Understanding Rheumatoid Arthritis Better With Caregiver Support

Living with rheumatoid arthritis (RA) can be tough, but having someone close—like a family member or friend—can make a big difference. A recent study, published on August 8, 2025, in Rheumatology International, explored how including caregivers or your closest support person in research can help us learn more about RA and improve patient outcomes. Here’s what it found, explained in simple terms.

What Was the Study About?

The study wanted to understand how caregivers or your nearest support person (like a spouse, sibling, or friend) can help researchers better understand RA. These supporters, called CoNSP (Caregivers or Nearest Support Persons), were included as patient advocates in a research project. The goal was to see what unique insights they could bring to the table.

The research was done between March 2018 and February 2019, involving people with RA and their CoNSP from the United States, Spain, and Italy. In total, 16 interviews were conducted with eight pairs (each pair was a person with RA and their CoNSP).

What Did They Find?

The study created something called The Advocacy Effect Theory. This theory explains how caregivers or support persons help in RA research. It breaks down into three main ideas:

1. Sharing the Same Viewpoint: People with RA and their CoNSP often see things the same way. They agree on the challenges and experiences of living with RA, which helps confirm what’s important.

2. Expanding the Viewpoint: CoNSP add more details to what the person with RA shares. For example, they might notice things about daily struggles or symptoms that the person with RA didn’t mention, giving researchers a fuller picture.

3. Bringing a New Viewpoint: Sometimes, CoNSP share completely new information that the person with RA didn’t think to mention. This could be about how RA affects their life or new challenges they face, which adds valuable insights.

Why Does This Matter?

Including caregivers or support persons in RA research is a game-changer. They bring a fresh perspective and share details that might otherwise be missed. This helps researchers understand RA better and can lead to improved treatments, support, and care for people living with it.

Takeaway

If you have RA, your loved ones or closest supporters can play a big role in helping researchers understand your condition. Their input adds depth and new ideas, making research more complete. So, when it comes to RA, teamwork between you and your support person can make a real difference!

The source for the study is:

Negrón, J. B., Lopez-Olivo, M. A., Carmona, L., Christensen, R., Ingegnoli, F., Zamora, N. V., Gonzalez-Lopez, L., Strand, V., Goel, N., Westrich-Robertson, T., & Suarez-Almazor, M. E. (2025). The advocacy effect: a grounded theory study on the inclusion of caregivers or nearest support persons in research to better understand patient outcomes in rheumatoid arthritis. Rheumatology International, 45, article number 188. https://doi.org/10.1007/s00296-025-05676-4

Diet for rheumatoid arthritis update

This is a very thorough study that was published frontiers in Nutrition on 8 November 2017: Managing Rheumatoid Arthritis with Dietary Interventions from the Disease Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha, India. 
It seems that they have gathered together the growing body of research evidence showing that food and diet can improve the symptoms of Rheumatoid Arthritis.

"Patients suffering from rheumatoid arthritis should switch from omnivorous diets, drinking alcohol, and smoking to Mediterranean, vegan, elemental, or elimination diets, as advised by their doctor or dietician."said Dr. Bhawna Gupta one of the report authors.

Many reports have stated that the population of gut microbes gets altered in a person affected with RA, and other autoimmune diseases,  and several animal studies have already proved that any alteration in gut microbiota corresponds to initiation of RA.  Self-help by means of dietary interventions can help in management of various disorders including rheumatoid arthritis (RA), a debilitating autoimmune disease. 

Mediterranean Diet

Dietary suggestions are appealing to patients as they are affordable, accessibile, and scientific evidences show they have substantial benefits in reducing disease symptoms such as pain, joint stiffness, swelling, tenderness and associated disability with disease progression.

In the review they have included all the dietary interventions that clearly indicate clinically and statistically significant and beneficial long-term effects for relieving symptoms, delay in disease progression and associated damages in RA patients.

Here are the recomendations from the study. I have not included all the supporting studies which you can see in detail in the report but just the simple dietary suggestions. Please keep in mind you do not have to do them all but just pick one to try:

Seven Days Fasting Followed by Vegan Diet. A fasting of 7–10 days with partial nutrient intake of vegetable broth, herbal teas, parsley, garlic, and decoction of potatoes; juice extracts from carrots, beets, and celery; and a controlled daily energy intake followed by 1 year of a vegan diet as compared to omnivorous diet was studied in different trials. Together these studies observed remarkable decrease in swollen and tender joints, pain, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP).

Carrot, celery and beetroot juice

Vegan Diet. A diet including intake of only fruits and vegetables, eliminating any animal product or by-products is vegan diet.

Mediterranean Diet is rich in oleic acid, omega-3 fatty acids, unrefined carbohydrates, and phytochemicals . MD involves high consumption of olive oil, cereals, fruits, vegetables, fish, and legumes; less red meat; and inclusion of moderate amount of red wine in diet. Studies have also shown that incorporation of olive oil in diet decreases the risk of developing RA.

Elemental Diet provides food in simplest form consisting of glucose, vitamins, trace elements, and essential amino acids, is hypoallergenic, contains all nutrients for daily requirements, and is thought to be less immunogenic. 

Elimination Diet Certain food and food components may worsen the disease conditions in RA . Thus, an elimination diet plan may as well be considered wherein we eliminate those food related antigens that may possibly aggravate the disease symptoms. 

Individual Food Items in Diet and Their Relevance to RA

In an average diet comprising of breakfast, lunch, and dinner, there are several food items which are rich source of some phytochemicals and their efficacy in eradication of diseases has been known and is included under traditional medicines on which 80% of the world population relies . Food items such as dietary fibers, cooking oil, polyphenols, bioactive compounds from several herbs and beverages like tea are among the cheapest sources of medication; however, their bioavailability has always been a matter of concern.

Dietary Fibers and Whole Grains

Most of the staple food consumed all over the world are comprised of dietary fibers and whole grains. A definitive explanation for dietary fibers can be put as remnants of food not digested in small intestine, which then moves to large intestine and gets fermented by the microflora and induces several health promoting effects. Insoluble fibers such as cellulose and lignin are found in fruits, vegetables, and whole grains; and soluble fibers including pectin, guar gum, and mucilage.

Spices. Ginger, Turmeric and Cinnamon bark are recommended.

Ginger root and ginger powder

Cinnamon bark

Essential Fatty Acids

Omega-3 or omega-6 fatty acids have shown their potential as immunosuppressants and anti-inflammatory agents. Borage seed oil provides high amount of omega-6 fatty acid or gamma-linolenic acid (GLA) and significantly reduce tender and swollen joints.

Gamma-linolenic acid and omega-3 fatty acid alpha-linolenic and stearidonic acid from black currant seed oil (BCSO) gives significant positive effects in pain relieving and reducing joint tenderness.

Fish oils provide high amount of omega-3 fatty acids, and their efficacy to treat RA has been checked in several controlled trials. RA patients were provided with fish oil with 3.6 g of omega-3 fatty acids per day. 

Synbiotics

Synbiotics are composed of probiotics and prebiotics (the non-digestible food products beneficial for growth of helpful bacteria in large intestine and provides health promoting effects)

Bifidobacterium and Lactobacillus are the key strains widely used as probiotics in commercial, pharmaceutical, and nutraceutical products. 

Yoghurt with probiotics and berries

Tea
Green tea. Epigallocatechin-3-gallate (EGCG) has proved its therapeutic potential and is a main phytochemical present in green tea that is obtained from dried leaves of Camellia sinensis and C. assamica of Theacease family.  The protective effects of green tea have been well proved in neurodegenerative disease, inflammatory disease, cardiovascular disease, and several types of cancer.

Herbs

Sallaki (Boswellia serrata) is widely recommended as an anti-inflammatory herb as prescribed in Ayurveda. it lowers inflammation.

Ashwagandha (Withania somnifera) is one of the plants being described in Ayurveda as a potent anti-inflammatory plant which reduced stiffness, disability to move knee and joints, and pain score.

These diets may  not cure the RA  but an effective incorporation of these food items in the daily food plan may help to:

•  reduce their disease activity, 
• delay disease progression, 
• reduce joint damage, 
• eventually mean a decreased dose of drugs administered for therapeutic treatment of patients.

SOURCE: 

Managing Rheumatoid Arthritis with Dietary Interventions
Shweta Khanna, Kumar Sagar Jaiswal and Bhawna Gupta

Disease Biology Laboratory, School of Biotechnology, KIIT University, Bhubaneswar, Odisha, India

                     

More information on arthritis

For more information on arthritis and related conditions, contact any of the following organizations:

National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)Information ClearinghouseNational Institutes of Health
1 AMS CircleBethesda, MD.
Email: NIAMSinfo@mail.nih.gov
Website: http://www.niams.nih.gov/
The NIAMS, a part of the National Institutes of Health (NIH), leads the Federal Government research effort in arthritis and musculoskeletal and skin diseases in the United States. The National Institute of Arthritis and Musculoskeletal and Skin Diseases Information Clearinghouse is a public service sponsored by the NIAMS.

Arthritis Foundation
P.O. Box 7669 Atlanta, GA .
Website: http://www.arthritis.org/
The Arthritis Foundation is the major voluntary organization devoted to supporting arthritis research and providing education and other services to people with arthritis. This foundation publishes free pamphlets on arthritis, as well as arthritis self-help books in English and Spanish.

American Academy of Orthopaedic Surgeons (AAOS)
P.O. Box 2058 Des Plaines, IL.
Email: pemr@aaos.org
Website: http://www.aaos.org/
The academy provides education and self-help services for orthopaedic surgeons (doctors) and other health providers. It supports improved patient care and informs the public about the science of orthopaedics (bone and joint health).

American College of Rheumatology (ACR)
1800 Century Place, Suite 250Atlanta, GA .
Website: http://www.rheumatology.org/
This group provides referrals to doctors and health professionals who work on arthritis, rheumatic diseases, and related conditions. It also provides educational materials and guidelines.

You Can Feel Better!

Arthritis can damage your joints, internal organs, and skin.
There are things you can do to keep the damage from getting worse. They might also make you feel better:

• Try to keep your weight down. Too much weight can make your knees and hips hurt.
• Exercise. Moving all of your joints will help you. The doctor or nurse can show you how to move more easily. Going for a walk every day will help, too.
• Take your medicines when and how you are supposed to. They can help reduce pain and stiffness.
• Try taking a warm shower in the morning.
• See your doctor regularly.




• Seek information that can help you.

Diet for Rheumatoid Arthritis? My Journey with Food and Rheumatoid Arthritis

As someone who’s always been curious about how my diet impacts my health, I was fascinated to learn that eating more fruits and vegetables could lower my risk of rheumatoid arthritis (RA), a chronic autoimmune condition that causes joint inflammation and pain. After diving into the research, I discovered that the foods I choose every day—colorful produce, fatty fish, and even olive oil—might play a big role in keeping RA at bay or easing its symptoms. Here’s what I’ve learned about how these foods work their magic and how I’m incorporating them into my life.

Nutrient Powerhouses: Fruits and Vegetables

I’ve always loved a good salad, but I didn’t realize just how powerful fruits and vegetables are until I explored their role in fighting inflammation. These foods are loaded with vitamins, minerals, and antioxidants like vitamin C (think oranges and bell peppers), vitamin E (found in spinach and avocados), and selenium (in mushrooms and Brazil nuts). These nutrients neutralize free radicals—those pesky molecules that can damage cells and fuel inflammation. By eating more of these foods, I’m giving my body a better shot at keeping RA at bay.

Then there are bioflavonoids, compounds in plants that have serious anti-inflammatory powers. I’ve started adding foods like apples, berries, and onions (rich in quercetin) and cherries (packed with anthocyanins) to my meals. Research shows these compounds can dial down the production of inflammatory molecules called cytokines, which are a big deal in RA because they drive the immune system to attack joint tissues. Since I started tossing more colorful produce into my diet, I’ve noticed I feel more energized, and I like to think I’m doing my joints a favor too.

Omega-3 Fatty Acids: Anti-Inflammatory Allies

Another game-changer for me has been learning about omega-3 fatty acids. Found in fatty fish like salmon, mackerel, and sardines, as well as plant-based sources like flaxseeds and walnuts, omega-3s are like a soothing balm for inflammation. They contain compounds called EPA and DHA, which help reduce the production of inflammatory molecules in the body. Studies suggest that a diet high in omega-3s can ease symptoms like joint stiffness and pain for those already diagnosed.

I’ve started incorporating more omega-3-rich foods into my weekly meals—grilled salmon for dinner or a handful of walnuts as a snack and a tablespoon in oatmeal on days I do not have other omega-3s. Clinical trials have shown that omega-3s can reduce joint tenderness and even cut down on the need for pain meds like NSAIDs. The trick, I’ve learned, is balancing omega-3s with omega-6s, which are found in processed foods and can promote inflammation if I eat too much of them. By choosing whole foods over processed snacks, I’m tipping the scales toward less inflammation.

The Mediterranean Diet: A Blueprint I’m Following

One dietary pattern that’s really caught my attention is the Mediterranean diet, common in places like Greece and Italy. This way of eating emphasizes fruits, vegetables, whole grains, olive oil, nuts, seeds, and fish, with just a little red meat or processed stuff. Studies show that people following this diet have a lower risk of RA, and I can see why. It’s packed with anti-inflammatory foods that align perfectly with the research on RA prevention.

Olive oil, a staple of the Mediterranean diet, is a standout for me. It’s rich in monounsaturated fats and contains oleocanthal, a compound that acts like a natural anti-inflammatory, kind of like ibuprofen. I’ve swapped out butter for olive oil in my cooking, and I love drizzling a small amount over salads. The diet also includes plenty of omega-3-rich fish and antioxidant-packed produce, which keeps inflammation in check. A 2018 study in Arthritis Research & Therapy found that people on this diet had lower levels of inflammatory markers like C-reactive protein (CRP), which makes me feel good about adopting some of these habits.

Putting It Into Practice

Inspired by all this research, I’ve been making small but meaningful changes to my diet. I aim to fill half my plate with colorful fruits and veggies—think spinach, tomatoes, and berries—at every meal. I’ve also been experimenting with recipes like grilled mackerel with a side of roasted veggies or smoothies with flaxseeds and blueberries. These choices are not only delicious but also make me feel like I’m taking control of my health. If you’re dealing with RA or worried about your risk, I’d recommend talking to a dietitian to tailor these ideas to your needs, especially if you’re on medication.

Why This Matters Beyond My Plate

What I love about this approach is that it’s not just about me—it could have a bigger impact. Eating this way, especially with a Mediterranean twist, is kinder to the planet since it focuses on plant-based foods and cuts down on resource-heavy meat production. It feels like a win-win.

Wrapping It Up

Learning about the link between diet and rheumatoid arthritis has been eye-opening for me. By filling my plate with fruits, vegetables, and omega-3-rich foods like fish and nuts, I’m not just enjoying my meals—I’m potentially protecting my joints and overall health. The Mediterranean diet has become my go-to guide, offering a delicious and sustainable way to eat for RA prevention. Whether you’re at risk for RA, have it already or just want to feel your best, I’ve found that these simple food choices can make a big difference. Here’s to eating well and living better!

Useful Resources

• I found this book really useful - The Complete Mediterranean Cookbook: 500 Kitchen-Tested Recipes for Living and Eating Well Every Day.
• The Mediterranean Diet Cookbook for Two: 100 Perfectly Portioned Recipes for Healthy Eating.
• The Mediterranean Diet Weight Loss Solution: The 28-Day Kickstart Plan for Lasting Weight Loss

You might also be interested in my other food related articles:

  

• What food is in Mediterranean diet? at help immune

• Can Omega-3 Fatty Acids Help Rheumatoid Arthritis?

• Study Finds Eating Fresh Fish May Ease Rheumatoid Arthritis Symptoms

Below is a list of sources that informed the content of this article on the relationship between diet and rheumatoid arthritis risk. These sources include peer-reviewed studies, reputable health organizations, and scientific reviews that provide evidence for the claims made in the article. Since the article draws on general scientific consensus and well-established research, I’ve included a mix of specific studies and authoritative resources that align with the information presented.

1. Johansson, K., et al. (2018). "Mediterranean diet and risk of rheumatoid arthritis: A population-based case-control study." Arthritis Research & Therapy, 20(1), 175.
   • This study found that adherence to a Mediterranean diet was associated with a lower risk of rheumatoid arthritis, particularly in men, and linked it to reduced levels of inflammatory markers like C-reactive protein (CRP). It supports the article’s discussion of the Mediterranean diet’s protective effects.
2. Calder, P. C. (2017). "Omega-3 fatty acids and inflammatory processes: From molecules to man." Biochemical Society Transactions, 45(5), 1105-1115.
   • This review explains the anti-inflammatory mechanisms of omega-3 fatty acids (EPA and DHA), including their role in reducing pro-inflammatory cytokines and prostaglandins, which is relevant to RA symptom management and prevention.
3. Hu, Y., et al. (2015). "Antioxidant intake and risk of rheumatoid arthritis: Results from the Swedish EIRA study." Annals of the Rheumatic Diseases, 74(6), 903-908.
   • This study highlights the role of antioxidants like vitamin C, vitamin E, and selenium in reducing RA risk, supporting the article’s emphasis on fruits and vegetables as sources of these nutrients.
4. Di Giuseppe, D., et al. (2014). "Long-term intake of dietary antioxidants and risk of rheumatoid arthritis in women." American Journal of Clinical Nutrition, 100(1), 157-162.
   • This research links higher consumption of antioxidant-rich foods (e.g., fruits and vegetables) with a lower risk of RA, providing evidence for the role of bioflavonoids and other plant compounds.
5. Proudman, S. M., et al. (2013). "Fish oil in recent onset rheumatoid arthritis: A randomised, double-blind controlled trial within algorithm-based drug use." Annals of the Rheumatic Diseases, 72(7), 1141-1146.
   • This clinical trial demonstrates that omega-3 supplementation can reduce RA symptoms, such as joint tenderness and morning stiffness, supporting the article’s claims about omega-3 benefits.
6. Minihane, A. M., et al. (2016). "Consumption of fish and fish oils: Impact on inflammatory and cardiometabolic health." Nutrition Research Reviews, 29(1), 82-94.
   • This review discusses the anti-inflammatory effects of omega-3s from fish and their competition with omega-6 fatty acids, which aligns with the article’s explanation of dietary balance.
7. Bustamante, M. F., et al. (2020). "Dietary flavonoids and the risk of rheumatoid arthritis: A systematic review and meta-analysis." Nutrients, 12(8), 2245.
   • This meta-analysis supports the role of bioflavonoids (e.g., quercetin and anthocyanins) in reducing inflammation and potentially lowering RA risk, as mentioned in the article.
8. Harvard T.H. Chan School of Public Health. (2023). "The Nutrition Source: The Mediterranean Diet."
   • Available at: https://www.hsph.harvard.edu/nutritionsource/healthy-eating-plate/
   • This resource provides an overview of the Mediterranean diet’s components and health benefits, including its anti-inflammatory properties, which are referenced in the article.
9. Arthritis Foundation. (2023). "Anti-Inflammatory Diet for Rheumatoid Arthritis."
   • Available at: https://www.arthritis.org/health-wellness/healthy-living/nutrition/anti-inflammatory/anti-inflammatory-diet
   • This source offers practical guidance on incorporating anti-inflammatory foods like fruits, vegetables, and omega-3s into a diet for RA management, supporting the article’s practical applications section.
10. National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS). (2022). "Rheumatoid Arthritis: Causes, Symptoms, Treatments."
    • Available at: https://www.niams.nih.gov/health-topics/rheumatoid-arthritis
    • This resource provides background information on RA and the role of lifestyle factors, including diet, in managing the condition, which informs the article’s context.

Notes on Source Selection

• The sources were chosen for their relevance, credibility, and alignment with the article’s claims about fruits, vegetables, omega-3s, and the Mediterranean diet.
• Peer-reviewed studies were prioritized to ensure scientific rigor, while reputable health organizations like the Arthritis Foundation and Harvard were included for practical and accessible information.
• All sources are recent (within the last 10-12 years) to reflect current scientific understanding, though the principles discussed (e.g., anti-inflammatory effects of omega-3s and antioxidants) are well-established in nutrition science.

RESOURCES FOR THIS ARTICLE: 

Review: Methods used to evaluate the free radical scavenging activity in foods and biological systems 

Review of methods to determine chain-breaking antioxidant activity in food 

Use of a free radical method to evaluate antioxidant activity 

Omega-3 fatty acids in health and disease

Yes, I am an Amazon affiliate and 3 cookbook links on this page take you to Amazon. You do not have to buy anything but if you do I receive a small percentage of the profits at no extra coat to you. 

What If I Still Hurt? with Rheumatoid Arthritis

Sometimes you might still have pain after using your medicine. Here are some things to try:

• Take a warm shower.
• Do some gentle stretching exercises.
• Use an ice pack on the sore area.
• Rest the sore joint.

If you still hurt after using your medicine correctly and doing one or more of these things, call your doctor. Another kind of medicine might work better for you. Some people can also benefit from surgery, such as joint replacement.

How Should I Use Arthritis Medicine?

Managing arthritis often means using a mix of medications—pills, creams, injections, or supplements. But knowing how to use them safely and effectively is just as important as having them in the first place.

Ask Questions Before You Leave the Doctor’s Office

Before you walk out with a prescription, take a moment to ask your doctor or pharmacist:

• When and how should I take this medicine? Some medications work best when taken with food or milk to protect your stomach. Others might need to be taken on an empty stomach or at specific times of day.

• Are there any side effects I should watch for? Common ones include nausea, dizziness, or skin reactions. Knowing what’s normal—and what’s not—can help you act quickly if something feels off.

• Can I take this with my other medications or supplements? Drug interactions are real. Always mention everything you’re taking, even vitamins or herbal remedies.

Using Creams and Topical Treatments

If your doctor recommends a cream or gel for sore joints:

• Apply only to the areas that hurt, and follow the instructions carefully.

• Wash your hands after applying, unless the cream is meant for your hands.

• Watch for skin reactions like burning, redness, or rashes. If your skin reacts badly, stop using it and call your doctor.

Stick to a Routine

• Set reminders or use a pill organizer to help you stay on track.

• Don’t skip doses or double up if you forget—ask your doctor what to do in that case.

• If you’re unsure whether a medicine is helping, don’t stop it on your own. Talk to your doctor first.

When to Call Your Doctor

Reach out if:

• You experience side effects that worry you

• You’re unsure how to take or apply your medicine

• You think the medicine isn’t working

• You want to try something new or stop a current treatment

How will the doctor help? re arthritic pain

After the doctor knows what kind of arthritis you have, he or she will talk with you about the best way to treat it.


The doctor may give you a prescription for medicine that will help with the pain, stiffness, and inflammation.

Health insurance or public assistance may help you pay for the medicine, doctor visits, tests, and x rays.

What Can I Do if I have symptoms of pain in joints?

Go see a doctor.


Many people use herbs or medicines that you can buy without a prescription for pain. You should tell your doctor if you do. Only a doctor can tell if you have arthritis or a related condition and what to do about it. It’s important not to wait. You’ll need to tell the doctor how you feel and where you hurt. The doctor will examine you and may take x rays (pictures) of your bones or joints. The x rays don’t hurt and aren’t dangerous. You may also have to give a little blood for tests that will help the doctor decide what kind of arthritis you may have.