The Mediterranean Diet May Help Lower Rheumatoid Arthritis Risk, New Study Says
Find out which foods had the strongest association.
Credit: Recipe photo: Jen Causey. EatingWell design.
Source: Eatingwell
Author: Carrie Myers, M.S. Published on May 22, 2025
Reviewed by Dietitian Annie Nguyen, M.A., RD
KEY POINTS
A new study suggests that following the Mediterranean diet may reduce the risk of rheumatoid arthritis.
Rheumatoid arthritis (RA) is an autoimmune disease with several potential causes.
Researchers found that eating foods like legumes and olive oil was especially helpful for lowering rheumatoid arthritis risk.
Rheumatoid arthritis (RA) is an autoimmune disease that targets the inner lining of the joints, causing inflammation and pain.[1] While it’s considered a form of arthritis, rheumatoid arthritis can affect many other areas of the body, including the heart, lungs, blood, nerves, eyes and skin. Women are two to three times more likely than men to get RA, and there is currently no cure for it.[2] Some cases of RA can be managed with careful lifestyle changes, but many people with RA also need medication.
Why some people get rheumatoid arthritis is still a bit of a mystery, but scientists do know that genetics plays a role. If you’ve got a family member with rheumatoid arthritis, you may be more likely to get it. Considering women are at a higher risk of the disease, female hormones may also play a role, as does age, since the risk for RA increases as we get older. If you have obesity, gum disease or a lung disease, including asthma, COPD, interstitial lung disease or bronchiectasis, you’re also at a higher risk of developing RA. The underlying common denominator for all these conditions is inflammation.
As far as lifestyle factors go, smoking is one of the main known risk factors for rheumatoid arthritis. But there is also evidence that being exposed to certain inhalants, bacteria and viruses may increase your rheumatoid arthritis risk.[1]
One area that lacks research is diet and rheumatoid arthritis. Researchers from China took a closer look to see if there was any connection between people following a Mediterranean diet eating pattern and the risk of rheumatoid arthritis. They not only did their own observational study, but also reviewed and analyzed previous studies on this topic, and recently published their findings in the European Journal of Clinical Nutrition.[3] Let’s break them down.
How Was This Study Conducted?
There were two parts to this study. For the first part, researchers drew data from the UK Biobank, a long-term study that collects health, medical and lifestyle data from people living in the United Kingdom. For this current study, researchers used food questionnaires from the Biobank to calculate MEDI-LITE scores, which assess how closely a person follows the Mediterranean diet.
Higher scores equate to higher adherence. These participants also could not have been diagnosed with rheumatoid arthritis before their last food frequency assessment.
For this first part of the study, there ended up being over 117,000 participants, with an average age of 57 when the study began. Almost 55% of participants were female, and they were followed, on average, for nine years. During follow-up, 773 participants were diagnosed with rheumatoid arthritis.
Besides age, sex and diet, researchers also pulled data on participants’ family history of rheumatoid arthritis, education levels, income levels, lifestyle factors (physical activity, smoking status, sleep) and health indicators (blood pressure, diabetes, other autoimmune diseases). For women, they also took into consideration the age at which they started their periods, their menopause status, number of pregnancies and use of hormones, including birth control and hormone replacement therapy.
The second part of this study was a systematic review and meta-analysis of previous studies on rheumatoid arthritis and diet. After searching research databases for applicable studies and whittling down to the ones that met their criteria, they ended up with five studies totaling over 362,000 participants with 4,273 cases of rheumatoid arthritis.
What Did This Study Show?
After running separate statistical analyses for the observational study and the meta-analysis, researchers found that higher adherence to the Mediterranean diet was associated with a lower risk of rheumatoid arthritis in both parts of this study. Specifically, in the observational study, those with the highest Mediterranean diet scores had about a 29% lower risk of rheumatoid arthritis compared to those in the lowest quartile.
The research team also found that when they ran analyses on individual foods common to the Mediterranean diet, legumes and olive oil seemed to have the strongest associations with reduced rheumatoid arthritis risk.
Study authors note a few limitations to their work. First, the food frequency questionnaires are self-reported, leaving room for bias, over- and under-reporting amounts and frequency of eating foods and forgetting some foods. Plus, diet and demographics were only captured at baseline, which doesn’t allow for changes in either over time. Lastly, the UK Biobank is made up of mostly white participants of European descent, so it is not clear that these results apply to other ethnicities.
How Does This Apply to Real Life?
While researchers can’t say for certain why the Mediterranean diet may reduce rheumatoid arthritis risk, they believe it has to do with the anti-inflammatory nature of this eating pattern, which includes lots of fruits, vegetables, nuts, seeds, fish, olive oil, whole grains and legumes. Plus, it’s low in inflammatory foods, like red and processed meats and added sugar.
We’ve got lots of Mediterranean diet meal plans to choose from, so whether your goal is to cut down on sugar or eat more plant-based protein, we’ve got a meal plan for you.
Researchers also note that having obesity can increase the risk of rheumatoid arthritis because it disrupts the immune system, potentially leading to the body attacking itself (which is essentially what happens with autoimmune diseases like rheumatoid arthritis). The Mediterranean diet has also been shown to support healthy weight management, which is another reason it may help lower rheumatoid arthritis risk, say researchers.
Whether you want to get to or maintain a healthy weight, you’ll want to check out our 7-Day High-Protein High-Fiber Mediterranean Diet Meal Plan, since the protein-fiber combo helps with weight management by keeping you full and satisfied longer; plus it helps stabilize blood sugar, avoiding the dramatic highs and lows that can come from eating more refined foods.
Though more research needs to be done, if you already have rheumatoid arthritis, diet may help manage symptoms, so check out our seven-day meal plan specifically for rheumatoid arthritis. It’s also important to keep moving. While this can be difficult if you’re in an RA flare, choose activities that feel good to you. Water walking or swimming are good choices since they’re non-weight-bearing. Or reduce the intensity and duration of the activities you normally do, and include gentle range-of-motion exercises and stretching.
You must also prioritize sleep and rest to help manage rheumatoid arthritis. A lack of quality sleep can increase pain and inflammation, driving energy levels and mood down. It also negatively affects your immune system, which is directly tied to rheumatoid arthritis. Plus, sleep and stress are tightly connected—a lack of sleep increases stress, which, in turn, will negatively influence RA symptoms.
The Bottom Line
This study suggests that higher adherence to a Mediterranean diet-style eating pattern may help lower rheumatoid arthritis risk. While there is no cure for rheumatoid arthritis, if you already have the condition, eating foods associated with the Mediterranean diet, including fruits, veggies, legumes, whole grains, nuts, seeds, fish and olive oil, and avoiding highly processed foods, like processed meats and foods high in added sugar, may help with symptom management.[4} In addition, gentle movement, plenty of quality sleep and lower stress levels can also help
SOURCES
EatingWell uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable and trustworthy.
U.S. Department of Health and Human Services. National Institutes of Health. National Institute of Arthritis and Musculoskeletal and Skin Diseases. Rheumatoid Arthritis.
American College of Rheumatology. Differences between the sexes in rheumatic disease.
Hu P, Lee E, Li Q, et al. Mediterranean diet and rheumatoid arthritis: a nine-year cohort study and systematic review with meta-analysis. European Journal of Clinical Nutrition. 2025. doi: 10.1038/s41430-025-01628-8
U.S. Department of Health and Human Services. National Institutes of Health. National Center for Complementary and Integrative Health. Rheumatoid arthritis: in depth.