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Eating Right with Arthritis: Arthritis Nutrition FAQs

An HSS Community Education & Outreach presentation

People with arthritis may wonder which foods and nutrients can be beneficial and which they should avoid. HSS nutritionists provide answers to the most frequently asked questions on this issue.

Vegetables on a grill.

How can following a proper diet help my arthritis?

Research continues to look at the role diet plays in arthritis. While there is no specific recommended diet, it is recommended to consume a general healthy diet. Focus on filling up your plate with fruits, vegetables, whole grains, lean meats with an emphasis on fatty fish, beans, as well as healthy fats from nuts/seeds and avocados. Limit intake of processed foods and saturated fat. Consuming a balanced diet may help reduce inflammation and improve joint pain.

Is weight management important in helping with my arthritis?

Maintaining a healthy weight is important for your overall well-being. It can help reduce the risk of heart disease, diabetes, and certain types of cancer. Maintaining a healthy weight can also improve mobility, ease joint pain by putting less stress on joints. Reducing fat stores can help reduce the body’s overall inflammation.

What are corticosteroids and how might they affect my diet?

Corticosteroids are medications that act as a powerful anti-inflammatory and immunosuppressive agent. They also increase the risk of developing other conditions such as type 2 diabetes, high blood pressure, heart disease, and obesity. Here are some nutrients to be mindful of when taking corticosteroids:

Calcium and Vitamin D: Corticosteroids can cause or worsen osteoporosis, which is when bones become fragile and more likely to break. Consuming adequate calcium daily is important for bone health. Vitamin D helps the body absorb the calcium, so having your blood levels of vitamin D checked and taking a supplement as indicated will be helpful in bone health. Examples of calcium containing foods are dark green, leafy vegetables (spinach, broccoli, collard greens), milk, cheese, and yogurt.

Sodium: Corticosteroids can elevate blood pressure, so limiting salt may be important. If you are experiencing fluid retention that causes swelling or edema, you should lower the amount of salt and sodium-containing foods you eat; in particular, processed foods should be avoided.

Fat: Corticosteroids can also elevate cholesterol and lipids, so watching intake of processed and fried foods as well as fatty meats to help decrease risk of heart related issues.

Sugar: Corticosteroids can cause an increase in blood sugars putting you at risk for diabetes. To help keep blood sugars stable, it is important to limit intake of concentrated sweets (desserts, juice, regular soda, other sugar-sweetened beverages).

Are sugar substitutes safe to use?

Artificial sweeteners have been on the market for more than 50 years and have been studied for decades. Some of the more popular calorie-free sweeteners are stevia, monk fruit, and sucralose, also known as Splenda. Stevia and monk fruit are relatively new on the market and have been given the designation from the Food and Drug Administration (FDA) as “generally recognized as safe” or GRAS. There have been no reported side effects. Splenda can withstand heat and can be a good alternative in cooking or baking. Some of the most reported side effects are headaches and digestive issues. Choosing a substitute that’s right for you may take some trial and error.

Are eggs okay to eat and what is the recommendation for consumption?

Eggs are considered a function food, meaning they are highly nutritious and offer additional health benefits beyond their nutritional value. Aside from being a great source of protein, eggs are a natural source of vitamin D and some are fortified with omega-3’s. Both omega-3’s and vitamin D have been shown to have an anti-inflammatory effect. Consuming two eggs per week as part of a well-balanced diet is recommended for most adults.

What about egg substitutes?

As far as liquid egg substitutes, liquid egg whites (also sold under the brand name Egg Beaters) are both good options if you are trying to reduce the calories in your diet. Newer liquid vegan egg substitutes, like Just Egg are also a great plant-based option and are primarily made from mung beans. These products also eliminate the cholesterol from the egg yolks. Just to note, research has shown that most of the cholesterol in our body is made by our liver, it does not come from cholesterol we eat. The liver is stimulated to make cholesterol primarily by higher intake of saturated and trans fats, not dietary cholesterol.

There are also plenty of ways to substitute eggs in baked goods. Most common are making flax or chia seed “eggs.” Applesauce or bananas are also alternatives to using eggs and still getting a great baked product.

Do nightshade vegetables contribute to arthritis?

Nightshade vegetables are a group of vegetables that includes potatoes, tomatoes, eggplant, bell peppers, and spices like paprika and cayenne. Nightshade vegetables contain a substance called solanine, which is toxic in large amounts and can promote inflammation. However, solanine is almost entirely found in the leaves and stems of these vegetables, not the edible parts. Research has not found any evidence that nightshades make arthritis worse or have a negative effect on joints.

Some people do have food sensitivities and some people with arthritis report worsening symptoms after eating nightshades. Eliminating them from the diet for two weeks and then slowly reintroducing foods one at a time two to three days apart may be helpful in identifying trigger foods.

Does chocolate influence arthritis?

Dark chocolate contains phytonutrients called flavonoids, which act as antioxidants and may help reduce inflammation. The darker you go, the more antioxidants you will get. Go for chocolate that’s at least 70% cacao or higher.

What is the difference between an Omega-3 and Omega-6 fatty acids?

Omega-3 and Omega-6 fatty acids are both “essential fats” because your body does not make them, and you need to get them from your diet. A healthy diet contains a balance of omega-3 and omega-6 fatty acids. Omega-3 fatty acids help reduce inflammation, and some omega-6 fatty acids tend to promote inflammation. The typical American diet tends to contain 14 to 25 times more omega-6 fatty acids than omega-3 fatty acids.

Omega-3 fats are important in many body functions including improving heart health, supporting mental health, and fighting inflammation. Foods that contain omega-3’s are fatty fish (more detail below) and are also found in dark leafy green vegetables, flaxseeds, walnuts, canola oil, and soybean oil.

There are several different types of omega-6 fatty acids. Most omega-6 fatty acids in the diet come from vegetable oils, such as linoleic acid (LA). Linoleic acid is converted to gamma-linolenic acid (GLA) in the body. GLA may reduce inflammation. However, too much omega-6 fats may contribute to inflammation. Aim to consume equal amounts of omega-3 and omega-6 fatty acids for overall health.

How much fish is okay to eat without having to worry about consuming too much mercury?

Mercury is not found in all fish, and it is safe to consume fish low in mercury on a daily basis. If you eat a high mercury fish, you will not feel sick immediately. However, eating fish with high amounts of mercury regularly causes it to build up in your blood over time.

Which kinds of fish are high in mercury?

The American Heart Association (AHA) recommends eating at least two servings a week of fish rich in omega-3s. A serving is 3.5 ounces.

The following data is obtained from the National Resources Defense Council, which compiles their information from the US Food and Drug Administration and the US Environmental Protection Agency

Fish with the lowest levels of mercury

Enjoy these fish varieties freely.

  • salmon
  • mackerel
  • albacore tuna
  • trout
  • sardines
  • anchovies
  • catfish
  • shellfish
  • crawfish
  • crayfish
  • flounder
  • hake
  • herring
  • mackerel (North Atlantic)
  • mullet
  • pollack
  • sole
  • tilapia
  • squid
  • trout (freshwater)
  • whitefish
  • haddock

Fish with the moderate levels of mercury

Limit consumption to six servings per month.

  • bass (striped, black)
  • carp
  • cod (Alaskan)
  • croaker (white pacific)
  • halibut (Atlantic and Pacific)
  • jacksmelt
  • lobster
  • mahi mahi
  • monkfish
  • perch
  • sablefish
  • skate
  • snapper
  • tuna (chunk light canned)
  • tuna (skipjack)
  • weakfish (sea trout)

Fish with high levels of mercury


Limit to three or fewer servings per month.

  • bluefish
  • grouper
  • Spanish mackerel
  • Chilean sea bass
  • tuna (canned albacore)


Avoid when possible.

  • king mackerel
  • orange roughy
  • shark
  • swordfish
  • tilefish
  • tuna (bigeye, ahi)


Laura Allman, RD
Nutritionist, Food and Nutrition Services Department
Hospital for Special Surgery

Reviewed and updated 2022 by
Danna Raphael, RD, CDN
Clinical Nutritionist, Inpatient Nutrition
Hospital for Special Surgery

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