What foods cause arthritis to flare up

By Dennis Thompson Jr and Cheryl AlkonMedically Reviewed by Alexa Meara, MD

Reviewed: February 27, 2021

There is no cure-all diet for rheumatoid arthritis. But if you suffer from RA symptoms such as joint pain and inflammation, it’s smart to stick to a nutritious diet and avoid foods that may make arthritis symptoms worse.

Where should you start? "You want to reduce inflammation [by avoiding inflammatory foods], and you want to avoid foods that can lead to being overweight," says Marian T. Hannan, DSc, MPH, a professor of medicine at Harvard Medical School and the codirector of the Musculoskeletal Research Center at the Marcus Institute for Aging Research at Hebrew SeniorLife in Boston. Extra pounds put strain on your joints and cause further pain and injury, especially in the knees, hips, and ankles. Extra fat also interferes with muscle strength and can infiltrate underused muscle, reducing muscle “quality.”

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Foods That May Worsen RA Symptoms

"There's no proven diet that will do anywhere near as well as the current drug therapy," says Vinicius Domingues, MD, a rheumatologist based in Daytona Beach, Florida, and a medical adviser to CreakyJoints. "There's no diet that's going to put your arthritis in remission.”

But what you eat — or don't eat — can make a difference. Here are some foods to think twice about, because they contribute extra calories and provoke inflammation that worsens your RA symptoms.

1. Red Meat

Many cuts of red meat contain high levels of saturated fat, which can exacerbate inflammation and also contribute to obesity. Red meat also contains omega-6 fatty acids, which can contribute to inflammation if your intake is too high. Some people with RA have reported that their symptoms improve when they rid their diet of red meat.

On the other hand, lean cuts of red meat may provide protein and important nutrients for people with rheumatoid arthritis, without causing additional inflammation. “Fish is a good alternative protein source,” says Dr. Domingues. Some fish, such as salmon, mackerel, tuna, sardines, and herring, are good sources of omega-3 fatty acids, which have been linked to reducing inflammation and may help improve the feeling of tender and swollen joints, according to a study published in the June 2020 Mediterranean Journal of Rheumatology.

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2. Sugar and Refined Flour

Your blood sugar levels can surge after you've eaten simple carbohydrates that are easily broken down by the body. Such foods include sugary snacks and drinks, white-flour bread and pasta, and white rice. A spike in your blood sugar prompts the body to produce pro-inflammatory chemicals called cytokines, which can worsen your RA symptoms if the inflammation affects your joints. These foods can also cause you to put on the pounds, stressing your joints. “There is no real replacement for these foods, but you can try gluten-free alternatives, which can be helpful,” says Domingues.

3. Fried Foods

Cutting out fried foods can reduce your levels of inflammation, according to researchers from the Mount Sinai School of Medicine. Their study, which was published in the Journal of Clinical Endocrinology and Metabolism, found that fried foods contain toxins called advanced glycation end products (AGEs), which can increase oxidation in the body's cells. Fried foods are also high in fat and can contribute to obesity. As an alternative to fried foods, “try to use an air fryer whenever possible, and choose baked foods over fried ones,” says Domingues.

4. Gluten

Gluten, a protein found in grains such as wheat, rye, and barley, may contribute to inflammation in some people. Doctors believe that the effect can be even greater for people with an autoimmune disorder such as celiac disease or rheumatoid arthritis. “If gluten causes a flare, staying away is the best option,” says Domingues.

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5. Alcohol

The effect of alcohol on rheumatoid arthritis is not clearly understood. Moderate alcohol consumption has been shown to decrease the risk for RA, in research published in Arthritis & Rheumatology. Research published in the BMJ had similar findings: Women who drank more than three glasses of alcohol a week had half the risk for rheumatoid arthritis that teetotalers had.

But drinking too much alcohol can cause a spike in the body's levels of C-reactive protein (CRP), according to research published in The Lancet. CRP is a powerful signal of inflammation, and the study's findings indicate that overindulgence in alcohol could increase inflammation and be detrimental to RA. Most medications are metabolized by the liver, and therefore, alcohol consumption should be limited if one is taking methotrexate, for example, to maximize liver function, says Domingues.

RELATED: Foods That People With Rheumatoid Arthritis Should Remove From Their Diets

6. Processed Foods

Processed foods, from supermarket-shelf snacks to meals that come ready-to-eat or require minimal cooking, tend to be loaded with ingredients that cause inflammation. Such products or packaged convenience foods are packed with sugar, refined flour, and saturated fats — all making the food easy and irresistible but also unhealthy. Always read the Nutrition Facts label and the ingredient list on processed foods to make wise choices that won't aggravate your rheumatoid arthritis symptoms.

As you work to improve your diet, remember that researchers have not been able to agree on a standard RA diet, and a change in the foods you eat isn't a substitute for treatment. Instead, think of these adjustments as steps to better RA management and overall well-being.

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