1) DECREASE common inflammatory foods
meat (e.g. beef, pork, lamb). Out of these, lamb is
perhaps least likely to cause digestive issues. Grass-fed meat
is considered the best.
Alternatives: fish is best, chicken is good. Egg is ok - you may wish to leave egg out of your new diet for the first few weeks. Animal sources of protein should be kept to a minimum however. Excellent sources of protein include: quinoa, tofu, beans, lentils, peas, spinach, mushrooms. If you have trouble digesting beans/lentils (e.g. excess gas), consider sprouting them first then cooking them.
Reduce: dairy (e.g. milk, cheese, yoghurt). Some people do not react to grass-fed raw dairy, but this is sometimes harder to source.
Alternatives to cow's milk:
rice milk is usually well tolerated, but there is also oat,
almond, soya, hemp milk. These alternatives are commonly found in
supermarkets. Try to get one fortified with vitamins/minerals.
Reduce: wheat and gluten (e.g. bread, pasta, biscuits, some cereals)
Alternatives: many supermarkets now stock gluten-free products, such as gluten-free pasta and flour. Try buckwheat, quinoa, rice (brown or wild rice is best) or millet. A good alternative to cereals are buckwheat/oat porridge or muesli, try to get fortified versions if available. If you are coeliac/celiac then you should only use "gluten-free" oats. .
sugar (e.g. tea, sweets, cakes, chocolates, biscuits)
Alternatives: if you must sweeten your tea then you may use artificial sweetners such as stevia or erythritol. Herbal teas can be very good (e.g. grated ginger, green tea (also with pomegranate), black tea, rosehip and hibiscus, 1/2 tsp turmeric with pinch black pepper, cinnamon, chamomile, nettle, peppermint/spearmint, pinch of clove or fennel seeds). You can also add some lemon or lime (juice or peel) for a different flavour. Don't be afraid to try different combinations. It is not recommended to drink excessive amounts of any one tea or artificial sweetners. If you must use sugar, the healthiest sugars are date sugar and blackstrap molasses. Also see here for other sugar alternatives.
Alternatives: grill, bake, saute sparingly, steam when possible.
Reduce: processed white flour and yeast (e.g. avoid most bread)
Alternatives: you can buy
gluten-free and yeast-free breads, e.g. sourdough. You could also
try making flat breads.
2) INCREASE common anti-inflammatory foods
Try the food alternatives
and herbal teas listed above.
When cooking with oils try virgin coconut oil or coldpressed rapeseed/canola oil or normal olive oil instead of safflower/corn/sunflower/vegetable oils. Also extra virgin olive oil (e.g. salads, drizzled over cooked vegetables). Always use oils sparingly - see tips on how to cook without oil.
A daily handful or two of blueberries, cherries (or blackberries/raspberries/strawberries/cranberries due to antioxidants), purple/red grapes (due to resveratrol), papaya is excellent for papain and vitamin C, also kiwi.
Cruciferous vegetables, such as broccoli, brussel sprouts, kale, watercress, collard greens, red cabbage, cauliflower etc. Start with very small portions first, then increase gradually if ok.
Seasoning dishes: add a little turmeric with black pepper when possible, use garlic, black onion seed (also called: kalonji, nigella sativa), onions, cinnamon (in tea, cereal, fruit), fresh grated ginger, high antioxidant herbs such as oregano/parsley/basil/thyme/sage/rosemary. All of these are commonly found in supermarkets.
Snack on potassium and magnesium rich foods, e.g. banana, baked sweet potato, dates, prunes, raisins, carrot juice. IF you can tolerate nuts (no more than small handful daily): almonds, cashews, one brazil nut (good for selenium also), pistachios, pine nuts, walnuts, sunflower/pumpkin seeds - all of these should be soaked in water for several hours first making them easier to digest. You can also boost magnesium levels by taking a bath (or feet only) with epsom salts.
If you have a juicer, have a green juice 2-4 times per week, e.g. peeled
cucumber +celery+apple+fresh ginger, or pineapple+spinach. They
may not be to everyones taste but they are very good for you. You
can add other fruit for a different taste, or vegetables (e.g.
carrot, beetroot) or some fresh ginger, try different combinations. Always thoroughly
wash them first, and try to buy organic if possible. Green
vegetable juices are amongst the best fluids to drink for
rheumatoid arthritis. To make them healthier, consider adding a
tsp of ground flaxseeds,
Bone broth: 1/4 to 1/2 cup per day. Click - how to make - note, after cooling, fat must be removed before consumption as shown in video. Can be made from bones/joints/cartillage/carcass of chicken/fish (4-12 hours), duck/beef/lamb/turkey (8-36 hours) - ideally in filtered water and a free range organic/pastured animal source. You can use any bones but marrow filled bones, knuckle, and oxtail are best. You can cook it in 2-3 hours if you use a pressure cooker instead of an ordinary pot. You can also re-use some of the bones for your next batch. Lasts for 1wk in the fridge in glass jars, or for several months in the freezer. You can drink it on its own, sip it with food, add it to stews, sauces, soups or cook beans/grains in it. Your local butcher may even give you some bones for free.
If you do not wish to make bone broth you could consider using an unflavoured gelatin product such as this (1 tsp twice daily).
Side note: in addition to the above, if you wish to find out what foods you are specifically intolerant to, you can try keeping a food diary, or consider purchasing a food specific IgG blood test, e.g. CNS (£65) or YorkTest (£250). I only recommend buying these products if you have little or no success with this rheumatoid arthritis protocol. To read more about food sensitivities please see here and here. You could also consider a free do-it-yourself pulse test to determine possible food intolerances, although may not be as accurate.
3) Healthy gut and
digestive system - do not miss this step.
We are what we eat, thus it
is vital our
gut can break down food properly and absorb the nutrients we
need for good health. One of the safest, healthiest and
cheapest ways to do this is to take fermented/cultured vegetables (if you do not
have a juicer to make a celery starter culture you can use this method). Some also use a quality miso
paste. Having regular bowel
movements is important
for your gut
help with this. Aim for 1-3 bowel movements per day.
Alternatively, you can use digestive supplements a few times per week, e.g. probiotics (CP-1 or Bio-Kult or perhaps ProbioticMax/acidophilus) and digestive enzymes, bromelain, papain - take with main meal. If on warfarin, aspirin or sedatives - see this advice first. For an excellent overview of the potential health benefits of fermented probiotics click here.
The supplement L-glutamine should also be considered, as it has been shown to repair the gut and/or keep it strong. Take one tsp first thing in the morning and last thing at night (with water or a fruit juice such as apple or orange), as it works best on an empty stomach. As with all supplements, start with lower doses and increase gradually if no side effects.
4) Mild exercise
Bodyweight exercises (beginner - intermediate) and yoga (beginner - intermediate) are best, and you don't need
to buy any equipment. Click links for video examples, there are
many others online. A regular brisk walk may also be beneficial.
There are also exercises to help with different parts of the
body that are painful. Exercise is
important to strengthen
and nourish the joints. Always build up exercise gradually
and don't overdo it.
5) Supplements if necessary
The following supplements
have been shown to help, however always do your own research.
Listed in order of importance:
Vitamin D daily (take with main meal of day, ideally one that has some fat/oil as this vitamin is fat soluble), 20 micrograms (μg) or 800 international units (IU). This can be an important longterm supplement, and at these doses is very safe.
Vitamin C (if you are eating lots of Vitamin C rich fruits and vegetables then you may not need to supplement). If you decide to supplement, vitamin C tablets are cheap (avoid ones with artificial sweeteners), also rosehip or amla powder (can usually be bought at an Indian grocery store). Note: a sign of too much VitC is watery stools.
Curcumin (increase effectiveness by taking with a
little fat/oil, e.g. drop of virgin coconut or olive oil,
nuts/seeds or avocado, and ideally with black pepper). See note first.
fish oil or krill oil (rich in omega 3) - one of the most common supplements. Alternatively good plant based omega 3 sources are ground flax/chia seeds, walnuts and some cruciferous vegetables.
Boswellia (references:one two three).
Others you may wish to research: type 2 collagen, glucosamine sulphate, chondrotin, hyaluronic acid as oral supplement (mainly for knee pain),magnesium, resveratrol, taurine, quercetin, boron, devil's claw, ashwagandha, msm, capsaicin gel (use sparingly), astaxanthin. As with all supplements, start with lower doses and increase gradually if no side effects.
Not sure how to get started? Try this for the first few days...
After waking, have a herbal
tea to begin the day. Choose whichever from the list above, and
try different ones throughout the day. Have 3 small meals
during your day.
Breakfast: fruit salad (a mix of chopped fruit), or buckwheat or quinoa or fortified oat porridge with a fortified non-dairy milk (add some extras for whatever flavour you like, e.g. blueberries, sultanas/raisins, sliced banana, cinnamon, cranberries, pre-soaked sunflower or pumpkin seeds for crunch, black onion seeds for a light peppery flavour, grated apple/pear, cold pressed honey, grated ginger and sprinkled turmeric for a light earthy spicy flavour, a little lime/lemon/orange zest, sprinkling of raw cacao powder for a chocolate taste). Fortified plain oat porridge is a good option, cheap and commonly available. You can now also get buckwheat or oat muesli.
You could alternate the above with a breakfast smoothie: blend: fortified non-dairy milk of your choice, blueberries, some pitted cherries and dates, banana. Healthy optional extras: a tsp of amla powder or ground flax/chia/hemp seed.
Lunch: vegetable soup, pumpkin ginger soup or a light salad (no oil). There are many online recipes to choose from. Also always consider adding/using the herbs/spices listed above.
Dinner: oily fish and sprouted bean salad, gluten free pasta with a garlic tomato sauce or chickpea pesto (mushrooms optional), salmon and brown/wild rice salad, salmon burgers, potato salad, oven baked sweet potato wedges lightly brushed with olive oil and above herbs/spices, curry parsnip soup, vegetable stir fry. Search for other recipes online.
Optional snack: banana, apple, celery/cucumber/carrot sticks with hummus/guacamole, or a handful or two of blueberries, cherries (or blackberries/raspberries/cranberries, purple/red grapes), rice cake with avocado and turmeric and black pepper, very small handful of mixed nuts or crush some nuts and add to some sliced banana+dates with cinnamon for a healthy treat, a green juice as mentioned earlier, chocolate milkshake (non-dairy milk+ pitted cherries and dates + raw cacao powder + banana), carrot juice, kale chips, pumpkin pie, baked sweet potato with some cinnamon and pinch of clove, several prunes.
Fermented vegetables: a tbsp before and after each meal. You can start with only one tbsp with each meal for the first few days if you wish.
Remember, try and incorporate a plentiful variety of fruits and vegetables into your diet. Keep a food diary. If you keep your meals small to begin with you may notice a difference in your inflammation/pain levels within a week. Strongly consider investing in a juicer or a high powered blender. Try not to over eat, and always be left feeling a little hungry after each meal.
If you get your symptoms down to a level you are happy with, you can consider re-introducing some foods you have eliminated, one at a time, eating it several times, then waiting several days before the next re-introduced food, to see if you react/flare-up. It is often the case that once your digestive system has become stronger, and symptoms greatly reduced, you will be able to increase variation in your diet, which will make life easier.
I hope you have found this
information helpful and I wish you all the best in your journey to
If the above protocol does not work you may need to consider going on a strict elimination diet and/or a plant based low-fat diet, see here.
it is recommended to consult your physician or other
health care professional before making any significant
change in your diet, exercise or supplements to determine
if it is suitable for you.