A randomised controlled trial of a Mediterranean Dietary Intervention for Adults with Rheumatoid Arthritis (MEDRA): Study protocol

Raad, Tala; George, Elena S.; Griffin, Anne; Larkin, Louise; Fraser, Alexander; Kennedy, Norelee; Tierney, Audrey C.

doi:10.1016/j.conctc.2022.100919

Cited by 10 publications

(4 citation statements)

References 45 publications

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“…The 12-week dietary intervention included data collection and consultations at baseline, 6 and 12 weeks. The published protocol details the study design and methods [30]. All participants gave their written, informed consent to take part in the study.…”

Section: Methodsmentioning

confidence: 99%

Effects of a Telehealth-Delivered Mediterranean Diet Intervention in Adults with Rheumatoid Arthritis (MEDRA): A Randomised Controlled Trial

Raad

George

Griffin

et al. 2023

Preprint

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Objective. To compare the effects a Mediterranean diet (MedDiet) versus the Irish Healthy Eating Guidelines (HEG) on physical function and quality of life in adults with rheumatoid arthritis (RA) in Ireland. Methods. Forty-four adults with RA were randomised (1:1) to the MedDiet or HEG for 12 weeks. The intervention included three video teleconsultations and two follow-up telephone calls facilitated by a Registered Dietitian (RD). Changes in physical function by Health Assessment Questionnaire- Disability Index (HAQ-DI) and quality of life by Rheumatoid Arthritis Quality of Life Questionnaire (RAQoL) were the primary outcomes measured. Secondary outcomes included changes in dietary adherence, physical activity by Yale Physical Activity survey (YPAS), patient-perceived pain and general health, and anthropometric measures. All measurements were administered at baseline and repeated at 6 and 12 weeks. Results. Forty participants completed the study. Participants were primarily females (87.5%), mean age was 47.5 (10.9) years. At the end of the intervention, participants in the MedDiet group reported significantly better physical function (p=0.006) and quality of life (p=0.037) compared to HEG group. From baseline to 12 weeks, physical function significantly improved in both diet groups, MedDiet (p <0.001) and HEG (p<0.001). Quality of life also significantly improved in the MedDiet (p<0.001) and HEG group (p=0.048). Physical activity improved significantly in the MedDiet (p=0.01) but not within the HEG group despite similar recommendations. Conclusion. Adhering to the MedDiet and Irish Healthy Eating Guidelines resulted in improvements in RA patient-reported outcomes. The changes observed in both diet groups are likely due to the improvement in overall diet quality irrespective of dietary prescription.

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Section: Methodsmentioning

confidence: 99%

Effects of a Telehealth-Delivered Mediterranean Diet Intervention in Adults with Rheumatoid Arthritis (MEDRA): A Randomised Controlled Trial

Raad

George

Griffin

et al. 2023

Preprint

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“…In a randomized controlled trial, a proportion of 44 RA patients received the Mediterranean diet and residue of patients applied a standard healthy diet for 12 weeks [77]. Mediterranean diet for this RA patients was rich in legumes, unsalted unroasted nuts, fermented dairy products, fish and poultry, but contained small amounts of red meat.…”

Section: Mediterranean Dietmentioning

confidence: 99%

The Integral Role of Diets Including Natural Products to Manage Rheumatoid Arthritis: A Narrative Review

Bayır

Mendes

Dadak

2023

CIMB

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Genetic and environmental factors including lifestyle are thought to play a key role in the pathophysiology of rheumatoid arthritis (RA). There is evidence that diet can enhance the inflammatory response in genetically predisposed individuals. On the other hand, certain types of diets can alleviate RA symptoms due to their anti-inflammatory and antioxidant activities. Also, natural compounds with potential effectiveness in RA management belong to different chemical classes such as flavonoids, polyphenols, carotenoids, and alkaloids with their antioxidant characteristics as well as probiotics. The nutritional approaches to prevent or extenuate the disease progress were examined in this narrative review which was conducted using the PubMed, ScienceDirect and Google Scholar databases and conforms to the Scale for the Assessment of Narrative Review Articles (SANRA) guidelines. Mediterranean and vegan diets equally have been shown to exhibit positive effects on RA as the consumption of dietary fiber, antioxidants and anti-inflammatory compounds from fruits, vegetables, grains, nuts, and seeds are high. Whereas Mediterranean diet additionally includes beneficial nutrients of animal origin such as omega-3 polyunsaturated fatty acids from fish and seafood, patients on vegan diet need to be monitored closely for intake of all critical nutrients. Certain calorie restrictions and intermittent fasting diets have been shown to benefit RA patients although there is an obvious need for further studies to establish solid evidence-based recommendations and guidelines. The research data available strongly suggest that dietary approaches with anti-inflammatory properties may help delay the onset of RA and/or improve symptoms and thus nutrition should be routinely addressed to facilitate management of the disease.

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“…Current synthesis of the literature from observational and intervention studies also supports that there is emerging evidence for a positive effect of a Mediterranean diet in patients with immune-mediated inflammatory conditions such as inflammatory bowel diseases, rheumatoid arthritis and psoriasis [32,33]. Given the mechanisms of action of a Mediterranean diet pattern is likely via its anti-inflammatory potential, clinical trials investigating its impact on chronic debilitating and highly prevalent conditions such as rheumatoid arthritis are underway [34].…”

Section: Introductionmentioning

confidence: 96%

The anti-inflammatory effects of a Mediterranean diet: a review

Itsiopoulos

Mayr

Thomas

2022

Current Opinion in Clinical Nutrition &Amp; Metabolic Care

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Purpose of reviewChronic noncommunicable diseases remain the leading cause of morbidity and mortality worldwide and the majority are preventable with a healthy diet and lifestyle, but controversy remains as to the best approach. Greater adherence to a traditional Mediterranean diet has consistently been associated with lower morbidity and mortality from cardiovascular disease, diabetes and many cancers, and lower all-cause mortality. Despite the well known benefits on chronic disease risk there remains some scepticism as to the effects of this dietary pattern across populations outside the Mediterranean and the mechanisms of action of this traditional plant-based dietary pattern.This narrative review aims to summarize the latest evidence on the health protective effects of a traditional Mediterranean diet on chronic noncommunicable diseases, specifically focussing on the anti-inflammatory effects of this highly published dietary pattern.Recent findingsRecent high-quality evidence now supports a Mediterranean diet in secondary prevention of cardiovascular disease with impacts on atherosclerosis progression, likely through reduction of systemic inflammation and irrespective of changes in cholesterol or weight. The Mediterranean diet has a low Dietary Inflammatory Index illustrating its anti-inflammatory potential. This dietary pattern beneficially modulates the gut microbiota and immune system, including emerging evidence for efficacy against severe acute respiratory syndrome coronavirus 2 (coronavirus disease 2019). Emerging evidence shows clinicians are not routinely recommending a Mediterranean diet despite well known evidence due to barriers such as lack of training, patient materials and concerns about potential patient adherence.SummaryThe physiological mechanisms of action of this healthy diet pattern are becoming better understood to be multisystem and involving the gut. Larger controlled trials investigating mechanistic effects in broader non-Mediterranean populations are warranted. Although reflected in therapeutic guidelines for chronic disease management worldwide there are individual, clinical practice and health system barriers to its implementation that need a multisectoral approach to address.

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A randomised controlled trial of a Mediterranean Dietary Intervention for Adults with Rheumatoid Arthritis (MEDRA): Study protocol

Cited by 10 publications

References 45 publications

Effects of a Telehealth-Delivered Mediterranean Diet Intervention in Adults with Rheumatoid Arthritis (MEDRA): A Randomised Controlled Trial

Effects of a Telehealth-Delivered Mediterranean Diet Intervention in Adults with Rheumatoid Arthritis (MEDRA): A Randomised Controlled Trial

The Integral Role of Diets Including Natural Products to Manage Rheumatoid Arthritis: A Narrative Review

The anti-inflammatory effects of a Mediterranean diet: a review

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