It has been established that the gut microbiome plays a role in immune system regulation, which is not surprising as 70% of the immune system lives in the gut. Rheumatoid Arthritis (RA) is an autoimmune condition which put simply, can occur when your immune system attacks healthy cells in the body by mistake. In all cases of autoimmunity there is a ‘loss’ of tolerance by the immune system and when combined with chronic inflammation whether through poor dietary choices, exposure to high stress or environmental toxins for example, may lead to the development of autoimmune conditions like RA.
Emerging research suggests that changes to gut bacteria may be associated with an increased risk of Rheumatoid Arthritis as irregular gut microbial patterns have been observed in people diagnosed with the condition confirming that as well as lifestyle and our environment, our diet plays a crucial role in the disease pathology.
The good news is that there are lots of steps we can take towards optimising the gut microbiome and reducing inflammation, I’ve summarised my top 10 nutritional tips to improve Rheumatoid Arthritis symptoms below.
- Adopt the Mediterranean diet
This is an anti-inflammatory dietary approach based on daily intakes of fresh vegetables, fruits, nuts, seeds, beans, pulses, olive oil, wholegrains and oily fish which can all help to lower rates of inflammation in the body. Adopting this diet can help reduce swollen joints and improve morning stiffness.
- Incorporate herbs & spices
As part of an anti-inflammatory diet using herbs and spices during the day can have an additive effect in reducing inflammation and other symptoms. They can also add extra flavour to meals. Some of the best for reducing inflammation include Turmeric, when combined with black pepper the body is better able to absorb the active ingredient curcumin. Add to soups, stews and curry or use to season a tray of roasted vegetables.
A powerful anti-inflammatory herb rich in phenolic compounds such as gingerols that are able to suppress inflammatory signals in the body that can lead to pain and inflammation. Try adding chopped fresh ginger to meals, grating into smoothies and soups or steeping slices of ginger in hot water and sipping throughout the day.
4. Eat the rainbow
Include a variety of colours on your plate. Along with vitamins and fibre, antioxidants are phytochemicals found in fruits and vegetables, particularly brightly coloured varieties – the most common are A, C & E. As part of the inflammation associated with RA, substances called free radicals are produced which can lead to damage in the body, antioxidants can help neutralise that damage and have an anti-inflammatory effect while also supporting immune health. Regular consumption of fruits and vegetables is connected to reduced symptoms of chronic disease states like RA.
5. Focus on healthy fats
Healthy fats are the unsaturated types; mainly polyunsaturated and monounsaturated, found in foods such as nuts, seeds and Extra Virgin Olive Oil which is also a rich source of polyphenols. Nuts and seeds are usually very good sources of healthy fats while also being good sources of fibre and other nutrients such as magnesium and calcium – think about including almonds, pistachios and pecans for example. This inclusion of beneficial fats over inflammatory animal fats which are typically the saturated fatty acids, helps to optimise your omega 3:6 ratio. Be mindful of brazil nuts, cashews and macadamia nuts which are higher in saturated fat and therefore may play a role in inducing inflammation.
6. Drink green tea
Green tea is a rich source of polyphenols, a powerful plant-based anti-inflammatory compound and antioxidant that helps to minimise cell damage caused by free radicals in the body. There’s a special compound in green tea known as EGCG that may help reduce inflammation and joint pain associated with RA. You need to be drinking at least 2 cups a day, and over a minimum of 6 months.
7. The importance of fermented foods
Fermented foods are shown to improve microbial diversity in the gut, while also minimising the activity of specific inflammatory proteins such as interleukin-6 for example, a key inflammatory protein linked to conditions such as RA. Fermented foods include things such as yoghurt, kefir, fermented cottage cheese, kimchi and kombucha.
8. Optimise fibre intake
A high-fibre dietary regime has been consistently shown to increase microbiome diversity and short-chain fatty acids (SCFAs)-producing bacteria in the human gut which can help reduce inflammation. Altered gut microbiomes have been observed in inflammatory disease states such as RA, and research suggests dietary fibre can have a positive influence on the composition and activity of gut microbes which has an impact on the level of inflammation in the body. Fibre-rich foods include vegetables, fruits, wholegrains and nuts & seeds for example.
9. Eat more oily fish
Oily fish includes Salmon, Mackerel, Anchovies, Sardines and Herring, the current guidelines suggest to aim for 2-3 portions of these types of fish every week, and choose from sustainable sources where possible. They contain the long chain omega-3 fatty acids known as EPA and DHA which have an important role on the inflammatory pathway, potentially even slowing the development of RA in some animal studies, and reducing pain, swelling and morning stiffness when using high doses (recommended under nutritionist supervision). You can get omega-3 from plant sources such as linseed and walnuts but the body has to convert them into EPA and DHA which is a slower and less reliable process than consuming EPA and DHA directly, however this can be a route for vegetarian clients or those not wishing to supplement with Omega-3.
10. Vitamin D
There may be an association between low vitamin D levels and RA. Research shows as a population we are typically low in sufficient levels of vitamin D and a supplement can therefore be helpful. Primarily we get vitamin D through exposure to sufficient sunlight, oily fish, egg yolks and mushrooms but it’s very difficult to get close to the recommended daily intake through diet alone. According to research, in the UK our RDA for vitamin D is 10mcg per day, the equivalent to 400iu’s. For those who spend less time outside, cover their skin or have a condition such as an autoimmune disease which requires optimal levels of Vitamin D, a higher dose may be required (under nutritionist supervision).