Every year on October 12th, World Arthritis Day, millions of people around the world come together to raise awareness about one of the most common and often misunderstood chronic conditions. Arthritis doesn’t just affect “old bones.” It’s a complex, inflammatory condition that can strike at any age and is one of the leading causes of disability. Cases have increased rapidly over the past three decades, driven by three main factors: aging, population growth, and obesity. In 1990, 256 million people had osteoarthritis. By 2020, this number rose to 595 million people (a 132% increase). By 2050, this number is projected to approach the 1 billion mark (1), with a significant impact on movement, independence, and quality of life.

For many, arthritis feels inevitable… something written in the family genes or an unavoidable part of getting older. But research is beginning to challenge that belief. While genetics certainly play a role, growing evidence shows that environment, diet, and lifestyle choices can either trigger or calm the inflammatory processes that drive arthritis. In other words, our genes may load the gun, but it’s our daily habits that pull the trigger.

The Role of Inflammation

At the heart of arthritis, whether it’s rheumatoid arthritis (RA), an autoimmune condition, or osteoarthritis (OA), a degenerative joint disease, lies inflammation. While some inflammation can be good and part of the body’s natural defense system, chronic inflammation causes ongoing low-grade damage to tissues, joints, and even organs.

Modern diets high in refined carbohydrates, added sugars, and processed seed oils promote this kind of chronic inflammation (2). These foods cause spikes in blood sugar and insulin, leading to an increase in inflammatory molecules such as C-reactive protein (CRP) and interleukin-6 (IL-6). Over time, this silent inflammation contributes to joint pain, stiffness, and swelling.

By contrast, research shows that low-carbohydrate and ketogenic diets, those that limit sugar and refined starches while emphasizing nutrient-dense, whole foods, can reduce inflammatory markers, lower body weight, and improve overall metabolic health (3,4).

Rheumatoid vs. Osteoarthritis: Different Conditions, Shared Triggers

Although RA and OA are distinct conditions, one autoimmune, the other degenerative, they share many of the same environmental and metabolic triggers. Both are increasingly linked to metabolic dysfunction, such as insulin resistance and obesity, which fuel inflammation and oxidative stress (5,6).  Low-carbohydrate diets, by stabilizing insulin levels and promoting weight loss, directly address these underlying issues. By improving metabolic health, they may also help cool the chronic “metabolic fire” that worsens joint damage and pain.

The gut connection

In recent years, scientists have uncovered a fascinating link between the gut and rheumatoid arthritis (RA). The trillions of bacteria living in our digestive system, known as the gut microbiota, appear to play an important role in how this autoimmune disease develops and progresses. Research shows that people with RA often have an imbalance in their gut bacteria, known as dysbiosis, which can disrupt immune function and trigger inflammation throughout the body (7). Certain bacterial groups (such as Firmicutes, Bacteroidetes, and Proteobacteria) are found in different amounts in RA patients compared to healthy individuals, suggesting that these microbes may influence the severity of the disease. When the gut becomes more permeable, or “leaky,” bacterial byproducts can pass into the bloodstream, worsening autoimmune reactions. Scientists are now exploring whether restoring a healthy gut balance, through probiotics, antibiotics, or dietary changes, could help reduce inflammation and improve symptoms. Understanding this gut–immune connection may open the door to new treatments that target the microbiome rather than just the joints.

Food as Medicine: The Rise of Citizen Scientists

Despite the advances in arthritis medication, many people still live with daily pain. At The Noakes Foundation, we support using nutrition as a powerful form of medicine, a way to complement medical treatment and support the body’s natural healing systems.

One of the most empowering ideas in modern health is the rise of the citizen scientist, individuals who take an active role in understanding and testing what works best for their unique biology. For people with arthritis, this means paying attention to how food affects pain, stiffness, and energy levels. Keeping a food and symptom journal can be a simple yet powerful way to track progress.

A practical first step might involve reducing or eliminating refined carbohydrates, processed foods, and sugary beverages, and instead emphasizing non-starchy vegetables, quality proteins, and healthy fats like olive oil, nuts, avocados, and fatty fish. Many people report noticeable improvements in symptoms within a few weeks of making these changes.

World Arthritis Day: A Call to Action

This World Arthritis Day, we are reminded that arthritis isn’t just a story of genetics or aging; it’s a story of environment, lifestyle, and empowerment. Science continues to show that inflammation, metabolism, and nutrition are deeply interconnected. While genes may load the gun, our choices… especially what we put on our plates, determine whether it fires.

We can all take part in this global movement toward better health by experimenting safely, learning from our own bodies, and supporting research that challenges conventional wisdom. The journey to joint health doesn’t start in the pharmacy; it starts in the kitchen.

References

1. Steinmetz, J. D., et al. (2023). Global, regional, and national burden of osteoarthritis, 1990–2020 and projections to 2050: A systematic analysis for the Global Burden of Disease Study 2021. The Lancet Rheumatology, 5(9), e508–e522. https://doi.org/10.1016/S2665-9913(23)00133-5
2. Sawalha, K., Tripathi, V., Alkhatib, D., Alalawi, L., Mahmood, A., & Alexander, T. (2023). Our hidden enemy: Ultra-processed foods, inflammation, and the battle for heart health. Cureus, 15(10), e47484. https://doi.org/10.7759/cureus.47484
3. Forsythe, C. E., et al. (2008). Comparison of low-fat and low-carbohydrate diets on circulating fatty acid composition and markers of inflammation. Lipids, 43(1), 65–77. https://pubmed.ncbi.nlm.nih.gov/18046594/
4. Ji, J., Fotros, D., Sohouli, M. H., Velu, P., Fatahi, S., & Liu, Y. (2025). The effect of a ketogenic diet on inflammation-related markers: A systematic review and meta-analysis of randomized controlled trials. Nutrition Reviews, 83(1), 40–58. https://doi.org/10.1093/nutrit/nuad175
5. Wei, G., Lu, K., Umar, M., et al. (2023). Risk of metabolic abnormalities in osteoarthritis: A new perspective to understand its pathological mechanisms. Bone Research, 11, 63. https://doi.org/10.1038/s41413-023-00301-9
6. Courties, A., Sellam, J., & Berenbaum, F. (2017). Metabolic syndrome-associated osteoarthritis. Current Opinion in Rheumatology, 29(2), 214–222. https://doi.org/10.1097/BOR.0000000000000373
7. Wasim, R., Sumaiya, Ahmad, A., Anwar, A., & Salman, A. (2025). Microbial imbalance in the gut: A new frontier in rheumatoid arthritis research. Inflammopharmacology, 33(5), 2277–2291. https://doi.org/10.1007/s10787-025-01737-7