Summary:
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterised by persistent inflammation and progressive joint degradation. It affects approximately 1% of the global population and occurs more frequently in women, with disease activity often influenced by hormonal fluctuations across the lifespan, including during pregnancy and menopause. The disease develops through a combination of genetic susceptibility and environmental triggers. Although pharmacological treatments such as non-steroidal anti-inflammatory drugs, corticosteroids, and anti-rheumatic drugs have significantly improved disease management, they are not curative and are often associated with limitations including adverse effects and reduced effectiveness in achieving long-term remission. This study was a narrative review that explored the potential role of dietary patterns such as fasting and broader lifestyle factors in the prevention and management of RA, due to their potential to influence inflammatory and immune pathways. Dietary patterns such as anti-inflammatory diets and Western-style diets have been associated with differing effects on RA outcomes. Western diets, typically high in processed foods, refined sugars, and saturated fats, have been linked to increased risk and severity of RA. In contrast, anti-inflammatory dietary approaches may support improved gut microbiota composition, reduced oxidative stress, and modulation of immune responses, all of which may contribute to improved disease outcomes. Fasting, including intermittent fasting and time-restricted eating, has also gained attention. Intermittent fasting involves repeated fasting periods lasting up to 48 hours, while time-restricted eating limits food intake to a specific daily window, typically resulting in a fasting period of at least 14 hours. These approaches are proposed to influence immune regulation through mechanisms such as reduced inflammatory signalling and metabolic adaptation. Overall, this study highlights emerging evidence supporting dietary and fasting-based interventions as potential strategies in RA management. While these approaches may improve inflammatory markers, symptom burden, and quality of life, the current evidence remains limited and mechanistic understanding is still developing. Further research is required to determine their clinical effectiveness, particularly in relation to long-term outcomes and hormonal transitions across women’s reproductive and menopausal stages.
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Abstract:
Rheumatoid arthritis (RA) is a systemic and chronic autoimmune disease affecting about 1% of the global population, with a higher prevalence in women. Its treatment has been improved greatly over the past 30 years but there is no definitive cure available, and another unmet need exists for transitional hormonal stages such as pregnancy or menopause, which spurs the need to research new therapy options. In recent years, dietary interventions, particularly fasting and plant-based nutrition, have gained attention for their potential to alleviate RA symptoms. Fasting has been shown to reduce systemic inflammation, promote autophagy, and modulate immune cell activity, possibly leading to decreased joint pain and swelling. Nutritional strategies, such as anti-inflammatory and plant-based diets, have been shown to impact the gut microbiome and potentially support weight management, improve metabolic health, and reduce oxidative stress, all of which might contribute to better RA disease outcomes. Although the precise mechanisms remain under investigation, these approaches offer promising complementary strategies for enhancing RA management and improving patients’ quality of life. This review explores the preventive and therapeutic potential of fasting and nutrition in RA, and their possible application in the context of hormonal fluctuations and transitional stages during a women’s life.
Article Publication Date: 10/02/2026
DOI: 10.3390/nu18040580
