mg
Pork liver	650 mg (per 125 g)	520 mg
Veal chop	480 mg (per 150 g)	320 mg
pork goulash	345 mg (per 155 g)	230 mg
veal	330 mg (per 150 g)	220 mg
Chicken Burger	270 mg (per 150 g)	180 mg
Lard	255 mg (per 15 g)	1700 mg
eel	225 mg (per 150 g)	150 mg
pork	150 mg (per 300 g)	50 mg
omelet	84 mg (per 140 g)	60 mg
Gyros	62.5 mg (per 125 g)	50 mg
beef	60 mg (per 150 g)	40 mg
egg yolk	38 mg (per 19 g)	200 mg
egg	36 mg (per 60 g)	60 mg
Landjäger	30 mg (per 30 g)	100 mg
Milk (1.5% fat)	15 mg (per 150 g)	10 mg

Source: DEBInet "Rheumatism - Nutrition"

Do without animals entirely?

Incidentally, there is no arachidonic acid in plant foods. That is why some rheumatism patients eat a vegetarian diet. There are different variants of this diet:

Vegans strictly avoid all food of animal origin.
Lacto-vegetarians say "no" to meat, fish and eggs, but not to milk and dairy products.
Lacto-ovo vegetarians allow themselves not only plant-based food but also milk, dairy products and eggs.
Pesco vegetarians (or Pescarier) combine their otherwise purely plant-based diet with fish and seafood.

But what are the benefits of (largely) avoiding animal foods in rheumatism? As for other forms of nutrition, the following also applies here: So far, there is no convincing scientific evidence that a meat-free or even vegan diet has a long-term positive effect on inflammatory rheumatic diseases. A certain restraint with schnitzel, liver sausage and cream - and thus a reduced supply of arachidonic acid - is definitely good for rheumatic joints!

Caution is advised with highly active inflammatory rheumatism such as rheumatoid arthritis: this can lead to an increased breakdown of protein! It is therefore not advisable to completely do without animal foods and thus animal proteins. Meat is also an important supplier of iron.

Rheumatism Diet: What To Eat?

As indicated above, the diet for rheumatism should focus on plant-based foods. Fresh fruits and vegetables - including potatoes, legumes, grains, and nuts - provide the body with plenty of vitamins, minerals, and antioxidants. They also contain valuable phytochemicals: These are various colors, smells and flavors (such as polyphenols or carotenoids), which among other things have an anti-inflammatory effect.

Vegetable oils such as linseed, rapeseed, soy, walnut and wheat germ oil also make a valuable contribution to nutrition in rheumatism. They are good sources of alpha linolenic acid. This is an omega-3 fatty acid that is converted in the body into eicosapentaenoic acid - another omega-3 fatty acid. These fatty acids counter inflammatory processes (in contrast to omega-6 fatty acids), so they should definitely be part of the rheumatic diet.

For the same reason, it is advisable to consume fish regularly for rheumatic diseases such as rheumatoid arthritis. Varieties such as mackerel or salmon contain large amounts of anti-inflammatory, long-chain omega-3 fatty acids such as eicosapentaenoic acid or docosahexaenoic acid. Clinical tests have shown that consuming 800 grams of fish per week can reduce the number of inflammatory swollen joints and the intensity of pain associated with rheumatic inflammatory diseases.

Spices should not be missing in the rheumatism diet: curry, garlic, caraway and ginger have anti-inflammatory effects. They are therefore not only suitable for refining dishes for reasons of taste.

Rheumatoid arthritis: coffee and alcohol

In order for the metabolism to function smoothly, you should consume 30 milliliters of water per kilogram of body weight every day. So if you weigh 60 kg, for example, it is best to drink at least 1.8 liters a day. Take note of this general recommendation on hydration for the rheumatism diet as well.

Coffee can make up part of the amount you drink every day. However, cover your fluid requirements mainly with water or unsweetened herbal or fruit tea.

On the other hand, alcohol is not very suitable as a drink. Alcohol can cause a wide variety of damage to the body. You should therefore only enjoy it in moderation if at all. If you have a healthy liver, an occasional glass of wine or beer is usually allowed. In larger quantities, however, alcohol can, among other things, accelerate the disease-related destruction of the joints. Anyone who also suffers from osteoporosis or gout should definitely keep their hands off alcohol.

It is best to discuss with your treating doctor whether and how much alcohol is advisable in your case.

Rheumatism nutrition: tips at a glance

Avoid high-fat animal foods such as lard, pork liver, egg yolks and high-fat meats and sausages. One or two servings of meat or sausage are sufficient. Avoid eating more than four egg yolks a week.
When it comes to milk and dairy products, it is best to choose low-fat variants (e.g. reduced-fat milk, skimmed yoghurt).
Eat fish such as mackerel, salmon, or herring twice a week.
Give preference to vegetable fats when cooking and preparing food. Vegetable oils, which contain plenty of omega-3 fatty acids, are particularly recommended. This applies to walnut, linseed, soy and rapeseed oil, for example. The last two also provide a lot of vitamin E - an important antioxidant.
Ideally, you will have five servings of fruit and vegetables on your menu per day. The measure for a portion is your own hand - only with dried fruits and nuts (as a fruit portion) should a portion be smaller (approx. 25 g) due to the high calorie content. A glass of fruit or vegetable juice also counts as one serving.
For cereals and cereal products (such as flour, bread, pasta, rice), go for the whole grain variant. This provides vitamins, minerals and fiber that are missing in the white flour variant. Whole grains also fill you up longer.
Whenever possible, eat freshly prepared meals rather than ready-made meals. The latter usually contain saturated fatty acids, hidden sugar, a lot of salt, preservatives and flavorings - all of which are not very healthy.
Don't drink too much alcohol. It is even better if you refrain from smoking altogether - as well as smoking (it makes rheumatism worse!).

Also, consider your likes and dislikes when choosing your meals.As healthy as fish for rheumatoid arthritis, if you don't like it, don't force yourself to eat herring salad or fish rolls regularly. As an alternative, fish oil capsules could then be considered. How much of it can be discussed with your doctor.

They may also recommend that you take a dietary supplement. Sometimes the right diet cannot cover the need for individual vitamins or minerals in rheumatism.

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