Arthritis Diet


Arthritis is the general medical term for the inflammation of a joint or a disorder characterized by such inflammation. Because of the various kinds of arthritis, no arthritis diet, as such, has been proposed as a treatment for all of these different joint disorders. Dietary therapies for osteoarthritis (OA) and rheumatoid arthritis (RA), the two most common forms of arthritis, fall into three major categories. The first is a mainstream management strategy that focuses on weight reduction and well-balanced diets as a way to relieve stress on damaged joints and slow the progression of arthritis. The second uses dietary supplements of various types that have been evaluated in clinical trials and have been found to benefit at least some patients. A third category uses alternative medical approaches that rely on dietary adjustments, including elimination diets, and/or traditional herbal remedies to treat arthritis.


Osteoarthritis (OA) is the more common of the two main types of arthritis in the North American population, particularly among middle-aged and older adults. OA is also the most common joint disorder worldwide, affecting an estimated 2.3% of the global population. The Centers for Disease Control and Prevention (CDC) estimate that OA affects about 50 million adults in the United States as of 2018 and accounts for at least $303.5 billion in healthcare costs each year. The number of adults with OA is expected to rise to 78 million by 2040. Osteoarthritis is also the single most common condition for which people seek help from complementary and alternative medical (CAM) treatments.

Nurse checking man's hand joints.

Nurse checking man's hand joints.
(Science Source)

The rate of OA increases in older age groups; about 80%–90% of people over the age of 65 show some evidence of OA when they are x-rayed. Only about half of these older adults, however, are affected severely enough to develop noticeable symptoms. By age 80, 100% of individuals show some signs of OA. OA usually does not completely disable people; most patients can manage its symptoms by watching their weight, staying active, avoiding overuse of affected joints, and taking over-the-counter or prescription pain relievers. OA most commonly affects the weight-bearing joints in the hips, knees, and spine, although some people first notice its symptoms in their fingers, wrists, or neck. It is often unilateral, which means that it affects the joints on only one side of the body. The symptoms of OA vary considerably in severity from person to person.

Differences between osteoarthritis and rheumatoid arthritis


Rheumatoid arthritis

Risk factors

Age related

Family history

Overuse of joints

Excessive weight

Physical effects

Affects joints

Autoimmune disease

Bony spurs

Enlarged or malformed joints

Treatment options

Weight management


Nonsteroidal anti-inflammatory drugs


Disease-modifying antirheumatic drugs

Pain management

Support groups


Joint splitting

Physical therapy

Passive exercise

Joint replacement

Hot and cold therapy

Massage therapy


Psychological approaches (relaxation, visualization)

Tai chi

Low-stress yoga

OA is not caused by the aging process alone. It is thought to result from a combination of factors, including traumatic damage to joints from accidents or sports injuries; repetitive use of the joint, often related to the person's occupation; obesity; and genetic factors. Race, however, does not appear to increase a person's risk of OA. Some risk factors for OA include osteoporosis and vitamin D deficiency.

Rheumatoid arthritis

Rheumatoid arthritis (RA), by contrast, is most likely to be diagnosed in adults between the ages of 30 and 50; women are affected three to five times as often as men. RA affects between 0.5% and 1% of adults in the developed countries worldwide. Race appears to be a factor, as RA is much more common among Native Americans (5%–6%) and rare among African Americans of Caribbean origin. RA has a hereditary component; people with relatives who have RA are more likely to develop the disease.

Unlike OA, which is caused by degeneration of a body tissue, RA is an autoimmune disorder in which the body's immune system attacks some of its own tissues. RA often develops suddenly and may affect other organ systems, not just the joints. RA is more debilitating than OA; 30% of patients with RA will become permanently disabled within two to three years of diagnosis if they are not treated. In addition, patients with RA have a higher risk of heart attacks and strokes; the disorder shortens most patients' lifespans by 3 to 12 years. RA differs from OA, too, in that the joints it most commonly affects are the fingers, wrists, knuckles, elbows, and shoulders. RA is typically a bilateral disorder, which means that both sides of the body are affected. In addition, people with RA often feel sick, feverish, or generally unwell, whereas those with OA usually feel normal except for the stiffness or discomfort in the affected joints.


The role of diet and nutrition in both OA and RA has been studied since the 1930s, but experts have come to little agreement regarding the details of dietary therapy for these disorders as of 2018. One clear finding that has emerged from decades of research is the importance of weight reduction or maintenance in the treatment of patients with OA. Another agreed-upon finding is the need for nutritional balance and healthy eating patterns in the treatment of either form of arthritis. Studies have also been done on the use of dietary supplements and complementary and alternative medicine (CAM) therapies.



Although some doctors recommend trying a vegetarian or vegan diet as a safe approach to weight loss for patients with OA, most will approve any nutritionally sound calorie-reduction diet that works well for the individual patient.

DIETARY SUPPLEMENTS. Some dietary supplements that are commonly recommended for managing the discomfort of OA and/or slowing the rate of cartilage deterioration include:

CAM DIETARY THERAPIES. Two alternative medical systems use dietary changes and herbal medicine to treat OA. The first is Ayurveda, the traditional medical system of India. Practitioners of Ayurveda regard OA as caused by an imbalance among the three doshas, or subtle energies, in the human body. This imbalance produces toxic by-products during digestion, known as ama, which lodge in the joints of the body instead of being eliminated through the colon. To remove these toxins from the joints, the digestive fire, or agni, must be increased. The Ayurvedic practitioner typically recommends adding such spices as turmeric, cayenne pepper, and ginger to food, and undergoing a three- to five-day detoxification diet followed by a cleansing enema to purify the body.

Traditional Chinese medicine (TCM) treats OA with various compounds containing ephedra (a substance now banned in the United States and Canada), cinnamon, aconite, and coix. This combination herbal medicine has been used for at least 1,200 years in TCM and is known as Du Huo Ji Sheng Wan, or Joint Strength. Most Westerners who try TCM for relief of OA, however, seem to find acupuncture more helpful as an alternative therapy than Chinese herbal medicines.

Rheumatoid arthritis

There is some indication that patients with RA benefit from cutting back on red meat consumption or switching entirely to a vegetarian or vegan diet. Other plant-based dietary interventions that have been tried include putting the patient on a seven-day fast followed by a vegan diet or a Mediterranean diet. Still other dietary interventions for RA include elimination diets or elemental diets. Elemental diets are liquid diets consisting of nutrients in their simplest forms, usually a combination of glucose, vitamins, trace elements, and essential amino acids.

Another dietary adjustment that appears to benefit some people with RA is switching from cooking oils that are high in omega-6 fatty acids (which increase inflammation) to oils that are high in omega-3 fatty acids (which reduce inflammation). This second group includes olive oil, canola oil, and flaxseed oil.

It is important to note that weight reduction is not recommended for patients with RA who are at a healthy weight. Excessive weight loss, especially if caused by avoiding a variety of foods or adopting fasting diets, may worsen RA symptoms. An overly low body weight in people with RA may even cause faster destruction of joints than in people who are slightly overweight. Eating a healthful diet to avoid nutritional deficiencies is an important part of managing the symptoms of RA.

DIETARY SUPPLEMENTS. The most common dietary supplements recommended for patients with RA are:

CAM DIETARY THERAPIES. Ayurvedic medicine recommends a compound of ginger, turmeric, boswellia, and ashwaganda to relieve the pain and fever associated with RA.

Traditional Chinese medicine (TCM) uses such plants as hare's ear (Bupleurum falcatum) and thunder god vine (Tripterygium wilfordii) to reduce fever and joint pain in patients with RA.



The function of dietary treatment for OA is to lower (or maintain) the individual's weight to a healthy level to minimize stress on damaged weight-bearing joints; to maintain the structure and composition of the cartilage in the joints; to protect the general health of tissues by including bioflavonoids and antioxidants in the diet; and by conducting food challenges when appropriate to determine whether specific foods are affecting the individual's symptoms.

Rheumatoid arthritis

Dietary treatment of RA is primarily used in addition to pharmaceutical treatment, as the disease cannot be managed by nutritional changes alone. Patients with RA must take a combination of medications, usually a combination of disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), to control pain and inflammation and slow the progression of the disease.

A well-balanced and healthful diet can help to offset the depression that often accompanies RA and can enable patients to maintain a normal schedule of activities. It also helps to prevent nutritional deficiencies caused by the use of prescription drugs to control the disease. For instance, the steroids used to treat RA reduce the level of calcium absorption in the body, which may increase the risk of osteoporosis. The American College of Rheumatology (ACR) strongly recommends that patients with RA consult a registered dietitian to determine whether specific foods are contributing to their symptoms; to evaluate emotional eating issues that may be related to pain and fatigue associated with RA; and to design a balanced diet that the patient will enjoy eating.


A general term for the inflammation of a joint or a condition characterized by joint inflammation.
The traditional system of natural medicine that originated in India around 3500 BCE. Its name is Sanskrit for “science of long life.” Some people have tried Ayurvedic medicines and dietary recommendations in the treatment of arthritis.
Chondroitin sulfate—
A compound found naturally in the body that is part of a large protein molecule (proteoglycan) that helps cartilage to retain its elasticity. Chondroitin sulfate derived from animal or shark cartilage can be taken as a dietary supplement by people with OA.
Disease-modifying antirheumatic drugs (DMARDs)—
A class of prescription medications given to patients with rheumatoid arthritis that suppress the immune system and slow the progression of RA.
Elemental diet—
A liquid diet consisting of nutrients in their simplest forms, usually sugars, essential amino acids, vitamins, minerals, and fats.
Elimination diet—
A diet in which the patient excludes a specific food (or group of foods) for a period of time to determine whether the food is responsible for symptoms of an allergy or other disorder. Elimination diets are also known as food challenge diets.
Generally recognized as safe (GRAS)—
A designation used by the U.S. Food and Drug Administration (FDA) for food additives since 1958 to indicate that a specific additive is safe for human consumption under the conditions of its intended use.
A type of amino sugar that is thought to help in the formation and repair of cartilage. It can be extracted from crab or shrimp shells and used as a dietary supplement by people with OA.
Mediterranean diet—
A dietary pattern based on the eating habits of people living in countries around the Mediterranean Sea. The Mediterranean diet is high in fruits, vegetables, whole grains, and olive oil; moderately high in fish, cheese, and yogurt; and low in consumption of red meat and rich desserts.
Methylsulfanylmethane (MSM)—
A naturally occurring organic sulfur compound used in complementary and alternative medicine to treat inflammatory conditions, including osteoarthritis.
A system of disease treatment that emphasizes natural means of health care, such as water, natural foods, dietary adjustments, massage and manipulation, and electrotherapy, rather than conventional drugs and surgery. Naturopaths (practitioners of naturopathy) often recommend dietary therapy in the treatment of arthritis.
Nonsteroidal anti-inflammatory drugs (NSAIDs)—
A class of drugs commonly given to treat the inflammation and pain associated with both RA and OA. NSAIDs work by blocking prostaglandins, which are hormone-like compounds that cause pain, fever, muscle cramps, and inflammation. Some NSAIDs are prescription drugs whereas others are available in over-the-counter (OTC) formulations.
A physician, usually a pediatrician or internist, who has additional specialized training in the diagnosis and treatment of diseases that affect the bones, muscles, and joints.
S-adenosyl methionine (SAMe, also spelled SAMe)—
A chemical found naturally in the body, it is made from methionine, an amino acid found in foods. SAMe has been used as a dietary supplement to treat depression and other psychiatric disorders as well as osteoarthritis.
A perennial herb of the ginger family used as a coloring agent as well as a spice in food preparation. It is used in some traditional Ayurvedic medicines for the relief of joint pain and inflammation.
A vegetarian who excludes all animal products from the diet, including those that can be obtained without killing the animal. Vegans are also known as strict vegetarians. Some people believe that a vegan diet is helpful in managing arthritis.
Rheumatoid arthritis


Some general precautions are in order for all people with arthritis:

People with either form of arthritis who are more than 30 lb. (13.6 kg) overweight, are pregnant, nursing, under age 18, or diagnosed with type 2 diabetes, kidney disorders, or liver disorders should consult a physician before attempting a weight reduction program.


People with diabetes should monitor blood sugar levels more frequently if they are taking glucosamine, because it is an amino sugar. Similarly, individuals who are taking blood thinners should have their blood clotting time checked periodically if they are taking chondroitin sulfate.

Rheumatoid arthritis

Plant oils containing gamma linolenic acid (GLA) have been reported to cause intestinal gas, bloating, diarrhea, and nausea in some people. In addition, these oils may interact with other prescription medications, particularly blood thinners. Some borage seed oil preparations contain ingredients known as pyrrolizidine alkaloids, or PAs, that can harm the liver or worsen liver disease. Only forms of borage oil that are certified to be PA-free should be used. Evening primrose oil may interact with a group of tranquilizers, known as phenothiazines, used in the treatment of schizophrenia. This group of drugs includes chlorpromazine and prochlorperazine.

Fish oil may affect the rate of blood clotting and cause nausea or a fishy odor on the breath in some people. Some fish oil supplements may also contain overly high levels of vitamin A. In addition, patients who take fish oil supplements must usually take them for several months before they experience any benefits.



Most dietary supplements for OA appear to be safe when purchased from reputable manufacturers and used as directed. Consumers should, however, be aware that herbal products and other dietary supplements are sometimes tainted, and that the risk of contamination is higher in traditional Chinese medicines or other imported products. Patients should check with a pharmacist or with the FDA to make sure a specific product is safe for use.

Dietary supplements sometimes recommended for OA may have side effects and/or interact with prescription medications:

Cost may be a consideration for some people, as these supplements are not usually covered by health insurance.

Rheumatoid arthritis

Chinese thunder god vine is reported to weaken bone structure and increase the risk of osteoporosis in patients with RA. Fish oils with high levels of vitamin A have been reported to cause vitamin A toxicity in some people.

Research and general acceptance


Weight loss is universally accepted by medical practitioners as a positive way to decrease joint pain and improve the general health of people with OA. As of 2018, 31 of the 38 clinical trials registered with the National Institutes of Health of dietary interventions in treating OA are trials of weight loss and exercise programs.

No mainstream clinical studies have found that patients with OA benefit from elimination diets. With regard to dietary supplements, findings are mixed. Two recently completed clinical trials evaluated the effectiveness of chondroitin and glucosamine supplements in relieving the pain of OA; one trial is studying the effectiveness of modified citrus pectin, and a fourth trial is testing the effectiveness of vitamin D supplementation combined with an exercise program. According to the National Center for Complementary and Integrative Health (NCCIH), information about the effectiveness of SAMe, MSM, and herbal products is limited; most of the studies that have been performed involve only small groups of patients studied for limited periods of time. Although some patients reported short-term minor improvement in their symptoms, the long-term effectiveness or safety of these supplements is not known as of 2018. In regard to glucosamine and chondroitin, study results are inconsistent, but most have shown little or no effectiveness in relieving joint pain.

Some clinical studies carried out in India report that an Ayurvedic compound that combines ginger, turmeric, and zinc reduced pain in patients with OA of the knees even when other aspects of Ayurvedic practice were not followed.

Rheumatoid arthritis

Dietary interventions for RA that show initial promise include vegetarian or vegan diets and the Mediterranean diet. A team of researchers in India who looked at 27 different studies of dietary interventions for RA done between 1995 and 2017 reported in early 2018 that these plant-based or plant-centered diets appear to slow the progression of RA by eliminating potential food allergens and adding a higher level of polyunsaturated fats to the diet. The researchers also noted that these foods are less expensive than most drugs and are therefore more readily available to less affluent patients. Of the 14 clinical trials of dietary interventions for RA registered with the NIH as of 2018, three are studies of vegan or vegetarian diets and another two are clinical trials of the Mediterranean diet.


According to the NCCIH, fish oil supplements look promising as a dietary supplement for RA, but more studies need to be done. “No dietary supplement has shown clear benefits for RA as of 2018, although emerging studies have shown some promise with Vitamin D. Dosage and safety issues and potential interactions with conventional medicines need to be more thoroughly evaluated.” Results of clinical trials to date are inconsistent; a group of German researchers reported in 2017 that the evidence for fish oils in relieving the pain of RA is only “of moderate quality.” One of the clinical trials registered with the NIH is a trial of oil derived from marine algae.

See also Antioxidants ; Calcium ; Dietary supplements ; Elimination diets ; Omega-3 and omega-6 fatty acids ; Vitamin A ; Vitamin B6 ; Vitamin D ; Zinc .



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American Association of Naturopathic Physicians (AANP), 818 18th St. NW, Ste. 250, Washington, DC, 20006, (202) 237-8150, (866) 538-2267, Fax: (202) 237-8152, .

American College of Rheumatology, 2200 Lake Boulevard NE, Atlanta, GA, 30319, (404) 633-3777, Fax: (404) 633-1870, .

Arthritis Foundation, 1355 Peachtree St. NE, Suite 600, Atlanta, GA, United States, 30309, (404) 872-7100, (800) 283-7800, .

National Ayurvedic Medical Association (NAMA), 8605 Santa Monica Blvd., #46789, Los Angeles, CA, 90069-4109, (800) 669-8914, , .

National Center for Complementary and Integrative Health (NCCIH), 9000 Rockville Pike, NIH Campus, Bldg. 31, Bethesda, MD, 20892, (888) 644-3615, , .

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), 1 AMS Circle, Bethesda, MD, United States, 20892-3675, (301) 495-4484, (877) 22-NIAMS, Fax: (301) 718-6366,, .

U.S. Food and Drug Administration (FDA), 10903 New Hampshire Ave., Silver Spring, MD, 20993, (888) 463-6332, , .

Rebecca J. Frey, PhD

  This information is not a tool for self-diagnosis or a substitute for professional care.