Small changes to your routine can be part of more complete care. This guide brings together practical guidance to improve the quality of your diet and look after your digestion, respecting each person's needs.
In short
- Nutrition complements treatment with your rheumatologist: it doesn't replace medications or justify stopping them.
- The Mediterranean diet has evidence of possible pain improvement, but results vary.
- There's no need to cut out gluten or dairy automatically.
- Consistency matters more than a diet that's hard to keep: start with one simple change.
01
What can food do?
A balanced diet can help manage symptoms, preserve muscles and bones and look after heart health. The Mediterranean diet has evidence of possible pain improvement, but results vary and don't guarantee control of disease activity.
Rheumatoid arthritis needs follow-up with a rheumatologist. Nutrition is complementary: it doesn't replace medications or justify stopping them.
Start with what's possible: choose one simple change for this week, such as adding a vegetable to lunch, swapping soft drinks for water or preparing meals for the days when you're most tired. Consistency is more useful than a diet that's hard to keep.
02
The essentials on your plate
Leafy greens, vegetables and fruit
Vary the colors and choose seasonal foods. Fresh or frozen, without ready-made sauces, they can make your routine easier.
Beans, lentils, oats and whole grains
They help increase your fiber intake. Adjust the amounts to your digestive tolerance.
Protein at main meals
Fish, chicken, eggs, lean meat, beans or tofu. They help preserve muscle mass.
Good-quality fats
Use olive oil and include small portions of nuts and seeds. Fish such as sardines can be part of your week.
Have soft drinks, excess sweets, processed meats and ultra-processed meals less often. Make gradual swaps: a simple home-cooked meal is already a good start.
Do I need to cut out gluten or dairy?
Not automatically. Restrictions should have an individual indication, such as celiac disease, allergy or intolerance. Cutting out food groups without substitutes can reduce important nutrients. No single food is responsible for everyone's pain.
Sample lunch: rice and beans, fish or chicken, zucchini and carrots, and greens with olive oil. Portions need to be adjusted in a consultation.
03
Look after your gut too
Why does it deserve attention?
The microbiota is the community of microorganisms that lives in the gut and is involved in digestion and in interactions with the immune system. The link between the microbiota and rheumatoid arthritis is still being studied; this doesn't mean that treating the gut alone controls the disease.
What does gut modulation mean?
In this guide, it means assessing your eating routine, hydration, bowel function and digestive symptoms to plan individualized care. Persistent constipation, diarrhea, gas and bloating deserve investigation, including the possible effects of medications.
Basic measures for your routine:
- Include fiber from fruit, vegetables, oats and legumes, increasing it gradually.
- Drink water throughout the day, respecting any medical restrictions.
- Notice your tolerance: cooked vegetables and small portions of beans may be more comfortable.
- Chew calmly and try to keep regular meal times.
- Keep a log of symptoms and bowel movements to discuss in your consultation.
Probiotics and supplements are not mandatory for people with rheumatoid arthritis. The choice depends on the indication and on safety, especially for immunosuppressed people. Don't start probiotics, glutamine, herbal remedies or high doses of nutrients on your own.
04
Make care easier
On days of pain or fatigue, prepare and freeze portions of beans, shredded chicken and vegetables. Use pre-washed vegetables, simple frozen foods and utensils that make cooking easier. Ask for help when you need it: eating well doesn't have to mean elaborate recipes.
- Breakfast
- Eggs, whole-grain bread and fruit; or plain yogurt with oats and fruit, if well tolerated.
- Lunch
- Rice, beans, a source of protein and vegetables.
- Snack
- Fruit with nuts, if you like.
- Dinner
- Vegetable omelet with potatoes; or vegetable soup with chicken and beans.
A plan made for you
In the consultation, your diet is organized around your symptoms, routine, tests when indicated, medications and gut health. We also assess your needs for protein, calcium and other nutrients, avoiding unnecessary restrictions, and monitor your response together with your medical treatment.
Dra. Daniely Catharino TooleyClinical, functional and orthomolecular nutritionist · CRN3/6794
References (4)+
- American College of Rheumatology. Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis (2022; published 2023).
- National Human Genome Research Institute. Microbiome.
- Su et al. Microbiome-derived bile acids (2023). Exploratory study, not a treatment protocol.
- NCCIH. Probiotics: Usefulness and Safety.
Educational content for adults. This guidance does not replace an individual consultation, diagnosis or treatment.