Healthy Eating Patterns

Arthritis New Zealand takes great care to ensure that the nutrition information is true, correct and as accurate as possible. However, the organisation makes no guarantees that any individual wanting to try a certain diet mentioned or food plan will heal or improve their arthritic condition.

It is always recommended to discuss nutrition with your doctor or other health professional.

Below is a list of Food Plans and Diets that have been related to arthritis. Each one comes with its own set of benefits, some scientifically proven and others not.

The Mediterranean Diet

What is it?

The Mediterranean Diet is based on traditional foods eaten in countries around the Mediterranean Sea. It is rich in vegetables, fruits, legumes, nuts, whole grains, fish, and healthy fats. It includes small amounts of red meat and low‑fat milk products.

Research:

The Mediterranean Diet is very well studied and offers overall general health benefits for all people. According to studies, people following the Mediterranean diet are more likely to live longer and less likely to die from heart disease, stroke, or cancer. For arthritis, research suggests that a Mediterranean Diet is an anti-inflammatory way of eating by promoting good health, and a good diet to maintain a healthy weight which will protect joints from being overloaded.

Tips to Follow the Mediterranean Diet:

Get 7-9 hours sleep. Having adequate sleep is the first step to making healthy food choices.
Eat mainly plants. Have 2 or more servings of vegetables every meal and 1-2 pieces of fruit. A serving is about a handful. Eat a variety of different coloured and textured fruits and vegetables. The more diverse types of plant foods you can eat in a week, the better, particularly for gut health.
Make leafy greens a daily staple. The darker coloured the better! If you are taking blood thinning medication, talk to your doctor before making a huge change to your leafy green intake.
Include whole grains with every meal. This includes oats (e.g. porridge or add to smoothies), brown rice, quinoa, millet, barley, buckwheat, and popcorn as well as whole grain products like wholemeal bread, Weetbix and wholemeal pasta.
Eat legumes and legume products. This includes lentils, chickpeas, kidney beans, black beans, and tofu at least three times a week. These foods are high in plant protein and great for filling up on. Baked beans and chilli beans count and are one way to get started eating legumes but be aware that both contain added sugar and salt. The Heart Foundation’s Full O’Beans cookbook has information and recipes for legumes.
Eat fish and seafood. More than 2 servings a week is recommended. Avoid deep-fried and battered fish. Oily fish, like salmon and mackerel, and shellfish like mussels, are high in anti-inflammatory omega-3 fats so aim to have these at least once a week. Seafood is so good for all types of arthritis! If you have gout, make sure you are taking your daily medication and enjoy seafood as one part of a healthy meal, but not your entire meal. Fresh or canned fish are both good choices.
Swap butter for olive oil. Extra virgin olive oil has more antioxidants than other types of olive oil and is the main type of fat consumed in the Mediterranean diet. If you don’t like olive oil, canola oil is another good option and is higher in Omega 3s than other budget-friendly vegetable oils.
Drink plenty of fluids. Drink at least eight cups of fluids a day. Water is best. Green and herbal teas are also great options.
Have lean white meat and eggs. If you eat chicken or other birds, make it skinless and not deep-fried. Keep those fatty Tītī for special occasions and be wary if you have high cholesterol. The Mediterranean diet has about 4 eggs per week and about 2 servings of chicken a week.
Limit red and processed meat. In the Mediterranean diet, red meat is eaten rarely, less than 2 servings per week. It’s eaten in a similar way that we use condiments to flavour meals, it’s not the main star of a meal. The Mediterranean diet limits the consumption of processed meats including bacon, ham, salami, and corned beef (sorry, we don’t make the rules). On the other hand, corned beef is low in purines so will affect those with gout less than eating chicken! (read about gout and purines).
Choose low-fat milk and milk products or soy milk and soy products. The Mediterranean diet prioritises low-fat yoghurt, cheese, and fermented dairy products. We drink a lot of milk in New Zealand so use low-fat animal milk or go with enriched soy milk such as with added calcium if you choose plant-based milk.
Cook and flavour food with herbs and spices instead of salt. Experiment with herbs and spices to find flavours you love. There’s no such thing as “getting it wrong,” so choose a new herb, and try it with your favourite foods to find your perfect match. If you eat salt, always choose iodised salt and have it on the table to be added to the meal only if needed and leave it out of cooking.
Limit sugar and sugary foods and drinks. Choose foods that are naturally sweet and naturally have lots of nutrients, like fruit. Keep sugary foods and drinks as occasional foods.
Eat unsalted nuts, seeds, and olives. Have a small handful (30g) of nuts or seeds as a snack daily. Add diced olives to salads/wraps/burgers, and sprinkle chopped nuts or seeds over your breakfast cereal, salad, or stir-fry.
Grow, gather, and swap at least some of your food. Traditionally this was the main way all people obtained food. Grow and eat from at least one plant, year-round. Give away food you have in excess or swap with others. Gathering food from the ocean is another way to keep you healthy through physical activity, connecting to the local environment and spending time with family or friends. The Mediterranean Diet highlights seasonality, local, and eco-friendly foods.
Eat together. Communal eating is a big part of the Mediterranean lifestyle.
Spend time with friends and family: Having good and meaningful relationships decreases feelings of loneliness and keeps your brain active and healthy.
If you drink alcohol, drink red wine in moderation: No alcohol is the best amount to drink for overall health, but if you do drink alcohol, let it be in moderation and in social situations. The Mediterranean diet allows for low to moderate amounts of red wine, usually with meals but The World Cancer Research Foundation says no amount of alcohol is safe.
Know your purpose: Wake up every morning knowing what you bring to the world, to your community, and your worth. A sense of purpose is a key characteristic of not only the Mediterranean lifestyle, but also other blue zone lifestyles around the globe. Blue zones are areas in the world where people experience the best quality and longevity of life, this includes the Mediterranean.
Have good boundaries with work and make time to relax: Making healthy choices is easier when you have adequate downtime from your responsibilities, and you feel relaxed. If you have a side hustle, make sure it’s relaxing, something you enjoy, or physically active if you have a sedentary job so you aren’t increasing stress or time sitting during your week.
Have fun! When you have things in your day or week that make you happy or have something planned to look forward to, you may be less likely to turn to sugary or oily comfort food to get your feel-good hormones going.

HAES - Healthy At Every Size

What is it?

The Health At Every Size (HAES) plan challenges the weight-based focus of the medical community. Instead of focusing on body weight, shape or size, the HAES approach encourages us to create a “fulfilling and meaningful lifestyle” through intuitive eating, body acceptance (regardless of size or shape), adequate sleep and regular physical activity for movement, to optimise both our physical and mental health at any size.

It is not anti-weight-loss but instead doesn’t promote or focus on weight loss as a health strategy. A key reason why is that weight is not a behaviour, and HAES focuses on health-improving behaviours. What’s more, focusing on weight while discussing healthy lifestyles, perpetuates the myth that weight is modifiable and the ongoing weight stigma many people experience daily.

If someone loses weight while changing their health behaviours, that’s considered a side effect of HAES, but not the primary goal.

Research:

There have been studies that show that HAES improves metabolic health, lowers blood pressure and lipids, improves energy expenditure, and improves eating habits and mental health. There is also research that shows the HAES approach as a possible means of improving the health-related quality of life for patients with arthritis, instead of fixating on weight-loss.

Tips to Follow the HAES Method:

Listen to your body’s hunger cues, rather than eating by the clock: Hunger signs can start with rumbling tummies and lack of energy, through to light-headedness, difficulty concentrating, uncomfortable stomach pains, irritability, feeling faint or even a headache. Ideally, eat when you’re comfortably hungry, rather than over-hungry. When we’re over-hungry, we tend to overeat past comfortable fullness.
Treat all food as equal – don’t label foods as ‘good’ or ‘bad’: All foods can be part of a healthful lifestyle. One choice at one mealtime doesn’t make or break your health, so don’t feel guilty about enjoying a variety of foods. Think of food as being on a spectrum from “more nutritious foods” through to “play foods” and allow yourself to eat freely in a way that nourishes your body and still satisfies you. Removing the “restricted” label from foods typically reduces cravings in the long-term.
Eat more of the nutritious foods you enjoy: Instead of forcing yourself to eat foods you don’t like, think about which of those whole foods are your favourites. Which vegetables and fruits are your favourites? Eat those more often.
Eat until you are comfortably full, instead of eating everything on the plate: Listen to your tummy – when it says it’s full – stop eating. Save leftovers for another meal or snack-time, rather than eating past full and not enjoying those last over-stuffed mouthfuls of food.

Nightshade-Free Diet

What is it?

Nightshade vegetables are a group of vegetables that belong to the family Solanaceae. Tomatoes, potatoes, eggplant and peppers are nightshade vegetables. Some people claim that cutting out nightshades helps improve arthritis and other health conditions.

Research:

Cutting out or reducing nightshade vegetables in the diet has been shown to help people with their pain but there is no concrete evidence that they actually cause inflammation. It has been reported that solanine present in the green parts of these vegetables is probably responsible for joint pain. However, scientific documentation on a correlation between S. nigrum consumption and inflammation of joints is lacking.

Keto

What is it?

In the short term, the Keto diet may give the desired effect of weight loss but there are no long term studies to prove that the diet is safe. Keto only looks at weight and not overall health. The Keto diet looks at putting your body into ketosis, burning fat as energy and not carbohydrates. This involves extremely limiting your carbohydrate intake and consuming more fat in your diet.

Research:

Following a Keto diet you will have to eliminate even the healthy carbohydrates including whole grains, legumes, most fruit, and some vegetables. This may cause you to lose out on essential vitamins, minerals and fibre.

It is easy to consume too much saturated fat if you are eating a lot of animal-based fat found in meat and butter. This can raise your ‘bad’ LDL-cholesterol levels and increase your risk of heart disease. You should always focus on choosing heart-healthy unsaturated fats like avocado, olive oil, nuts, and seeds and limit saturated fats like butter, coconut oil and fat from meat.

Keto focuses on weight loss rather than eating healthily and its long-term effects aren’t yet known.

Paddison Programme

What is it?
It promotes a plant based diet with an elimination and reintroduction phase as well as physical activity and stress reduction.

Claims:
To reverse rheumatoid arthritis symptoms.

Research:
There has been no independent scientific research on the Paddison Programme but some people claim that it has helped reduce their Rheumatoid Arthritis symptoms. There are testimonials from some people that have tried the programme but the results will vary for different individuals.

It was developed by Clint Paddison who developed Rheumatoid Arthritis at age 31 and claims to have controlled his symptoms with this programme.

Is it recommended?
The American College of Rheumatology and Arthritis New Zealand do not recommend this diet for people with rheumatoid arthritis.

Safety:
If you want to try this or any other diet that removes food groups you currently eat, speak to your doctor or specialist so they know you are doing this and consult a registered dietitian for advice before beginning the programme.