Avoiding/Managing Rheumatoid Arthritis

Arthritis is the umbrella term for a cluster of joint diseases involving inflammation of the joints, hence “arthr-” (joint) “-itis” (suffix used to denote inflammation). These are mostly, but not all, autoimmune diseases, in which the body’s immune system mistakenly attacks our own joints.

Inflammatory vs Non-Inflammatory Arthritis

Arthritis is broadly divided into inflammatory arthritis and non-inflammatory arthritis.

You may be wondering: how does one get non-inflammatory inflammation of the joints?

The answer is, in “non-inflammatory” arthritis, such as osteoarthritis, the damage comes first (by general wear-and-tear) and inflammation generally follows as part of the symptoms, rather than the cause. So the name can be a little confusing. In the case of osteo- and other “non-inflammatory” forms of arthritis, you definitely still want to keep your inflammation at bay as best you can, but it’s not as absolutely critical a deal as it is for “inflammatory” forms of arthritis.

We’ll tackle the beast that is osteoarthritis another day, however.

Today we’re going to focus on…

Rheumatoid Arthritis

This is the most common of the autoimmune forms of arthritis. Some quick facts:

• It affects a little under 1% of the global population, but the older we get, the more likely it becomes
• Early onset of rheumatoid arthritis is most likely to show up around the age of 50 (but it can show up at any age)
• However, incidence (not onset) of rheumatoid arthritis peaks in the 70s age bracket
• It is 2–4 times more common in women than in men
• Approximately one third of people stop work within two years of its onset, and this increases thereafter.

Well, that sounds gloomy.

Indeed it’s not fun. There’s a lot of stiffness and aching of joints (often with swelling too), loss of joint function can be common, and then there are knock-on effects like fatigue, weakness, and loss of appetite.

Beyond that it’s an autoimmune disorder, its cause is not known, and there is no known cure.

Is there any good news?

If you don’t have rheumatoid arthritis at the present time, you can reduce your risk factors in several ways:

• Having an anti-inflammatory diet. Get plenty of fiber, greens, and berries. Fatty fish is great too, as are oily nuts. On the other side of things, high consumption of salt, sugar, alcohol, and red meat are associated with a greater risk of developing rheumatoid arthritis.
• Not smoking. Smoking is bad for pretty much everything, including your chances of developing rheumatoid arthritis.
• Not being obese. This one may be more a matter of correlation than causation, because of the dietary factors (if one eats an anti-inflammatory diet, obesity is less likely), but the association is there.

There are other risk factors that are harder to control, such as genetics, age, sex, and having a mother who smoked.

See: Genetic and environmental risk factors for rheumatoid arthritis

What if I already have rheumatoid arthritis?

If you already have rheumatoid arthritis, it becomes a matter of symptom management.

First, reduce inflammation any (reasonable) way you can. We did a main feature on this before, so we’ll just drop that again here:

Keep Inflammation At Bay

Next, consider the available medications. Your doctor may or may not have discussed all of the options with you, so be aware that there are more things available than just pain relief. To talk about them all would require a whole main feature, so instead, here’s a really well-compiled list, along with explanations about each of them, up to date as of this year:

Rheumatoid Arthritis Medication List (And What They Do, And How)

Finally, consider other lifestyle adjustments to manage your symptoms. These include:

• Exercise—gently, though! You do not want to provoke a flare-up, but you do want to maintain your mobility as best you can. There’s a use-it-or-lose-it factor here. Swimming and yoga are great options, as is tai chi. You may want to avoid exercises that involve repetitive impacts to your joints, like running.
• Rest—while keeping mobility going. Get good sleep at night (this is important), but don’t make your bed your new home, or your mobility will quickly deteriorate.
• Hot & cold—both can help, and alternating them can reduce inflammation and stiffness by improving your body’s ability to respond appropriately to these stimuli rather than getting stuck in an inappropriate-response state of inflammation.
• Mobility aids—if it helps, it helps. Maybe you only need something during a flare-up, but when that’s the case, you want to be as gentle on your body as possible while keeping moving, so if crutches, handrails etc help, then by all means get them and use them.
• Go easy on the use of braces, splints, etc—these can offer short-term relief, but at a long term cost of loss of mobility. Only you can decide where to draw the line when it comes to that trade-off.

You can also check out our previous article:

Managing Chronic Pain (Realistically!)

Take good care of yourself!

We’ve talked before about how important fiber is:

Why You’re Probably Not Getting Enough Fiber (And How To Fix It)

And even how it’s arguably the most important dietary factor when it comes to avoiding heart disease:

What Matters Most For Your Heart? Eat More (Of This) For Lower Blood Pressure ← Spoiler: it’s fiber

And yes, that’s even when considered alongside other (also laudable) dietary interventions such as lowering intake of sodium, various kinds of saturated fat, and red meat.

So, what should we know about fiber, aside from “aim to get nearer 40g/day instead of the US average 16g/day”?

Soluble vs Insoluble

The first main way that dietary fibers can be categorized is soluble vs insoluble. Part of the difference is obvious, but bear with us, because there’s more to know about each:

• Soluble fiber dissolves (what a surprise) in water and, which part is important, forms a gel. This slows down things going through your intestines, which is important for proper digestion and absorption of nutrients (as well as avoiding diarrhea). Yes, you heard right: getting enough of the right kind of fiber helps you avoid diarrhea.
• Insoluble fiber does not dissolve (how shocking) in water and thus mostly passes through undigested by us (some will actually be digested by gut microbes who subsist on this, and in return for us feeding them daily, they make useful chemicals for us). This kind of fiber is also critical for healthy bowel movements, because without it, constipation can ensue.

Both kinds of fiber improve just about every metric related to blood, including improving triglycerides and improving insulin sensitivity and blood glucose levels. Thus, they help guard against various kinds of cardiovascular disease, diabetes, and metabolic disease in general. Do note that because whatever’s good for your heart/blood is good for your brain (which requires a healthy heart and bloodstream to nourish it and take away waste), likely this also has a knock-on effect against cognitive decline, but we don’t have hard science for that claim so we’re going to leave that last item as a “likely”.

However, one thing’s for sure: if you want a healthy gut, heart, and brain, you need a good balance of soluble and insoluble fibers.

10 of the best for soluble fiber

10 of the best for insoluble fiber

10 of the best for a balance of both

You’ll notice that the above “balance” is not equal; that’s ok; we need greater quantities of insoluble than soluble anyway, so it is as well that nature provides such.

This is the same kind of balance when we talk about “balanced hormones” (does not mean all hormones are in equal amounts; means they are in the right proportions) or “balanced microbiome” (does not mean that pathogens and friendly bacteria are in equal numbers), etc.

Some notes on the above:

About those fiber types, some of the most important soluble ones to aim for are:

• Beta-glucan: found in oats and barley, it supports heart health.
• Pectin: found in fruits like apples, citrus, and pears, it helps with cholesterol control.
• Inulin: a type of prebiotic fiber found in artichokes.
• Lignin: found in seeds and wheat bran, it has antioxidant properties.
• Resistant starch: found in beans and lentils, it acts as a prebiotic for gut health.

See also: When Is A Fiber Not A Fiber? The Food Additive You Do Want

One fiber to rule them all

Well, not entirely (we still need the others) but there is a best all-rounder:

The Best Kind Of Fiber For Overall Health?

Enjoy!