Often patients will ask what diet works best for which rheumatologic diagnosis. There are certain ideas I will share with you about what  and why I think some diets work and some don’t. Some experts recommend low fat vegetarian diets as anti-inflammatory. I do think there is some logic and basis for this point of view. For years we have given certain supplements such as the omega 3 fatty acids, since multiple studies have shown to help inflammatory arthritis. Therefore, I think there is some basis to increasing the omega 3s in the diet, avoiding the high fat in red meats and increasing intake of fruits and vegetables. Some diets say to avoid nightshades such as tomatoes, potatoes and eggplants. Personally I don’t believe there is much logic to this diet. Some patients expect diets to “cure” their conditions. I realized the other day why diets don’t cure. Patients look at diet as medicinal. They can help symptoms, but in my humble experience do not cure. The reason is that I think these diseases are often started by either a virus or genetic issues. We can modify the symptoms, but we can not shut down or reverse the cause that started the disease. For example, heart disease can be treated by diet, stress reduction, medication, angioplasty and bypass. All these things help but they do not stop progression of disease. When people have bypass or a cardiac  placed, it may slow down the disease, but often the artery reblocks. I think this is similar in arthritis. In Rheumatoid Arthritis we can use medicines such as Methotrexate to slow down the arthritis, but over years joints still cripple even though the symptoms are controlled enough to be functional. That is why I feel many patients expectations of diet are too high. They expect if they eat just the right diet all will go well. As in diabetes, diet is important to keep blood sugar controlled, but sticking to the diet does not cure the diabetes, it helps keep complications to a minimum.