While eating a poor diet can play a role in the inflammation associated with rheumatoid arthritis (RA), eating a normally healthful diet rich in whole grains can also be inflammatory for some people. That's because whole wheat, rye, barley, and some varieties of oats contain a protein called gluten that causes intestinal inflammation and damage in people who have a condition known as celiac disease. In celiac disease, the lining of the intestine loses its integrity and becomes more permeable, resulting in what is known as "leaky gut syndrome."

The Link Between RA and Celiac Disease

RA is one of several medical conditions genetically linked to celiac disease. This means there is a crossover of risk factors involved in developing either of these diseases, so that in some families, being at high risk of developing one condition may put you at higher risk of developing the other. Nathan Wei, MD, director of the Arthritis Treatment Center in Frederick, Maryland, says there is speculation among researchers that conditions that cause a "leaky gut" may allow bacteria to enter the bloodstream and trigger an autoimmune condition like rheumatoid arthritis.

Both rheumatoid arthritis and celiac disease are autoimmune diseases, which means the body mistakenly attacks itself and destroys its own tissue. Neither disease can be prevented because the causes are still unknown. Celiac disease can be asymptomatic; you can have the condition and not know it, but you may still ultimately suffer intestinal damage that can lead to other health problems. That's why it's important to be tested for celiac disease if you are in a high-risk group.

Symptoms of Celiac Disease

You should be tested if rheumatoid arthritis or celiac disease run in your family, or if you develop the following symptoms:

  • abdominal pain
  • bloating
  • gas
  • diarrhea
  • constipation
  • unexplained weight loss that continues for more than a couple of weeks

Fortunately, a gluten-free diet will keep celiac disease under control. And according to NYU Langone Medical Center, the sooner you start following the diet, the less damage will be done to your intestinal walls. These basic tips will help you get started:

  • Substitute rice, quinoa, millet and buckwheat (kasha) for wheat in your diet. These gluten-free grasses and grains can be used to make side dishes, baked goods, breakfast porridges, salads like wild rice salad or taboulleh, and desserts, such as rice or millet pudding.
  • Experiment with rice flours, bean flours, nut flours and coconut flour in baking. Although you can purchase ready-made gluten-free breads and other baked goods as well as gluten-free baking mixes in health food stores and larger supermarkets, you can probably make better-tasting foods from scratch and, in the long run, spend less money on your diet. Look for recipes that are specially designed to use these alternative flours.
  • Focus more on what you can eat than what you can't. Beyond grains, most whole foods don't contain gluten so get your fill of fresh fruits, vegetables, legumes such as dried beans and lentils, seafood poultry, lean meats, and low-fat dairy products. Since many of the foods that do contain gluten are highly processed, high in fat and high in sugar (think breaded, fried foods and packaged cakes, doughnuts, cookies and pies), you are better off avoiding them anyway.

Dr. Nathan Wei reviewed this article.




Nathan Wei, MD, FACP, FACR
Arthritis Treatment Center, Frederick, MD
Lab Test Online: Celiac Disease

New York University Langone Medical Center: Celiac Disease

University of Maryland Medical Center: Rheumatoid Arthritis

Zhernakova, A. "Meta-Analysis of Genome-Wide Association Studies in Celiac Disease and Rheumatoid Arthritis Identifies Fourteen Non-HLA Shared Loci."  PloS Genetics Feb 2011:7(2)