The Slovenian Association of Rheumatic Patients (Društvo revmatikov Slovenije) invites patients to do something for themselves and thus make an important contribution to the treatment of their rheumatic disease. Above all, it is most important that they take care of a healthy diet and appropriate body weight, that they are physically active and that they learn to manage stress, says Darja Ambrožič, MD, nutrition consultant.

At the same time, the Association states that it is important to follow the instructions of the rheumatologist and all the professionals involved in the treatment, to take medication regularly and to consult the specialists about all problems and issues. The more answers patients have to their questions, the easier it is for them, as one of the biggest causes of stress is uncertainty – they say in the Association, which has been existing for almost 40 years

Healthy diet and appropriate body weight

Several studies have shown the impact of one’s lifestyle, especially diet and physical activity, on the onset of symptoms and the course of rheumatoid arthritis. They have also shown the beneficial effects of food on various inflammatory mediators involved in the onset and course of the disease, which can also be influenced by medications. Nutrition has also been shown to be a very difficult and complex area of research, which at the same time requires a very personal, individual approach. This is why there are no uniform dietary recommendations that apply to all the patients, but strong consensus has been reached on some basic guidelines to follow.

Processed foods should be avoided

Recommended foods include lots of fresh or as little heat-treated vegetables as possible (green leafy vegetables, legumes, cruciferous vegetables, such as broccoli and kale), abundant use of spices (turmeric and ginger), seasonal fruits (berries), probiotics (yogurts), nuts, green tea, i.e. foods rich in natural antioxidants and substances that have a known anti-inflammatory effect. Several studies have shown that a vegan diet or foods that do not contain a lot of red meat, such as a Mediterranean diet rich in vegetables, fish, olive oil, and spices, has a beneficial effect on the course of rheumatoid arthritis. With an appropriately varied diet, the dietary supplements with the exception of vitamin D and omega-3 fatty acids are probably not needed. It should be noted that, notwithstanding the above recommendations, the diet should always be harmonized with the prescribed medications and the state of the disease in each individual.

Processed foods high in salt, sugar, trans fats, various additives and preservatives, and large amounts of foods of animal origin (especially red meat) should be avoided. There is no convincing evidence that alcohol consumption reduces the activity of rheumatoid arthritis. Some researches have shown that alcohol can even worsen the chances of improving the health condition. It is also important to know that alcohol in combination with medications can promote the occurrence of side effects of medications. Therefore, it is recommended for the alcohol to be consumed only occasionally, in small amounts, e.g. a glass of red wine with a meal.

Smoking worsens the course of the disease

Researches show that rheumatoid arthritis is more common in smokers and that the course of the disease is often more aggressive. Smoking is not only a risk factor for rheumatoid arthritis, but it is also a major risk factor for cardiovascular disease, which is one of the leading causes of mortality even in patients with rheumatoid arthritis. Smoking is harmful and is therefore strongly discouraged.

One of the important goals of changing eating habits is to maintain an appropriate body weight with a suitable body composition – the ratio between muscle and fat and its distribution are important. It is recommended to measure body composition, especially because of some drugs (e.g. glucocorticoids) that have a significant effect on reducing muscle mass and bone structure, while maintaining or even increasing adipose tissue mass. Adapted to the individual, his illness, physical activity and body composition, foods known to have anti-inflammatory effects should be included in the diet.

Physical activity

According to European recommendations for the treatment of inflammatory arthritis, including rheumatoid arthritis, regular physical activity should be an important part of the treatment. Regular physical activity has a positive effect on the course of the disease, so it is necessary to remain positive to physical activity even when the patient feels tired and stiff and his joints and muscles ache. Exercise should be adapted to the patient’s current abilities and not abandoned altogether. Adjustments or short breaks are only necessary in the case of active inflammation of joints or periosteal structures.

It is recommended to start the exercise gradually and draw up an exercise plan together with a physiotherapist and / or trainer who will be able to coordinate all types of exercises to suit the patient’s condition and will give him pleasure.

Stress management

The patient should organize the days in such a way that there is enough time included in the daily schedule for regular physical activity and rest. It is necessary to learn techniques to reduce stress, e.g. yoga and meditation. Sometimes it helps to stop for a moment and to breathe slowly and deeply. Lifestyle change is a long-distance run, the effects are mostly not visible overnight, but they are long-term – states the Slovenian Association of Rheumatic Patients, which offers countless good tips and information.



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