Anti-Inflammatory Diet for Arthritis: What the Evidence Shows

Quick answer: An anti-inflammatory diet for arthritis is a Mediterranean-style pattern of vegetables, fruit, whole grains, legumes, nuts, fish and olive oil, with little processed food and sugar. It may help some people, but the evidence is limited, and Harvard Health states that no diet has been shown to replace medication. Use it alongside the treatment your rheumatologist prescribes.

Arthritis is a broad term. Rheumatoid arthritis is an autoimmune condition, and osteoarthritis is not, so research on one does not always apply to the other. This guide sticks to what two health organizations and published reviews say, and to what an ingredient checker can and cannot do.

What Harvard Health and the Arthritis Foundation Say

Harvard Health says there is no specific diet known to reliably improve rheumatoid arthritis, that early studies suggest an anti-inflammatory diet may help, and that there is no current evidence suggesting diet alone can replace medications for controlling the condition. It names the Mediterranean diet as an example, with produce, high-fiber whole grains, legumes and nuts, fish and poultry and olive oil, and says such diets typically discourage heavily processed foods, sugary foods and drinks, and refined grains.

The Arthritis Foundation says there is no miracle diet for arthritis, but that a whole-foods, Mediterranean-style pattern may help fight inflammation and improve joint pain and other symptoms. It also says a diet low in processed foods and saturated fat is good for overall health and may help manage disease activity.

How Strong Is the Evidence for the Mediterranean Diet?

Reviews are cautious. A 2018 systematic review of human prospective studies in Rheumatology International found that two intervention studies reported less pain and better function with the Mediterranean diet, and only one reported a lower disease-activity score, and its authors say there is insufficient evidence for a wide recommendation. A 2018 review in Autoimmunity Reviews concluded that the diet may provide benefits in reducing pain and swollen and tender joints in people with rheumatoid arthritis, but described the certainty as low because few trials focus on the condition and many have methodological limitations.

In plain terms: the pattern is low-risk and good for general health, and some studies point to less pain, but no one should expect it to control rheumatoid arthritis the way medication does.

Foods the Arthritis Foundation Highlights

• Cold-water fish such as salmon, sardines and tuna, about 3 to 4 ounces twice a week.
• Nuts and seeds, about 1.5 ounces a day, noting that more is not always better.
• Colorful fruits and vegetables, such as berries, cherries, spinach, kale and broccoli.
• Extra virgin olive oil, 2 to 3 tablespoons a day.
• Beans, about a cup twice a week or more.
• Whole grains, making at least half of your grains whole.

These are the foundation's reference points for people with arthritis, and your care team may advise differently. For a week of meals built on the same foods, see our anti-inflammatory diet meal plan.

Fish Oil, Nightshades and Gluten

• Fish oil: the foundation says studies show fish oil supplements reduce joint swelling, pain, morning stiffness and disease activity in people with rheumatoid arthritis. Ask your doctor before taking a supplement.
• Nightshades: the foundation says there is no scientific evidence that tomatoes, peppers, eggplant or potatoes trigger flares, and suggests a short elimination trial then reintroduction only if you notice a pattern.
• Gluten: the foundation links gluten to inflammation for people with celiac disease or gluten sensitivity. NIDDK lists type 1 diabetes and thyroid disease among conditions that can occur with celiac disease, so ask your doctor about testing if you have digestive symptoms. Do not start a gluten-free diet before testing, because it can affect the results.

Foods Both Sources Suggest Limiting

• Heavily processed foods. Harvard Health lists them, and the Arthritis Foundation recommends a diet low in processed foods and saturated fat.
• Sugary foods and drinks.
• White bread and cereals and refined grains such as white pasta and white rice, which Harvard Health says anti-inflammatory diets typically discourage.
• Excess alcohol, which Harvard's Nutrition Source lists among the foods to limit on an anti-inflammatory diet. Ask your doctor about alcohol and your medicines.

What Food Cannot Do

• It cannot replace medication. Harvard Health says no current evidence suggests diet alone can control rheumatoid arthritis.
• It cannot be tested like a drug. Most diet studies in arthritis are small, short or low in certainty, as the 2018 reviews note.
• It cannot be judged in a day. Joint symptoms fluctuate, so a change in diet needs weeks of notes before you can see a pattern.
• It does not suit everyone. People with allergies, celiac disease, diabetes or other conditions need advice tailored to them.

Keeping a Food and Symptom Log

If you suspect that a food makes your joints worse, a log is more reliable than memory. Write down what you eat and drink, the time, and how your joints feel over the next day or two, along with your medicines, sleep and activity. The Arthritis Foundation suggests that anyone who notices flares after nightshades try a short elimination of a few weeks and then reintroduce them, and that approach should be discussed with your doctor or a registered dietitian first. Bring the log to your appointment. Our guide to the food diary app covers what to track and how to keep it reliable.

A Day of Eating for Arthritis

This is an illustration built from the Arthritis Foundation's food groups, not a prescribed plan.

• Breakfast: oats with berries and a tablespoon of walnuts.
• Lunch: a bean and vegetable salad dressed with extra virgin olive oil.
• Snack: a handful of nuts or an orange.
• Dinner: baked salmon or sardines with leafy greens and a whole grain.
• Drinks: water, tea or coffee.

For the rest of the week, see our anti-inflammatory diet meal plan and recipes.

Questions to Ask Your Doctor or Dietitian

• Is my arthritis rheumatoid, osteoarthritis or another type, and does that change what diet research applies to me?
• Would a Mediterranean-style pattern be reasonable alongside my medicines?
• Is a fish oil supplement appropriate for me, and could it interact with anything I take?
• Should I try an elimination diet, and if so, how do I do it safely and reintroduce foods?
• Do any of my medicines affect my weight, appetite or blood sugar?

Do Not Change Medicines Because of a Diet

Many people with rheumatoid arthritis take medicines that need monitoring, and some, such as long-term glucocorticoids, affect weight and other body functions. NIDDK notes that long-term glucocorticoid medicines, used for conditions including rheumatoid arthritis and lupus, are the most common cause of Cushing's syndrome, in which the body makes too much cortisol. If your weight changes or you notice new symptoms, tell your doctor, and never stop a medicine because of what you read about food.

Checking Packaged Foods With Foodsage

Processed foods are what Harvard and the Arthritis Foundation both suggest limiting, and packaged food is where they hide. Foodsage lets you choose rheumatoid arthritis, or other conditions such as lupus, celiac disease and Hashimoto's, add custom sensitivities, and choose avoid categories such as industrial seed oils, added sugars, artificial additives and refined starches. Each scan returns a verdict that names the ingredients that matched. It also has a meal and symptom log you can share with your doctor. Foodsage does not diagnose or treat arthritis, and it does not replace your care team. For the broader evidence and its limits, see our anti-inflammatory diet guide, and for another autoimmune condition, lupus diet: what the evidence says.

When to See a Doctor

See a doctor for persistent joint pain, swelling or morning stiffness, or if your symptoms change on treatment. Tell your care team before changing your diet or adding supplements. This guide is general information, not medical advice.