Finding breakfast ideas that support rheumatoid arthritis (RA) and feel gentle on the digestive system can be challenging, especially if you’re also managing conditions like lactose intolerance, gastroparesis, or SIBO.
I’ve lived with RA for over 20 years, and after a lot of trial and error, I’ve found a morning smoothie that gives me steady energy, supports joint health, and is customizable based on what my GI tract is doing that day.
Below, I’ll walk through the ingredients, the research behind them, and some important context about the role of nutrition in RA management.
What I Put in My RA-Friendly Morning Smoothie (and Why)
Each ingredient was chosen for a specific reason, either for its anti-inflammatory properties, nutrient density, or digestive tolerability. I also got advice from a registered dietitian who’s familiar with my medical history while putting this together.
Blueberries: Antioxidants and Anti-inflammatory Benefits
Research suggests that intake of blueberries, strawberries and raspberries may help reduce joint pain and stiffness in inflammatory conditions (citation: “Dietary fruits and arthritis,” 2019).
Blueberries are rich in anthocyanins, compounds shown to lower inflammation and oxidative stress (citation – please note that this study wasn’t done specifically on a population of people with RA, however – Anthocyanins and Human Health—A Focus on Oxidative Stress, Inflammation and Disease, 2020).
Tip: Frozen blueberries work just as well as fresh!
Ginger & Turmeric: Anti-inflammatory, Anti-Oxidative Effects
The UCSF Osher Center for Integrative Health has an excellent, evidence based site which provides an overview of “Nutrition for People with Rheumatic Diseases: General Nutrition Recommendations (citation here). On their site they recommend both ginger and turmeric for their anti-inflammatory and anti-oxidative properties.
Ginger contains gingerols and shogaols, which have been shown in some clinical studies to reduce inflammatory cytokines (citations: The effect of ginger supplementation on IL2, TNFα, and IL1β cytokines gene expression levels in patients with active rheumatoid arthritis: A randomized controlled trial, 2019; also, “Effect of Ginger on Inflammatory Diseases,” 2022).
Turmeric (particularly its active compound, curcumin) has been shown to lower inflammatory markers in RA and reduce joint pain in some randomized trials (citation” Effect of curcumin on rheumatoid arthritis: a systematic review and meta-analysis).
Pro tip: Add black pepper to improve absorption, or use a turmeric blend with built-in bioavailability enhancers.
Baby Spinach: Micronutrients Galore
Spinach provides folate, vitamin K, magnesium, and antioxidants, all of which may support immune and joint health. In one study, people with chronic pain who ate more leafy greens along with an overall anti-inflammatory diet (citation The effect of an anti-inflammatory diet on chronic pain: a pilot study, 2023).
Additionally, one article that analyzed dietary influences on RA disease activity concluded that people with rheumatoid arthritis should eat five or more fruit and vegetables per day, so the spinach along with blueberries helps me start the day off right! (citation: Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations?, 2020). Similarly, the UCSF Osher Center for Integrative Health recommends that you “Cover at least half your plate with an abundance of non-starchy vegetables and fruits from the entire color spectrum,” and lists leafy greens like spinach as an example (citation here).
Additionally, spinach blends smoothly and is easier for me to digest than mature greens.
Gastroparesis note: Blanching the spinach makes it even gentler on the stomach.
Walnuts & Chia Seeds: Plant-Based Omega-3s
Walnuts and chia seeds are rich in alpha linoleic acids (ALAs), which are a type of anti-inflammatory omega-3 fatty acids that may even modulate (decrease) disease activity in RA (citation: The Effect of Omega-3 Fatty Acids on Rheumatoid Arthritis, 2020 ). Chia seeds are also an excellent source of fiber.
According to this Arthritis Foundation article, “Walnuts have the highest omega-3 content (of nuts), and researchers studying their effects have found they lower C-reactive protein (CRP), a marker of inflammation linked to increased risk of cardiovascular disease and arthritis. Eating walnuts regularly can lower cholesterol, relax blood vessels to lessen stress on the heart and reduce blood pressure.” (citation: Arthritis Foundation Article ).
Low-fiber option: Reduce the quantity, or soak your chia seeds first to lighten the digestive load.
Whey Protein Isolate: Easy-to-Digest Protein
Protein is essential for people with rheumatoid arthritis because we are prone to sarcopenia or or muscle wasting which occurs in up to 66% of people with rheumatoid arthritis (citation: Sarcopenia in Rheumatoid arthritis. A narrative review, 2023). Sarcopenia is also associated with low protein intake (same citation above) so getting enough protein in my diet is essential, along with strength training.
I do eat lean meats in my regular diet, but for smoothies I prefer to use protein powders. While many dietitians recommend plant-based protein sources, I personally experience severe bloating with soy, hemp, and other legume-based proteins due to my GI conditions.
Whey protein isolate works for me because:
- It is low in lactose, making it more tolerable for mild lactose intolerance.
- It digests easily during gastroparesis flares.
- It provides high levels of leucine, which supports muscle health — especially important for people with RA who are prone to muscle loss.
If you tolerate plant proteins, that’s awesome! They’re great for many people living with RA. Many official guidelines recommend a plant-focused diet for people with RA. In my case I have to adapt and use whey protein in this case.
Adjusting My Smoothie for Gastroparesis or SIBO
Because of my gastroparesis and history of SIBO, I adjust this smoothie depending on symptoms. You might need to modify it too.
Here are some modifications I’ve made:
- Use fewer nuts or seeds
- Reduce or blanch greens
- Choose a lower-fiber fruit (like banana or peach) on tougher days
- Use lactose-free or low-fat yogurt if needed
- Blend longer for a smoother texture
Smoothies can be a gentle way to get nutrients in when solids feel heavy!
Putting Nutrition in Context: An Adjunct, Not a Replacement for Medications
This part is so important, and something I emphasize with everyone I support: nutrition is most often an adjunct or complementary approach, not a replacement for medical treatment (aka medications) for rheumatoid arthritis.
Research consistently shows that medications such as DMARDs, biologics, and JAK inhibitors are the primary tools for controlling inflammation and preventing long-term joint damage, as well as systemic complications like heart and lung disease (citation). Nutrition and lifestyle strategies can support that process, but they rarely replace it.
In my Rheum to THRIVE framework and self-paced course, nutrition is part of the “H” pillar:
H = Healthy / Helpful Habits (Exercise, Nutrition & Sleep)
Food plays a meaningful role, but so do movement patterns, sleep quality, stress management, social support, and medication adherence. For example, the ACR Integrative Treatment Guidelines (2022/2023) list consistent exercise as the strongest non-pharmaceutical recommendation for RA, while a Mediterranean-style diet is conditionally recommended based on available evidence (Citation: 2022 American College of Rheumatology (ACR) Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis, 2023).
I also take a non-restrictive, non-dogmatic approach to nutrition. Instead of focusing on what to eliminate, I ask:
“What can I add to support my health?”
I focus on adding more anti-inflammatory foods, those rich in antioxidants, fiber, omega-3s, and protein, rather than creating rigid lists of “good” and “bad” foods.
One of my favorite perspectives, borrowed from my friend Emily Johnson (“Arthritis Foodie”), is the 80/20 rule: 80% of what I eat supports my health; the other 20% supports my joy and quality of life.
That balance actually feels sustainable for me and for many in my community!
To add some personal context: I don’t tend to have strong dietary triggers for RA symptoms the way some people do. For example, red meat or sugar don’t noticeably worsen my joint pain or fatigue. That doesn’t mean I eat them freely; I still keep them in moderation for overall health and longevity, but it does mean I don’t panic if I “indulge.”
And because I have a history of an anxiety disorder, both I and my therapist agree that a perfectionistic or fear-based approach to eating would be mentally unhealthy for me. The stress, rigidity, and anxiety around food can, themselves, be inflammatory. Moderation and flexibility support both my physical and mental health.
💛 Final Thoughts
If you’ve lived with RA for a while, you’ve probably heard “there’s no one-size-fits-all plan” more times than you can count, but it’s true. This smoothie is a great example: it works beautifully for my body, but my body has its own complexities beyond RA that may not match yours.
Please use this recipe as inspiration, not a prescription. And if you’re struggling to identify what might work for your unique body, I highly recommend working with a Registered Dietitian—a credentialed professional with rigorous training and state licensure. Unlike the general term “nutritionist,” RDs must meet strict education and clinical standards.
And now, back to smoothies: if you try this version or make your own variation, I’d love to hear how it goes! Feel free to ask questions or share your experience in the comments.
💛Additional Evidence-Based Resources for Nutrition in RA
- USCF Osher Center – Nutrition and Rheumatic Diseases:
- National Rheumatoid ARthritis Society, UK – resource list for Diet and RA
- ACR integrative guidelines for RA
- Arthritis Foundation webinar: the power of nutrition for arthritis, with Dr Neha Shah from Stanford University
- My Rheum to THRIVE self paced course provides an excellent overview of nutrition for rheumatic disease (but of course I can’t be entirely unbiased as I created it!)
Additionally, if you are looking for some great rheumatoid arthritis nutrition educators, I personally follow and love learning from:
Add comment