Background/Purpose: After my RA diagnosis over eleven years ago, I was optimistic that the first biologic DMARD I took would slow the progression of my RA and ease symptoms. I spent the next decade switching medications to find better options, all while taking steroids between biologics to continue to have a decent quality of life. Weight gain came quickly and stayed. I began having gastrointestinal problems like microscopic colitis, but the moment that sent me racing for a healthier lifestyle was when I was diagnosed with non-alcoholic fatty liver disease (NAFLD).

Intervention: After a doctor told me I had fatty liver in 2022, I began exercising more regularly. I still had pain and fatigue, but my lab work showed low inflammation levels. Since 2015, I’ve been tracking my pain, sleep, and fatigue using patient-reported outcome measures available in the ArthritisPower app. Beginning in 2020, when I felt more isolated after a big move away from family and friends and the pandemic began, I also started tracking my satisfaction in social activities. I’ve been gluten-free and dairy-free for over a decade, but in January of 2023, I added one more change to determine how my diet might have an impact on my pain, fatigue, and sleep. This was because I always seemed to feel worse after eating processed foods and red meat, which are considered high-inflammatory foods.

Because I needed more information first, I researched low-inflammatory foods and diet plans. It was important for me to find a plan I could easily adhere to while keeping my meals free of gluten and dairy. I read that the Mediterranean diet is plant-based at its core, and I wondered if this diet plan would help me minimize inflammation and feel better. So, I made the decision to fully implement the Mediterranean diet and try it for four months (Table).

Within the first week of my Mediterranean diet, I felt major changes in my body. I had more energy and less fatigue. I continued tracking my symptoms over four months and found that my pain, fatigue, and sleep disturbance decreased noticeably on my ArthritisPower Health Picture (Figures 1 and 2). In addition, my desire to reach out to friends and socialize improved.

Maintenance: Eating healthy fats and avoiding foods that increase inflammation have been key to helping me feel better. I learned that blood work never tells the whole story. Before implementing the diet, I felt terrible even though my C-reactive protein (CRP) and erythrocyte sedimentation rate were lower than ever. Having a visual to represent how I feel helps me to communicate to my doctor that my medications are indeed working well now and that my dietary changes have helped me to feel as good as my blood work looked. The slight increase in fatigue and sleep disturbance in April reflects the two weeks I paused the new diet.

Quality of Life: Adhering to the diet helped me to make major improvements in my well-being. Today I have normal liver levels, more energy, less fatigue, less pain, and more inclination to socialize with family and friends. Managing RA is not only about effective medications; patients may need to also make lifestyle changes to support their treatment plan. There are limitations to the diet as it is high in healthy fats and may not help with weight loss, so continuing daily exercise and using portion control are essential.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/saved-by-plants-how-a-necessary-lifestyle-change-led-to-a-happier-life-with-decreased-rheumatoid-arthritis-pain-and-fatigue/