Does the Mediterranean diet help arthritis?

Checked on 10 October 2026 against NICE NG100 (rheumatoid arthritis), the NHS Eatwell Guide and Arthritis UK's eating well pages. This page is general education, not a personal diet plan.

What the Mediterranean diet actually is

The Mediterranean diet is not a strict plan with rules, points or banned foods. It is a pattern of eating based on the traditional diets of countries around the Mediterranean Sea. It is built around vegetables, fruit, beans, wholegrains, nuts and fish, with olive or another plant oil as the main fat, moderate dairy, eggs and poultry, and less red meat, processed meat and sugary or highly processed food. Herbs, garlic and spices add flavour so less salt is needed.

If that list sounds familiar, it is because it is very close to the NHS Eatwell Guide. Arthritis UK makes the same point: a Mediterranean-style diet is "very similar to the recommended diet in the UK". You do not need special products, imported ingredients or a subscription to follow it.

What the evidence says for arthritis

It is worth being honest here. The Mediterranean diet has some of the better evidence of any eating pattern for people with arthritis, but that evidence is still limited and it does not replace medicines, exercise or weight management.

Official UK guidance

• NICE NG100 (rheumatoid arthritis): NICE tells clinicians to inform adults with RA who want to experiment with their diet that "there is no strong evidence that their arthritis will benefit", but that they "could be encouraged to follow the principles of a Mediterranean diet (more bread, fruit, vegetables and fish; less meat; and replace butter and cheese with products based on vegetable and plant oils)".
• Arthritis UK: says research has shown that a Mediterranean-style diet is helpful for people with some types of arthritis.
• NICE NG226 (osteoarthritis): does not recommend a specific diet. Its core treatments for osteoarthritis are therapeutic exercise and, where appropriate, weight management.

Key studies

• A Swedish randomised trial in rheumatoid arthritis (Sköldstam and colleagues, Annals of the Rheumatic Diseases, 2003) compared a Mediterranean diet with an ordinary Western diet for 12 weeks in 51 people with RA on stable medicines. The Mediterranean group had a small reduction in disease activity and better physical function and vitality. It was a small, short study.
• A systematic review in rheumatoid arthritis (Forsyth and colleagues, Rheumatology International, 2018) found only four studies that met its criteria. It reported benefits for pain and physical function, but concluded there was not enough evidence to recommend the diet widely for preventing RA.
• A systematic review in osteoarthritis (Morales-Ivorra and colleagues, Nutrients, 2018) found just three studies. Higher adherence was linked with better quality of life, but the authors said the evidence was limited and longer trials were needed.
• A Cochrane review of diets for rheumatoid arthritis (Hagen and colleagues, 2009) found the effects of dietary changes, including Mediterranean diets, were uncertain because the trials were small and of low quality.

Why it is worth doing even if joint benefits are modest

The strongest reasons to eat this way are not only about joints:

• Heart health. People with inflammatory arthritis, such as rheumatoid arthritis, have a higher risk of heart and circulatory disease. Eating more fibre, oily fish and unsaturated fats, and less saturated fat and salt, is standard NHS advice for protecting the heart.
• Weight. For osteoarthritis, NICE says any weight loss is likely to help people living with overweight or obesity, and a filling, high-fibre pattern can make that easier. See our healthy weight guide.
• It is flexible. Nothing is completely banned, so it is easier to keep going for years rather than weeks.

How to build a Mediterranean-style plate

A simple way to start is to use your plate as a guide, in line with the Eatwell Guide:

• About half the plate: vegetables or salad, with fruit for dessert or snacks.
• About a quarter: wholegrain starchy food, such as wholemeal bread, brown rice, wholewheat pasta, bulgur wheat, new potatoes with skins or oats.
• About a quarter: protein, such as fish, beans, lentils, chickpeas, eggs, chicken or tofu.
• A small amount of fat: olive or rapeseed oil for cooking and dressing.
• Flavour: garlic, onions, lemon, herbs and spices instead of extra salt.

What to eat more of and less of

Eat more often	Eat in moderation	Eat less often
Vegetables, salad and fruit (fresh, frozen or tinned in juice or water)	Cheese, yoghurt and milk (choose lower-fat and lower-sugar options where you can)	Red meat such as beef, lamb and pork
Beans, lentils, chickpeas and peas	Eggs	Processed meat such as bacon, ham, sausages and salami
Wholegrain bread, oats, brown rice, wholewheat pasta	Chicken and turkey	Butter, lard, ghee and cream
Oily fish such as salmon, sardines, mackerel, trout, pilchards and herring	Unsalted nuts and seeds (a small handful)	Sugary drinks, sweets, biscuits, cakes and pastries

Useful NHS numbers:

• Fish: at least 2 portions a week, 1 of which should be oily. A portion is around 140g. Women who have not been through the menopause, including those trying for a baby, pregnant or breastfeeding, should have no more than 2 portions of oily fish a week. Tuna does not count as oily fish.
• Red and processed meat: if you eat more than 90g (cooked weight) a day, the NHS recommends cutting down to 70g.
• Salt: adults should have no more than 6g a day, around 1 level teaspoon.
• Alcohol: the UK low-risk guideline is no more than 14 units a week, spread over 3 or more days. Wine is part of some traditional Mediterranean diets, but you do not need to drink to follow the pattern. See the medicine notes below.

If you think a particular food makes your symptoms worse, read our guide to foods that may trigger symptoms before cutting anything out. It explains how to test a suspected food safely without losing important nutrients.

A UK shopping list

Everything here is in ordinary UK supermarkets and discounters, and own-brand is fine.

• Fresh: onions, garlic, carrots, peppers, tomatoes, salad leaves, broccoli, apples, bananas, oranges, plain yoghurt, milk, eggs and a block of feta or mature cheddar.
• Freezer: peas, spinach, mixed vegetables, berries and fish fillets.
• Cupboard: olive or rapeseed oil; tinned tomatoes, chickpeas, beans and lentils; tinned sardines, mackerel or salmon; porridge oats, wholewheat pasta, brown rice or bulgur wheat; wholemeal bread; unsalted nuts and seeds; dried herbs, cumin, paprika and lower-salt stock cubes.

A sample 7-day Mediterranean-style week

This is an example to show what the pattern looks like with everyday UK food. It is not a calorie-counted plan. Portion sizes depend on your age, size, activity and goals. If you have diabetes, kidney disease, coeliac disease, gout, a history of eating problems, unplanned weight loss or other medical needs, ask your GP for a referral to a registered dietitian for advice that fits you.

Day	Breakfast	Lunch	Evening meal
Monday	Porridge with sliced banana and a spoon of seeds	Lentil and vegetable soup with wholemeal bread	Baked salmon, new potatoes with skins, broccoli and peas
Tuesday	Plain yoghurt with frozen berries and oats	Wholemeal pitta with hummus, salad and a hard-boiled egg	Chickpea, spinach and tomato stew with brown rice
Wednesday	Wholemeal toast with peanut butter and an apple	Leftover chickpea stew	Chicken and vegetable tray bake with olive oil and herbs, with bulgur wheat
Thursday	Scrambled eggs with tomatoes on wholemeal toast	Sardines on toast with salad	Wholewheat pasta with tomato, courgette and bean sauce and a little cheese
Friday	Porridge with grated apple and cinnamon	Tuna, sweetcorn and bean salad	Baked white fish with roasted peppers, onions and potatoes
Saturday	Yoghurt, fruit and a handful of unsalted nuts	Vegetable omelette with salad	Homemade bean chilli with brown rice and a side salad
Sunday	Wholemeal toast with mashed avocado or tomato	Leftover chilli in a jacket potato	Roast chicken with plenty of vegetables, gravy made with less salt, and fruit for pudding

Snack ideas: fruit, a small handful of unsalted nuts, plain yoghurt, carrot sticks with hummus, or oatcakes. For a full planner with a shopping list and batch-cooking tips, see our meal plans for arthritis.

Making it easier when your joints hurt

• Use ready-prepared veg. Frozen chopped onions, pre-cut stir-fry packs and bagged salads save painful chopping.
• Cook once, eat twice. Soups, stews, chilli and tray bakes reheat well. Freeze portions on a good day for a flare day.
• Open tins safely. Ring-pull tins, an electric or lever tin opener and a jar opener reduce strain on the hands.
• Keep a flare-day shelf of tinned fish, beans, oats and frozen veg.

Eating this way on a budget

You do not need expensive olive oil or fresh fish every day. Rapeseed oil is an unsaturated oil the NHS lists alongside olive oil and is usually cheaper. Tinned sardines, mackerel and pilchards count towards your fish portions. Dried or tinned beans and lentils are among the cheapest sources of protein and fibre, and frozen vegetables are as nutritious as fresh. If you are struggling to afford food, Citizens Advice can check whether you are getting all the help you are entitled to.

Medicines and safety notes

Changing to a Mediterranean-style diet is safe for most people, but a few points matter if you take arthritis or other medicines:

• Warfarin: foods high in vitamin K, such as broccoli, spinach and other green leafy vegetables, can affect how warfarin works. The NHS says you can still eat them, but talk to your warfarin clinic before making big changes, and aim to keep the amount you eat fairly steady from week to week. Do not take vitamin K supplements, and avoid cranberry and grapefruit juice while on warfarin.
• Methotrexate: alcohol and methotrexate can both affect the liver. If wine is part of your idea of a Mediterranean diet, check with your rheumatology team how much, if any, is safe for you.
• NSAIDs such as ibuprofen and naproxen: take them with or after food as your leaflet advises. A healthy diet does not replace any stomach protection you are prescribed.
• Diabetes medicines: large changes to carbohydrate intake can affect blood glucose. Speak to your diabetes team or GP first.
• Kidney disease: lots of beans, nuts, tomatoes and some salt substitutes can be high in potassium or phosphate. Ask your kidney team or dietitian.

This is a food pattern, not a supplement plan. Ask a pharmacist to check any supplement, such as fish oil or turmeric, against your medicines first. Our omega-3 evidence review covers fish oil safety in detail.

Five small first steps

1. Swap butter for an olive or rapeseed oil spread, or use oil for cooking.
2. Add one extra portion of vegetables to your main meal each day.
3. Have one meal with tinned or fresh oily fish this week.
4. Replace one meat meal with beans, lentils or chickpeas.
5. Switch white bread, pasta or rice to wholegrain versions, one at a time.

Small changes kept up for months matter more than a perfect week. Read our anti-inflammatory diet guide for how this pattern compares with other "anti-inflammatory" eating advice.

How to tell if it is helping you

Effects on joints are usually modest and slow, so keep a simple record. Once a week, score pain, stiffness and fatigue from 0 to 10, and note flares, medicine changes, sleep and activity, since these affect symptoms too. Give it at least 3 months and take your notes to your next appointment. You may also notice benefits in energy, digestion, weight or blood pressure.

When to get medical help

Diet changes should not delay medical care. Speak to your GP, rheumatology team or NHS 111 if:

• you have a hot, red, swollen joint, especially with a fever or feeling unwell. Call 999 or go to A&E if you feel very unwell
• your joint pain, swelling or stiffness is getting worse despite your treatment
• you are losing weight without trying, or have lost your appetite
• you have ongoing diarrhoea, blood in your poo, or stomach pain after changing your diet
• you want individual advice because of diabetes, kidney disease, food allergies, coeliac disease or another condition. Ask your GP about a referral to an NHS dietitian