Intermittent fasting (IF), an eating pattern of both consuming food and fasting, may help with managing rheumatoid arthritis (RA). However, IF is not for everyone, and only limited research has explored its potential benefits.
In people with RA, the immune system incorrectly targets joint tissue, often in the wrist, hand, or foot.
IF may help temporarily disable certain immune cells that incorrectly target the body’s own tissue without reducing immune defenses against disease and injury.
IF is an eating plan that partly or entirely restricts calories for specific periods during the day. It may have several benefits, including weight and fat loss and lower blood glucose and pressure. However, some proponents of IF suggest that it might also reduce inflammation to manage RA symptoms.
This article explains some research on whether IF can support people with RA, what IF involves, and how to try it safely.
Some research has linked IF to improved inflammation in people with chronic inflammatory conditions such as rheumatoid arthritis.
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It might also lead to fewer monocytes in the blood, as their levels depend on the glucose and protein a person eats. A low energy sensor in the liver and lower levels of a protein in the blood that signals the release of monocytes may prevent these cells from leaving the bone marrow.
While the authors acknowledged that older research had found a link between IF and improved RA symptoms, how this happened was not clear. However, the advantage of IF for RA symptoms might be that fasting improves symptoms without compromising immune cells when they are necessary, such as when targeting infections or injuries.
Some research has indicated that IF can support weight loss, which might reduce RA disease activity, according to a 2020 report.
However, according to an article the Academy of Nutrition and Dietetics published, research does not support IF as a sustainable weight loss method or treatment for any condition.
Different IF plans involve different time periods during which a person restricts calories.
- Alternate day fasting (ADF): People following an ADF plan involves consuming no calories in one day and only drinking water, tea, or black coffee. The next day, they can eat their usual calories. Choosing health-supporting foods is best.
- Modified fasting (MF): On fasting days, a person reduces calories to 20% to 25% of their usual intake or around 500 calories, returning to their usual intake on non-fasting days. One type of MF, the 5:2 method, involves modified fasting for 2 days per week and eating as usual for 5 days.
- Time-restricted feeding: People eat during an 8- to 12-hour window during a single day, fasting the rest of the time. The fasting period includes sleep.
IF can be a challenging eating schedule, especially if a person chooses ADF or MF. People can switch schedules if they feel uncomfortable during a particular plan.
People considering IF should speak with a doctor or registered dietitian before starting a particular eating plan. This is especially important for people who currently take medication or have an underlying medical condition.
Easing into the changes may be the safest way to make sure a particular plan is comfortable and sustainable. Over time, people can work in more healthful foods on non-fasting days.
IF may have risks for the following groups of people, and they should try to avoid regularly skipping meals. Groups include:
- people with diabetes
- pregnant people
- individuals who are nursing
- those with a medical history of disordered eating or eating disorders
The Arthritis Foundation reports that dietary changes will not completely cure RA. However, they may help people manage inflammation and maintain a moderate body weight, which can help relieve pressure on the joints and improve the effectiveness of some medications.
Body fat may also have links to higher levels of inflammation-linked proteins called cytokines. Eating in a way that helps people maintain a moderate level of body fat might also reduce inflammation.
The Mediterranean diet has shown promising results in research on helping manage RA changes. This eating style involves choosing meals that focus on fruits and vegetables, whole grains, and healthy fats from fatty fish.
Consuming omega-3 fatty acids, which occur in oily freshwater fish, may help. Peas and beans are also healthful, low fat sources of protein, which may help address muscle loss in those with RA.
Whole grains, fruits, and vegetables may help reduce levels of C-reactive protein (CRP), which has links to inflammation levels.
More research is necessary to assess the long-term safety and benefits of IF.
Much of the research on IF has involved mice, has been short term, or has produced contradictory results.
However, some studies have shown IF can be beneficial aside from helping to reduce inflammation.
According to a 2022 narrative review, IF is about as effective as other methods of calorie restriction for weight management.
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Animal research has also found that IF may:
However, human studies are necessary to see if this benefit translates to humans.
Intense exercise that involves the areas experiencing swelling, stiffness, or pain can worsen symptoms of RA. Foot symptoms may mean that running worsens symptoms, while boxing and weightlifting might make upper body pain worse.
Sometimes symptoms may get worse with no trigger at all.
No full cure is available for RA, but medications and lifestyle changes might help a person manage symptoms during flare-ups.
Intermittent fasting (IF) might help reduce inflammation and manage body weight in people with rheumatoid arthritis (RA). However, more long-term research involving humans is necessary to assess its safety and effectiveness.
Different types of IF, such as modified fasting, alternate-day fasting, and time-restricted feeding, might suit a person’s lifestyle and tolerance better if they wish to try IF.
However, it may not be safe for someone on certain medications or with specific health conditions or events. It is best to speak with a doctor before trying IF.
