10 Rheumatoid Arthritis (RA) trigger foods you should never eat

10 Rheumatoid Arthritis (RA) trigger foods you should never eat
January 31, 2014 11:00 PM

A number of various types of foods have been implicated as triggers for Rheumatoid Arthritis over the years. Knowing what foods may behave as triggers may help patients avoid the flare ups that occur as a result of ingestion of such foods. However, it should be kept in mind that most of these trigger foods are individual-specific, meaning that each individual will have its own degree of sensitivity to various trigger foods and some people may completely tolerate such foods without any adverse effect. Only the major trigger foods have been considered here.

Dairy Products

Dairy products include milk and milk-derived products such as cheese and yogurt. Sources of milk may include cows and goats. According to the research conducted by Physician’s Committee for Responsible Medicine, dairy products behave as potential triggers for RA because of the proteins they contain. However, proteins derived from plants are rarely implicated as triggers suggesting that proteins derived from animals have greater tendency to be immunogenic. This happens only in sensitive individuals since, normally, milk proteins are not immunogenic. As a result of immunogenicity antibodies are produced which cross-react with joint proteins (cartilage) by the phenomenon of molecular mimicry, immune complexes, complement system is activated, inflammatory mediators are produced and inflammation then results, aggravating arthritis symptoms.

Eggs

Eggs are also one of the major trigger foods for RA. The proteins in the eggs are rendered immunogenic in a subset of patients with Rheumatoid Arthritis and the basic mechanism is the same as that described for the dairy products.

Meat and meat-products

Sources of meat that have been implicated as triggers for RA include beef, pork, chicken, turkey and several species of fish. No direct evidence has been available for meat as a trigger for RA. Only indirect evidence is available. Meat has high iron content and high omega 6 to omega 3 fatty acid ratio. Iron acts as a catalyst for free radical production. Free radicals cause tissue damage and trigger arthritis symptoms. Similarly, omega 6 fatty acids in animal membranes are a direct source of arachidonic acid. From arachidonic acid, the mediators of inflammation are produced. Hence, greater the supply of arachidonic acid provided by meat, greater the inflammation and that is why meat and meat-products are advised to be avoided in a major subset of RA patients. A point worthy of notice here is that, grass fed beef has high omega 3 fatty acid content so it may have minimum risk of trigger effect.

High carbohydrate content foods

There is a non-verified theory that the ingestion of high carbohydrate content food results in the production of intermediates in the body known as Advanced Glycation End-products (AGEs) such as acrylamide and heterocyclic amines. Such food-derived AGEs are proposed to interact with cellular receptors and induce intracellular oxidative stress. The oxidative stress further produces mediators of inflammation causing more damage to the tissues. High carbohydrate content foods include white-flour baked goods, white rice and bread etc.

Coffee

Coffee by itself is not a trigger for rheumatoid arthritis but when taken with high carb content, the process of glycation takes place and an intermediate is formed known as acrylamide. Acrylamide as discussed earlier, is an Advanced Glycation End-product and induces oxidative stress. Also, coffee makes methotrexate (the medication for RA) less potent. Research also shows that chronic ingestion of large quantity of coffee (up to 11 cups per day) induces the production of an autoantibody but this fact remains to be established.

Oils rich in omega 6 fatty acids

Linoleic acid accounts for a major proportion of dietary omega 6 fatty acid. It comes from cooking oils such as corn oil, cottonseed oil and sunfloweroil etc. Such oils with high omega 6 fatty acid content when metabolized, produce mediators of inflammation. Plants, unlike animals, do not have arachidonic acid; they have linoleic acid instead.

Foods rich in Gluten

Foods rich in gluten (a protein) may include grains such as wheat, oat, rye etc. There are a number of patients who cannot tolerate gluten and develop some sort of food allergy. Their gut cannot digest gluten and in the attempts to digest it, the small intestine gets damaged. As a result, the protein along with other intestinal contents enters the bloodstream and becomes a target for the immune system. Rest of the events are familiar. Antibodies are produced, immune complexes form and inflammation results, aggravating the arthritis symptoms.

Processed and Fried Foods

Food processing includes various types of procedures such as heating at high temperatures, grilling and frying. Commonly processed foods include French fries, potato chips and grilled meat etc. Such processing results in the production of Trans fatty acids and also it results in the production of Advanced Glycation End-products. Both of these factors cause oxidative stress and increase the production of inflammatory mediators. Hence, they are also advised to be avoided.

Citrus fruits

Citrus fruits such as oranges and lemons are implicated in some references as triggers of Rheumatoid Arthritis. Although normal amounts of citrus fruits are actually good for the immune system since they contain antioxidants, but their excess may promote the inflammatory process since acidic environment favors inflammation and citrus fruits are acidic. However, according to a recent research, it is not the acidity that is responsible for triggering the inflammatory process but the high salicylate content in it.

Vegetables from the Nightshade Family

Many vegetables from the Nightshade family have been implicated as RA triggers such as tomatoes, potatoes and eggplant etc. The previous explanation for this was their immunogenic nature and induction of antibodies but a recent theory suggests that, like some citrus fruits, it is the high salicylate content in these vegetables that triggers RA symptoms. In accordance with this theory, few members of this plant family having low salicylate content such as some varieties of potatoes (Sebago with white flesh, brown skin) can be added to diet with fewer risk of adverse effects.

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Written by: Michal Vilímovský (EN)
Education: Medical student, 3rd Faculty of Medicine, Charles University, Prague, Czech Republic
Published: January 31, 2014 11:00 PM
Next scheduled update: January 31, 2016 11:00 PM
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