This is the first few pages of the nutrition section in my up coming book Self-Managing Rheumatoid Arthritis.
Surviving Food, Nutrition and RA
We all know that good nutrition is an important part of staying healthy. Most of us have limited knowledge on what constitutes eating well. Our problems are many when we try to figure this out. What is good nutrition? How does it fit into our family style? How do we manage when we have pain and fatigue? How do we manage when our budgets are limited?
To complicate matters, each of us is unique both in body make-up and in our responses to our environment. We need diets or food plans that work for us individually. It is a given that a good diet will help you manage your RA. Good food will help. You might already realize your particular dietary needs.
Some will do better on a vegetarian diet. Some will do better without dairy. Many will thrive on a Mediterranean diet or an anti-inflammatory diet. Some are gluten intolerant. Some will be coping with food allergies. The challenge is to find the diet that works for you as an individual. The challenge is to let yourself choose a diet that works for your body. Trial and error works but first you will need to decide what foods you are willing to include in your plan and establish an approach that will work for you.
All of us will do better if we avoid empty calorie food, processed food, large amounts of sugary or white flour food. We will do better when we add more fruits and vegetables.
A common but little-known complication of RA is malnutrition. In fact, it is estimated that more than 40% of rheumatoid arthritis patients are malnourished. This doesn’t mean that you are skinny. It means that your body is not getting the nutrients you need to be healthy. RA patients are living in a constant state of inflammation. The increased production of cytokines increases resting metabolism and protein breakdown. People with RA need a reliable protein source daily.
Another part of our problem is that RA can cause such overwhelming fatigue and pain that it is difficult to muster the energy to prepare and then eat a meal. Just to make a sandwich requires unwrapping the bread, putting the slices on a plate, wrapping the bread bag back up, opening containers and adding spreads, meat or veggies, closing containers, putting them away. Sitting down at the table with your sandwich and eating it. Sounds easy enough. But if you are so wiped out by the extreme fatigue of RA and your hands are swollen and ache deeply in a way that is hard to explain, making a sandwich can be an overwhelming task. It is a task that can be skipped. And it frequently is.
Yet we know that RA is a lifetime experience and we need to eat despite our infirmities.
For those with chronic illness, nutrition is especially important. Frequently, someone with RA will likely have other issues such as diabetes or hypertension or another autoimmune disease. Such issues must be taken into consideration.
Those with RA have a variety of lifestyles. Some live alone. Some live with spouses. Some live with a family member like I do. There are those raising children. There are those caring for elderly parents. For each of these family combinations, we have responsibilities toward providing healthy meals. The needs of our family members don’t go away because we have RA.
Income is an issue. Many of us have limited incomes. With RA, medication is a necessity, and it is expensive. Food expense is a variable especially when a person lives alone. The food allowance may be the part of our budget that is reduced when medication costs are increased. Nutrition suffers.
Unable to perform routine activities of daily living, cooking and shopping. Pain in movement of the hands. Lack of energy in getting to the store. Mouth is dry, food is too hard to chew. Jaw joints have RA and it is painful to chew. RA creates a mountain of obstacles to overcome.
Additionally, it is difficult to rally the energy to go to the grocery store, get out of the car, walk in, select items, pay for them, go back to the car, put the groceries in, get in yourself, drive home, carry the groceries inside, and put them away. Exhausting thought. Nap time.
How do you survive all this?
I think it starts with rebooting our approach to managing. It starts with learning the essentials of what do we need to know about eating well. It starts with learning how can we manage without collapsing on the kitchen floor. It starts with learning the shortcuts. It starts with the reality of where we are. It starts with learning to manage with what we have to work with.
We all know that we need protein. Plan to have it. A supply of boiled eggs in the frig. Cottage cheese maybe. Pick up a rotisserie chicken at the grocery. It is cheaper than fast food. It is a good source of protein. We need vegetables. Pick up a packaged salad or a pound of carrots. A frozen package of carrots and peas at Smiths is $1 and takes 6 minutes in the microwave. Life can be very good. Food doesn’t have to be expensive. And it doesn’t have to be a lot of work.
Choose a diet style that appeals to you
Eat fruits and vegetables and protein daily. Eat real food. Avoid processed food.
This is the mantra. It means eating fruit and vegetables. Fruit is sweet and takes care of your sweet tooth. Vegetables are moist and taste good in a dry mouth. There are many sources protein from chicken to peanut butter. Fast food and frozen pizza are empty calories and have no nutritional value. When someone chooses one of the following diets and subsequently sticks with it, it is probably a diet that agrees with the individual’s body type. All these diets can be healthy. Choose wisely.