October brings a snappy chill in the air to many areas of the country. Autumn also comes with a surge of delightfully sugary treats almost everywhere you look: Pumpkin spice coffee concoctions heaped with whipped cream, hot cinnamon-apple cider, campfire marshmallows, and piles of Halloween candy of every variety, from bite-sized chocolate bars to bulk bags of candy corn.
Does it matter for your RA? Some research shows that too much refined or added sugar in your diet may affect RA symptoms, inflammation and risk, and that too much weight can be bad for RA too.
Sugar can worsen RA symptoms
In a 2017 survey of 217 adults with RA1, researchers asked the respondents to look over a list of 20 common foods and drinks, and then describe, if they consume these items regularly, if they made their RA symptoms improve, get worse or stay the same.
Sugary soda drinks and desserts were most often cited as worsening RA symptoms by the respondents. Sugar-filled pop made RA symptoms worse for 12.7% of respondents, and desserts worsened RA symptoms for 12.4%. About half of the people who filled out the survey had experienced an RA flare in the last six months, but overall, their RA disease activity was low.
Which foods may improve RA symptoms in some people? It’s no surprise: 11.1% of respondents picked blueberries and 10.9% said fish made their RA symptoms feel better.
Full-sugar soda, but not diet versions, may increase RA risk
Another study’s results highlight the potential triggering effect of sugary sodas on the development of RA. In a paper published in 20142, researchers examined data on 79,570 women from the landmark Nurses’ Health Study which included detailed health and lifestyle information for each person from 1980 through 2008, and then examined similar data on 107,330 women from a second Nurses’ Health Study, which included their health information from 1991 through 2009.
Their analysis showed that women who drank one or more sugary soda pop drinks a day had a 63% increased risk of developing seropositive RA—which just means their blood test for the inflammatory marker rheumatoid factor was positive—compared to women who drank less than one serving of sugary soda a month or who drank diet soda with no sugar. They did not find any link between drinking sugary sodas and seronegative RA, or RA cases where rheumatoid factor blood tests are negative. The risk seropositive RA from daily consumption of sugary soda was independent of any other lifestyle or diet factors, the study’s findings showed.
The researchers also found that if women substituted one serving of skim milk for their sugary pop, their risk of seropositive RA went down about 20%. Why didn’t diet soda have an effect on seropositive RA risk for these women? The researchers’ best guess is that artificial sweeteners in diet soda may have different effects on the body’s metabolism than drinks with sugar.
High-fructose corn syrup and excess free fructose may spark inflammation
One possible culprit in the complex relationship between sugars and RA is fructose, a common type of sugar that’s naturally found in fruit but may be processed and added to many foods and drinks.
A 2016 study of 1,209 adults ages 20 to 30 found that if people consumed drinks high in excess free fructose or high-fructose corn syrup five or more times a week, they were three times more likely to have arthritis that wasn’t due to “wear and tear” on joints or older age3. The researchers believe that drinks rich in these types of fructose may cause a reaction in your gut, then form compounds called enFRUages that leach out of your intestinal walls to trigger inflammation in other tissues.
The researchers found that arthritis rates went up not just from drinking high amounts of sugary soft drinks, but fruit drinks and apple juice sweetened with high-fructose corn syrup and excess free fructose sugars. Naturally sweetened drinks may be a better choice—or water.
Overindulgence could lead to obesity, which makes it harder for your RA drugs to work
Overweight and obesity are common challenges. If you’re overweight (a body-mass index (BMI) of 25 or higher) or obese (a BMI of 30 or higher), your risk of high blood pressure, high cholesterol and type-2 diabetes go up. Those high “numbers” can increase your risk of heart disease too4. Elevated RA disease activity and inflammation can also increase your heart disease risk over the long term5.
Obesity can also make it harder for your RA drugs to work effectively to control inflammation and lower your RA disease activity scores. In a paper published in 2013, researchers in Italy studied 641 adults with RA and found that 66 of them were obese6. They also found that patients with higher BMIs were more likely to have higher disease activity even after one year of taking TNF inhibitors. Obese people in the study had a lower rate of reaching RA remission even with these powerful medications.
What do I do about my sweet tooth? A few tips.
- Sugar doesn’t cause obesity, but excess sugar is one factor that can contribute to weight gain4. Here are some tips to help you enjoy sweet stuff in a healthy, balanced way:
- Enjoy natural sources of sugar7: fresh, ripe fruit like cherries or dried fruit like raisins instead of cookies or candy.
- Check labels of all foods in your pantry to look for added sugars on the nutrition label8. Bread, ketchup, baked beans and other foods that don’t taste sweet can be packed with extra sugar.
- Try not to drink your sugar. Soda pop is a leading source of added sugar in most people’s diets.
- Trim the amount of sugar you add to dishes like oatmeal or cereal. You may not notice a huge change in taste if you use half as much sugar.
Keep track of your RA disease activity over time with your Vectra score
This one simple blood test result gives you a comprehensive picture of your RA inflammation levels on a scale of 1-100. Patients with Vectra Scores in the lower range are at a lower risk for future joint damage from RA. Knowing your risk of joint damage can help you and your rheumatologist make decisions about your treatment plan. Learn more about what your Vectra Score reveals and how you can use it as your personalized RA assessment tool at https://vectrascore.com/.