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Despite insufficient evidence, studies have found that people with rheumatoid arthritis may experience worsening symptoms with sugary foods.

At present, there is insufficient evidence to say that rheumatoid arthritis can be caused by sugar. 

However, a 2017 survey of people with rheumatoid arthritis found worsening of symptoms with sugary foods, specifically desserts and soda. This could be because sugar causes a pro-inflammatory state in the body due to resultant hyperinsulinemia.

4 theories that link sugar intake with rheumatoid arthritis

1. Change in the bacterial flora of gum and mouth
   • Some experts think that the easy availability of sugar to the public caused the spurt in patients with rheumatoid arthritis (RA). They think that sugar changes the bacterial flora of the gum and mouth. This, in turn, made some people more likely to fall prey to the condition (bacterial dysbiosis).
2. Increased ACPA levels
   • The blood levels of anticitrullinated protein antibodies (ACPA), a type of protein, are found to be elevated in many people with rheumatoid arthritis. ACPA triggers the inflammation and causes the development or increase in the intensity of RA symptoms. Some experts believe sugar causes ACPA to increase in blood, which worsens the RA symptoms.
3. Impact on the gut microbiome
   • Sugar affects the balance of good and bad bacteria in your gut. RA people already have problems with this balance. Intake of sugar can disrupt this balance further and make RA symptoms worse.
4. Weight gain
   • Increased intake of sugar can cause weight gain and fat accumulation, which can trigger inflammation in the body and worsen arthritis. The weight gain can put stress on the knee joints and make the RA-associated knee pain worse.

4 ways to cut down sugar from the diet

If you have rheumatoid arthritis (RA), you may want to lower your sugar intake. However, remember not to eliminate sugar from your diet at once. This may increase your sugar cravings. 

Instead, try the following strategies to minimize your sugar intake:

1. Keep sugary foods out of your reach: Do not stock sugary stuff, such as pastries, candy, and cookies, in your cupboards and fridge. Instead, stock your fridge with fruits. Fruits can help satisfy your sweet cravings and provide you with antioxidants, which can help reduce joint inflammation.
2. Opt for bland foods and skip the sugary drinks: Opt for unsweetened foods or beverages, such as iced tea, plain yogurt, and unflavored oatmeal. Then, add sweetener according to your taste. This way, you can control your sugar intake. Skip the sugary drinks, such as sweetened sodas, and go for fruit juices with no added sugars.
3. Read the labels carefully: Sometimes, fat-free or low-fat products are loaded with sugars. So, read labels while grocery shopping.
   • Avoid products that list sugar as the first ingredient or has other forms of sugar on their labels, such as:
     • Corn syrup
     • High-fructose corn syrup
     • Raw sugar
     • Cane sugar
     • Evaporated cane juice
     • Dextrose
     • Agave
     • Brown rice syrup
     • Coconut palm sugar
     • Barley malt syrup
4. Have breakfast and healthy snacks: Having a healthy and fulfilling breakfast in the morning can curb your sugar cravings throughout the day. Options include wholewheat bread with a fruit spread instead of a jam spread, oatmeal, low-fat yogurt or milk, eggs, a serving of nuts and seeds, and fresh fruits.