anti-inflammatory foods

The Role of Microbiome and Diet on Disease Activity and Immune-Inflammatory Status in Rheumatoid Arthritis

22 April 2026

Rodziewicz A, Bryl E.

Summary

What the study found

This review highlights how modifiable environmental factors, particularly diet and gut health, play a significant role in managing the severity and inflammation of rheumatoid arthritis. It demonstrates that nutritional interventions can alter the gut microbiome, which in turn influences the body's immune response and overall disease activity.

Key findings

The Mediterranean diet and omega-3 fatty acids (EPA and DHA) are the most thoroughly researched and effective dietary patterns for reducing systemic inflammation.
Modifying the gut microbiota through targeted nutrition and supplements can directly impact the development and severity of autoimmune symptoms.
Specific nutritional factors like vitamin D, antioxidants, and reduced salt intake are linked to improved immune-inflammatory status in patients.
Alternative approaches, such as vegan or gluten-free diets, show promise for symptom management, though evidence is currently less robust than standard anti-inflammatory protocols.

Practical takeaways

To support joint health and lower systemic inflammation, individuals should prioritize anti-inflammatory fats and a plant-forward diet rich in fiber to nourish beneficial gut bacteria. Maintaining optimal levels of vitamin D and considering high-quality probiotics may offer additional protective benefits against autoimmune activity.

Limitations

There is a significant need for more large-scale clinical trials to establish definitive causal links between specific microbial changes and long-term disease outcomes. The review notes that the mutual dependencies between diet and the microbiome remain complex and require further investigation.

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease of autoimmune background and unknown etiology. The importance of genetic factors in RA development is well-established. Environmental factors have also been extensively researched in relation to risk of RA and managing its symptoms. Smoking, physical activity, diet, and gut microbiota are considered to be the most essential modifiable factors in RA. Among dietary interventions, the most researched is Mediterranean diet, monounsaturated fatty acids, fish consumption, and fish oil (EPA, eicosapentaenoic acid and DHA, that is, docosahexaenoic acid). Others concerned gluten-free and vegan or vegetarian diet, salt intake, supplementation with vitamin D, antioxidants, prebiotics, and probiotics. Diet modifications can alter the gut environment, and the association between RA development or severity and the composition of gut bacteria has already been shown. This review focuses on effectiveness and usefulness of various dietary approaches and supplements in RA prevention and management, including the influence on disease activity and inflammatory status. The composition of gut microbiota and its changes in response to dietary factors are also considered. There is a great need for further research into mutual dependencies of diet, microbiome, and RA activity. The current state of knowledge provides promising evidence for future nutrition and microbial therapies.

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