A Randomized Controlled Dietary Intervention Improved the Serum Lipid Signature towards a Less Atherogenic Profile in Patients with Rheumatoid Arthritis

Lindqvist, Helen M.; Bärebring, Linnea; Gjertsson, Inger; Jylhä, Antti; Laaksonen, Reijo; Winkvist, Anna; Hilvo, Mika

doi:10.3390/metabo11090632

Cited by 8 publications

(7 citation statements)

References 26 publications

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“…CVD is the leading cause of death in patients with RA and occurs more often in this patient group than in the general population ( 36 ). We recently demonstrated that a Mediterranean-like diet rich in unsaturated fatty acids as well as fiber improved blood lipid profiles in patients participating in the ADIRA trial, possibly lowering the risk for atherogenesis ( 37 , 38 ). Furthermore, calcium and vitamin D play an important role in bone health.…”

Section: Discussionmentioning

confidence: 99%

Inadequate Dietary Nutrient Intake in Patients With Rheumatoid Arthritis in Southwestern Sweden: A Cross-Sectional Study

Wadell

Bärebring²,

Hulander³

et al. 2022

Front. Nutr.

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BackgroundPatients with rheumatoid arthritis (RA), who suffer from impaired physical function and fatigue, may have difficulties with grocery shopping and preparing meals. Also, to improve symptoms, patients often experiment with diets but seldom consult a dietitian. Although this could lead to a nutritiously deprived diet, an up-to-date, thorough description of the nutrient intake in Swedish patients with RA is absent. Here, we investigated the habitual dietary energy and nutrient intake in patients with RA living in southwestern Sweden.Materials and MethodsThree-day food records performed at two time points during the ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) trial, were used. The intake of energy and nutrients was analyzed using The Swedish Food Composition Database.ResultsA total of 62 participants (50 females, 12 males) were included in the study, where 18 participants completed one 3-day food record and 44 participants completed two 3-day food records. Median (IQR) intake of total fat was above or in the upper range of recommendations (females: 37.1 [32.5, 41.7] energy percent (E%), and males: 40.3 [37.5, 42.9] E%). Median (IQR) intake of saturated fatty acids exceeded recommendations (females: 14.9 [12.5, 17.0] E% and males: 15.4 [12.2, 17.0] E%), while median (IQR) carbohydrate and fiber intakes were below recommendations (females: 41.7 [36.3, 45.4] E% and 17.2 [12.8, 20.9] g, respectively, and males: 38.8 [35.2, 40,3] E% and 18.5 [15.7, 21.0] g, respectively). The reported intake of other macronutrients was in line with recommendations. For several micronutrients, e.g., vitamin A and D, folate, and calcium, median intake was below recommended intake. Vitamin A intake was especially low and did not reach lower intake level (LI) for 14 and 17% of females and males, respectively. For females, about 10% did not reach LI for vitamin D, calcium, and riboflavin.ConclusionWe found that patients with RA residing in southwestern Sweden reported a high intake of saturated fatty acids and low intake of fiber and several micronutrients.Clinical Trial Registration[https://clinicaltrials.gov/ct2/show/NCT02941055?term=NCT02941055&draw=2&rank=1], identifier [NCT02941055].

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Section: Discussionmentioning

confidence: 99%

Inadequate Dietary Nutrient Intake in Patients With Rheumatoid Arthritis in Southwestern Sweden: A Cross-Sectional Study

Wadell

Bärebring²,

Hulander³

et al. 2022

Front. Nutr.

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“…Our lipidomic results indicate that hepatic CE decreases, while the bile acids and steroid hormones increase (mimicking CD-fed mice), while adipocytes from visceral and subcutaneous depots increased PUFA-containing DG, TG, and LPC; i.e., the effects of dietary intervention in the liver are quantitative, but more qualitative in adipocytes. Caloric restriction per se does not modify the lipid composition, but the type of diet may determine the qualitative lipid aspects such that dietary sources enriched with PUFA modify the phospholipid plasma membrane composition, promoting better metabolic outcomes, than SFA-enriched diets [ 47 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Combining Dietary Intervention with Metformin Treatment Enhances Non-Alcoholic Steatohepatitis Remission in Mice Fed a High-Fat High-Sucrose Diet

et al. 2022

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Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) are serious health concerns for which lifestyle interventions are the only effective first-line treatment. Dietary interventions are effective in body weight reduction, but not in improving insulin sensitivity and hepatic lipid mobilization. Conversely, metformin increases insulin sensitivity and promotes the inhibition of de novo hepatic lipogenesis. In this study, we evaluated the metformin effectiveness in NASH prevention and treatment, when combined with dietary intervention in male mice fed a high-fat high-sucrose diet (HFHSD). Eighty 5-week-old C57BL/6J male mice were fed a chow or HFHSD diet and sacrificed at 20 or 40 weeks. The HFHSD-fed mice developed NASH after 20 weeks. Lipoprotein and lipidomic analyses showed that the changes associated with diet were not prevented by metformin administration. HFHSD-fed mice subject to dietary intervention combined with metformin showed a 19.6% body weight reduction compared to 9.8% in those mice subjected to dietary intervention alone. Lower hepatic steatosis scores were induced. We conclude that metformin should not be considered a preventive option for NAFLD, but it is effective in the treatment of this disorder when combined with dietary intervention.

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“…Several intervention trials have studied the effect of diet on ceramides and in relation to difference health outcomes. Since only one study was performed in patients with AIRDs [ 178 ], we discuss here the effect of diet in healthy, overweight and individuals with increased CVD risk.…”

Section: Dietary Interventions As Anti-ceramide Treatmentsmentioning

confidence: 99%

“…In the only RCT using participants with an AIRD diagnosis, Lindqvist and associates [ 178 ] applied a dietary cross-over intervention to improve the serum lipid profile of patients with RA, towards a less atherogenic one. The Anti-Inflammatory Diet In Rheumatoid Arthritis (ADIRA) trial showed that, although several components of the ceramide-and phospholipid-based CVD risk score (CERT2) were improved post-intervention, no significant difference was observed in the CERT2 of the intervention-receiving arm, compared to the control diet [ 178 ]. Furthermore, the trial revealed that a “healthier” composition of cholesteryl esters, phosphatidylcholines, alkenylphosphatidylcholines, TG and alkylphosphatidylcholines was apparent after the MD intervention was conducted [ 178 ].…”

Section: Dietary Interventions As Anti-ceramide Treatmentsmentioning

confidence: 99%

“…The Anti-Inflammatory Diet In Rheumatoid Arthritis (ADIRA) trial showed that, although several components of the ceramide-and phospholipid-based CVD risk score (CERT2) were improved post-intervention, no significant difference was observed in the CERT2 of the intervention-receiving arm, compared to the control diet [ 178 ]. Furthermore, the trial revealed that a “healthier” composition of cholesteryl esters, phosphatidylcholines, alkenylphosphatidylcholines, TG and alkylphosphatidylcholines was apparent after the MD intervention was conducted [ 178 ].…”

Section: Dietary Interventions As Anti-ceramide Treatmentsmentioning

confidence: 99%

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Ceramides in Autoimmune Rheumatic Diseases: Existing Evidence and Therapeutic Considerations for Diet as an Anticeramide Treatment

et al. 2023

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Autoimmune rheumatic diseases (AIRDs) constitute a set of connective tissue disorders and dysfunctions with akin clinical manifestations and autoantibody responses. AIRD treatment is based on a comprehensive approach, with the primary aim being achieving and attaining disease remission, through the control of inflammation. AIRD therapies have a low target specificity, and this usually propels metabolic disturbances, dyslipidemias and increased cardiovascular risk. Ceramides are implicated in inflammation through several different pathways, many of which sometimes intersect. They serve as signaling molecules for apoptosis, altering immune response and driving endothelial dysfunction and as regulators in the production of other molecules, including sphingosine 1-phosphate (S1P) and ceramide 1-phosphate (C1P). With lipid metabolism being severely altered in AIRD pathology, several studies show that the concentration and variety of ceramides in human tissues is altered in patients with rheumatic diseases compared to controls. As a result, many in vitro and some in vivo (animal) studies research the potential use of ceramides as therapeutic targets in rheumatoid arthritis (RA), ankylosing spondylitis, systemic lupus erythematosus, fibromyalgia syndrome, primary Sjögren’s syndrome, systemic sclerosis, myositis, systemic vasculitis and psoriatic arthritis. Furthermore, the majority of ceramide synthesis is diet-centric and, as a result, dietary interventions may alter ceramide concentrations in the blood and affect health. Subsequently, more recently several clinical trials evaluated the possibility of distinct dietary patterns and nutrients to act as anti-ceramide regimes in humans. With nutrition being an important component of AIRD-related complications, the present review details the evidence regarding ceramide levels in patients with AIRDs, the results of anti-ceramide treatments and discusses the possibility of using medical nutritional therapy as a complementary anti-ceramide treatment in rheumatic disease.

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A Randomized Controlled Dietary Intervention Improved the Serum Lipid Signature towards a Less Atherogenic Profile in Patients with Rheumatoid Arthritis

Cited by 8 publications

References 26 publications

Inadequate Dietary Nutrient Intake in Patients With Rheumatoid Arthritis in Southwestern Sweden: A Cross-Sectional Study

Inadequate Dietary Nutrient Intake in Patients With Rheumatoid Arthritis in Southwestern Sweden: A Cross-Sectional Study

Combining Dietary Intervention with Metformin Treatment Enhances Non-Alcoholic Steatohepatitis Remission in Mice Fed a High-Fat High-Sucrose Diet

Ceramides in Autoimmune Rheumatic Diseases: Existing Evidence and Therapeutic Considerations for Diet as an Anticeramide Treatment

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