Diet and Exercise

Get moving
Exercise can play an important role in managing your RA because it helps reduce pain and strengthens muscles around your affected joints to preserve mobility. Click HERE for more exercise tips

Get cooking
Eating a balanced diet is important to help manage a healthy weight. Keeping extra pounds off can ease the stress on your weight-bearing joints and prevent further strain and damage. Click HERE for more tips on healthy eating.

Maintain a healthy diet

Like exercising, eating a healthy and balanced diet is important for everyone. It’s important to eat a wide variety of foods, including fruits and vegetables, protein (meat, poultry, fish) dairy products, and whole grains.

Canada’s Food Guide is a good resource for making sure you are getting the required amount of carbohydrates, fats, proteins, vitamins, minerals and calories.

Maintain a healthy weight

When you are overweight, the extra stress on your weight-bearing joints (back, hips, knees, ankles and feet), puts them at risk of further strain and damage. Losing even a little bit of weight can make a big difference to your joints. Although your rheumatoid arthritis may limit the amount of exercise you can do, it is important that you adapt your diet according to your activity levels and energy needs, so you can maintain a healthy weight.

Losing 10 pounds can reduce the stresson your knees by 40 pounds!

Calcium and vitamin D

There is some evidence that arthritis progresses faster in people with low levels of vitamin D. Vitamin D is produced in the body when our skin is exposed to sunlight. It’s very common for Canadians to have low levels of vitamin D because of the particularly long and cold winters which limit our exposure to the sun.

One of the main sources of vitamin D is milk. Other sources include: eggs, chicken liver, salmon, sardines, herring, mackerel, swordfish, and halibut, as well as cod liver oils. Some people may need to take a vitamin D supplement to keep their levels up. Your
doctor can advise you about your vitamin D level and supplements.

Vitamin D is also needed for the body to absorb calcium, an essential basic nutrient
that is important for the maintenance of healthy bones.

Omega-3 polyunsaturated fatty acids

It has been shown that consuming omega-3 polyunsaturated fatty acids can actually be helpful for inflammatory arthritis, such as RA. Omega-3s can be found in high levels in cold water fish and some plant seed oils and nuts.

There are many ways to increase your intake of omega-3s, including:

  • Eat cold-water fish, such as salmon or rainbow trout, at least twice a week.
  • Ground flaxseeds or walnuts are a good source of omega-3. Sprinkle some on salads, yogurt or cereal.
  • Omega-3 fat supplements are available. Consult with your doctor if you would like to take a supplement.
  • Choose canola oil and soft, non-hydrogenated margarine made from canola oil for cooking and baking.
  • Choose omega-3 eggs.

Recipe ideas

Looking for some good recipes that contain omega-3 polyunsaturated fatty acids and vitamin D?

Try one of these!

Food allergies and RA

Currently, there is no evidence that RA is caused by food allergies. However, it is very common for some people to have allergies or an intolerance to certain foods.

If you think that you might have food allergies, speak to your doctor so you may be referred to an allergy specialist.


Getting Started Checklist

Before you start any exercise routine, there are a few things you should keep in mind:

Consult with your health care provider before starting any exercise program.

Get some exercise goals for yourself, but make sure they are within your reach. Be realistic about what you can achieve and be patient.

Start slow and pace yourself. When you start exercising, you may feel pain and stiffness at first. However, there are different kinds of pain: muscle pain and joint pain. Some muscle pain is normal if you haven’t been exercising for a while, but joint pain is not something you should be experiencing. If you think you are having joint pain, speak to your health care professional or a physiotherapist.

Be sure to listen to your body. Give yourself more rest periods on the days that you exercise.

Think about what types of fitness activities you’d like to do. There are so many options to choose from! It could be one of your goals to try a new one each month, for example.

REMEMBERExercise should be prescribed by your doctor, then guided and monitored by a physiotherapist – there’s a fine line between exercising inflamed joints too little and too much.

Wearing theright shoes

Your first priority should be comfort when it comes to your shoes. If your feet are swollen, make sure there is enough room in the toe area of the shoes and around the ankle to accommodate the swollen area. A pair of lace-up or Velcro shoes may enable you to better adjust your shoes if you have any swelling.

You should also look for a pair of shoes that provide good support for the heel and arch of your feet. If you have orthotics, be sure to have them with you when you go shopping for new shoes.

If you run or walk, you should buy new shoes after you’ve done 500 km with the same pair. If you do other types of exercise, change your shoes once a year.

What type of exercise
is best for me?

Regardless of whether or not your physical therapist prescribes flexibility, strengthening or endurance exercises, there are additional recreational activities you may wish to discuss with your health care team depending on which area of your body your RA affects the most.

If your RA affects…
Upper extremities
(shoulders, elbows, hands)

You can…
Swim, do aquatic exercises, walk, cross-country ski

Back, spine


Lower extremities
(hips, knees, ankles, feet)

Swim, do aquatic exercises, row, golf, ride a stationary bicycle, canoe, do water running


Here are some good ways to help you stick with your exercise regimen:

  • Choose activities you like
  • Exercise with a friend
  • Schedule exercise as part of your daily routine

These exercises work on the range of motion of your joints, helping to maintain or restore normal joint movement and relieve stiffness.

Helpful tips

Perform them in a non-weight-bearing position, such as lying or sitting on your bed or couch.

Move your joints in their full range of motion as much as possible without causing yourself pain.

If the joint you’re moving is healthy or has arthritis and isn’t currently painful, do 5-10 repetitions of each range of motion exercise, holding each repetition for no more than three seconds.

These exercises elongate your muscles, helping to maintain or restore normal flexibility.

Helpful tips

The best time to do stretches is when your muscles are warm, for example, after a walk or another type of activity.

Repeat each stretch 2-3 times, holding each stretch for 10-30 seconds.

Don’t bounce or jerk when doing stretches.

Skip stretching for the day if you have a joint that is hot, swollen, painful or in a flare-up.


Mopping, vacuuming and gardening are activities that can improve your flexibility.

These exercises increase your muscles’ ability to provide support and stability to a joint.

  • You shouldn’t start strength activities without the help of an expert; speak to your health care provider for advice.

Helpful tips

Strengthening exercises should be done every other day (2 to 4 times a week) so your joints and muscles have a day of rest in between workouts.

Start with light weights or resistance bands. You should be able to do 10-15 repetitions of each exercise.

Be sure to take breaks after each set of repetitions and in between activities.

If you have a joint that is hot, swollen, painful or in a flare-up, do not perform strengthening exercises without consulting your health care provider.

Raking and carrying leaves, lifting and carrying groceries, and climbing the stairs are activities that can improve your strength.

These exercises help your heart, lungs and circulation to increase your stamina so that you can work longer without tiring as quickly. When you start, aim for a moderate intensity level where you can still talk comfortably and feel warm with some sweating.

Helpful tips

Your goal should be to do a total of 30 minutes of endurance activities 4-7 days a week at a moderate pace.

Avoid activities that include jumping, rapid twisting, turning and sudden stops, as they are very stressful to your knees, ankles and spine.

Some aerobic fitness classes, racquet and contact sports, and jogging should also be avoided, as they can aggravate joint pain and put you at risk for joint injury.

Good endurance activities are walking, water activities, cycling, golfing without a ride-on cart, yard and garden work, and low-impact dancing.