# Nutrition and diets in rheumatoid arthritis
Dietary choices play a supporting role in rheumatoid arthritis. Research suggests that certain eating patterns and nutrients can influence inflammatory markers and symptoms. This tab describes which diets and nutritional approaches are scientifically investigated and what is known about them so far.
Mediterranean dietary pattern
ResearchediPositive results in clinical studies, not yet standard treatment
This pattern emphasizes vegetables, fruit, whole grains, nuts, oil (especially olive oil), fish and moderate amounts of dairy products. Meat plays a smaller role. The pattern has been widely investigated in various chronic diseases, including in relation to joint disorders.
Research on dietary patterns in rheumatoid arthritis (2026) shows that certain macro- and micronutrients common in this pattern are associated with lower inflammatory markers. The DASH diet (Dietary Approaches to Stop Hypertension), which closely resembles the Mediterranean pattern, is linked in recent studies (2026) to lower risks of joint problems. The benefit is that this pattern also supports cardiovascular health, which is important for people with rheumatoid arthritis because they have a higher cardiovascular risk.
The supporting effect would come from the high content of antioxidants and anti-inflammatory substances from vegetables and fish. There are no known risks or interactions with standard treatments.
Ketogenic diet
ResearchediPositive results in clinical studies, not yet standard treatment
A ketogenic diet is very low in carbohydrates and emphasizes fats and proteins. Research on this diet in rheumatoid arthritis is still limited, but a recent review (2026) links ketogenic and similar low-carbohydrate approaches to possible benefits for inflammation and symptom management, especially in combination with other measures.
However, the field of research is still young. What is known is that major dietary changes — including to ketogenic — can lead to changes in gut flora and energy levels, and this can affect how arthritis feels in some people. For people on medications that strongly depend on nutrient intake (such as certain treatments), caution should be exercised.
Autoimmune Protocol (AIP)
ExperimentaliOngoing in study setting, outcome still unknown
The Autoimmune Protocol (AIP) is a restrictive dietary pattern that aims to exclude groups of foods that may trigger gut inflammation and immune reactions. It excludes grains, dairy, eggs, nuts, seeds, nightshade vegetables (tomato, pepper) and processed foods. After a few weeks, people typically reintroduce foods step by step to see what they tolerate.
A qualitative study from 2026 among people with rheumatoid arthritis following this diet describes mixed experiences: some reported less joint pain and better functioning, others felt restricted or saw no difference. Research shows no robust clinical evidence, but many participants viewed the protocol as a way to better understand their food reactions.
Risks: the diet is highly restrictive, which can lead to social consequences and nutritional deficiencies, especially for calcium, iron and certain vitamins, unless well planned with professional guidance.
Antioxidant-rich food
ResearchediPositive results in clinical studies, not yet standard treatment
This is not about a specific diet, but about consciously eating food rich in antioxidants: blueberry, broccoli, spinach, dark chocolate, green tea and the like. Antioxidants can help prevent cell damage from free radicals and are involved in inflammation inhibition.
Recent research (2026) shows that higher antioxidant intake (measured as a food-based antioxidant index) in patients with rheumatoid arthritis is associated with lower inflammatory markers, better sleep quality and better quality of life. However, the association is observational; it is unclear whether the antioxidants themselves, or the overall pattern of nutritional awareness, is responsible.
No known risks, provided it is integrated as a supplement to regular medication.
Nutrition with attention to selenium content
ResearchediPositive results in clinical studies, not yet standard treatment
Selenium is a trace element that is part of the body's antioxidant defense system. Recent data from the American population (2026) show that lower serum selenium values are associated with increased cardiovascular risk in people with rheumatoid arthritis. This is relevant because rheumatoid arthritis itself increases cardiovascular risk.
Selenium-rich foods include especially nuts (in particular Brazil nuts), fish, proteins and whole grains. Research suggests that monitoring or awareness of selenium use may be advisable, especially because rheumatoid arthritis combined with poor nutrition sometimes leads to selenium deficiency.
However, a supplement or dietary change should be discussed with your healthcare provider, as high doses of selenium can be harmful.
Intermittent fasting
ResearchediPositive results in clinical studies, not yet standard treatment
Intermittent fasting (for example 16 hours fasting and 8 hours eating window, or one day per week with reduced food intake) is being studied in various inflammatory diseases. In related conditions (Sjögren's syndrome, also an autoimmune disease), research from 2026 shows that intermittent fasting can affect gut flora and certain inflammation reduction.
For rheumatoid arthritis itself, the evidence is indirect. Intermittent fasting can affect muscle breakdown, which in rheumatoid arthritis is already a risk (muscle mass is usually lost more quickly). This requires caution, especially for people who are already vulnerable.
Intermittent fasting should only be attempted under professional supervision.
Nutrition to support muscle building and maintenance
ResearchediPositive results in clinical studies, not yet standard treatment
People with rheumatoid arthritis more often lose muscle mass than others, regardless of their weight. Recent research (2026) shows that muscle breakdown (sarcopenia) is an independent predictor of mortality risk.
Protein-rich nutrition and regular strength training are being studied as a countermeasure. The recommendation is usually not extremely high protein, but rather sufficient protein distributed throughout the day, combined with physical activity. Studies show that relative muscle mass can be maintained, even if someone loses weight, provided protein and movement are sufficient.
Specific amounts are determined together with your healthcare provider and dietitian.
Nutrition and gut flora (microbiota)
ResearchediPositive results in clinical studies, not yet standard treatment
Research (2026) shows that the composition of your gut flora influences inflammation levels and the progression of rheumatoid arthritis. Food containing dietary fiber (whole grains, vegetables, fruit, legumes) supports bacteria that produce short-chain fatty acids (SCFAs), which have anti-inflammatory effects.
This supports the importance of fiber-rich nutrition and dietary diversity. Fermented products (kefir, sauerkraut) are mentioned in studies as possible support for healthy gut flora, but evidence is indirect.
No specific risks, but sudden large changes in fiber intake can cause abdominal discomfort.
Vitamin D
ResearchediPositive results in clinical studies, not yet standard treatment
Vitamin D plays a role in immune regulation. Recent reviews (2026) emphasize the importance of adequate vitamin D in rheumatoid arthritis, also because of seasonal effects that can play a role. People with rheumatoid arthritis more often have low vitamin D levels.
Food naturally contains little vitamin D (mainly oily fish, egg yolk), so many people rely on sun exposure or supplementation. Discuss this with your healthcare provider; blood tests will determine if supplementation is needed.
Creatine supplementation (combined with exercise)
ResearchediPositive results in clinical studies, not yet standard treatment
Creatine is a natural substance found in small amounts in meat, and research from 2026 suggests that combined with strength training it can improve inflammation markers and support symptom management in rheumatoid arthritis.
However, this is research and supplement territory, not a dietary choice. It falls outside the scope of normal nutritional advice and requires consultation with your medical team.
---
**Nutritional choices are tailored to the individual.** Because rheumatoid arthritis progresses very individually, and because nutrition interacts with medications and body composition, dietary changes should always be made with advice from your healthcare provider or a specialized dietitian. They can properly assess your situation and possible interactions.
_This information never replaces a doctor's judgment. Always discuss your situation with your own healthcare provider._