Rheumatoid arthritis (RA) is a debilitating disease and is associated with increased risk of cardiovascular disease and osteoporosis. Poor nutrient status in RA patients has been reported and some drug therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), prescribed to alleviate RA symptoms, may increase the requirement for some nutrients and reduce their absorption. This paper reviews the scientific evidence for the role of diet and nutrient supplementation in the management of RA, by alleviating symptoms, decreasing progression of the disease or by reducing the reliance on, or combating the side-effects of, NSAIDs. Supplementation with long-chain n-3 polyunsaturated fatty acids (PUFA) consistently demonstrates an improvement in symptoms and a reduction in NSAID usage. Evidence relating to other fatty acids, antioxidants, zinc, iron, folate, other B vitamins, calcium, vitamin D and fluoride are also considered. The present evidence suggests that RA patients should consume a balanced diet rich in long-chain n-3 PUFA and antioxidants. More randomized long-term studies are needed to provide evidence for the benefits of specific nutritional supplementation and to determine optimum intake, particularly for n-3 PUFA and antioxidants.

Smoking is a highly significant modifiable risk factor in pregnancy. Despite its association with an extensive list of adverse outcomes, 35% of pregnant teenagers smoke throughout their pregnancy ( NHS, 2011a ). Although a successful method of quitting, engagement with Stop Smoking Services (SSS) is low among young women ( National Institute for Health and Care Excellence (NICE), 2010 ). Alternative methods of encouraging this group to utilise SSS are needed. In this study, qualitative data were collected from 32 teenage pregnant smokers and 60 specialist teenage midwives, and used to develop an online tool—‘Baby Be Smoke Free’ (BBSF)—to support smoking cessation in young pregnant women. The tool was piloted in the antenatal clinic of an inner city tertiary referral centre with high rates of teenage pregnancies. Thirty six young women were recruited and qualitative feedback was gathered from a further 15 young pregnant women. BBSF increased awareness of the impact of smoking and motivation to quit. Four out of the 36 women requested support from SSS. Broader testing and refining is required, but BBSF could be a useful intervention to engage this hard to reach group of pregnant women.