Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Feb 8;12:19-28.
doi: 10.2174/1874312901812010019. eCollection 2018.

Role of Diet in Influencing Rheumatoid Arthritis Disease Activity

Free PMC article

Role of Diet in Influencing Rheumatoid Arthritis Disease Activity

Humeira Badsha. Open Rheumatol J. .
Free PMC article


Background: Patients with Rheumatoid Arthritis (RA) frequently ask their doctors about which diets to follow, and even in the absence of advice from their physicians, many patients are undertaking various dietary interventions.

Discussion: However, the role of dietary modifications in RA is not well understood. Several studies have tried to address these gaps in our understanding. Intestinal microbial modifications are being studied for the prevention and management of RA. Some benefits of vegan diet may be explained by antioxidant constituents, lactobacilli and fibre, and by potential changes in intestinal flora. Similarly, Mediterranean diet shows anti-inflammatory effects due to protective properties of omega-3 polyunsaturated fatty acids and vitamins, but also by influencing the gut microbiome. Gluten-free and elemental diets have been associated with some benefits in RA though the existing evidence is limited. Long-term intake of fish and other sources of long-chain polyunsaturated fatty acids are protective for development of RA. The benefits of fasting, anti-oxidant supplementation, flavanoids, and probiotics in RA are not clear. Vitamin D has been shown to influence autoimmunity and specifically decrease RA disease activity. The role of supplements such as fish oils and vitamin D should be explored in future trials to gain new insights in disease pathogenesis and develop RA-specific dietary recommendations.

Conclusion: Specifically more research is needed to explore the association of diet and the gut microbiome and how this can influence RA disease activity.

Keywords: Diet; Disease; Dysbiosis; Inflammation; Microbiome; Rheumatoid arthritis.

Similar articles

See all similar articles

Cited by 3 articles


    1. Hetland M.L., Christensen I.J., Tarp U., Dreyer L., Hansen A., Hansen I.T., Kollerup G., Linde L., Lindegaard H.M., Poulsen U.E., Schlemmer A., Jensen D.V., Jensen S., Hostenkamp G., Østergaard M., All Departments of Rheumatology in Denmark Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: Results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. Arthritis Rheum. 2010;62(1):22–32. doi: 10.1002/art.27227. - DOI - PubMed
    1. Darlington L.G., Ramsey N.W., Mansfield J.R. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet. 1986;1(8475):236–238. doi: 10.1016/S0140-6736(86)90774-9. - DOI - PubMed
    1. Smedslund G., Byfuglien M.G., Olsen S.U., Hagen K.B. Effectiveness and safety of dietary interventions for rheumatoid arthritis: A systematic review of randomized controlled trials. J. Am. Diet. Assoc. 2010;110(5):727–735. doi: 10.1016/j.jada.2010.02.010. - DOI - PubMed
    1. Duerkop B.A., Vaishnava S., Hooper L.V. Immune responses to the microbiota at the intestinal mucosal surface. Immunity. 2009;31(3):368–376. doi: 10.1016/j.immuni.2009.08.009. - DOI - PubMed
    1. Macpherson A.J., Harris N.L. Interactions between commensal intestinal bacteria and the immune system. Nat. Rev. Immunol. 2004;4(6):478–485. doi: 10.1038/nri1373. - DOI - PubMed

LinkOut - more resources