Don’t neglect nutrition in rheumatoid arthritis!

Cutolo, Maurizio; Nikiphorou, Elena

doi:10.1136/rmdopen-2017-000591

Cited by 38 publications

(54 citation statements)

References 47 publications

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“…red meat, salt, excessive food intake) or reduce inflammation (e.g. fatty fish, fruit and vegetables) [4][5][6]. Indeed, the trend towards a higher prevalence of autoimmune diseases, including RA, in Western societies as opposed to the Eastern world and developing countries [7], implicates a number of possible environmental triggers.…”

Section: Dietary Factors As 'Triggers' Of Diseasementioning

confidence: 99%

“…Additionally, an increased sodium (salt) intake, also characteristic of the 'Western' diet, has been associated with a higher risk of RA with a dose-response relationship between sodium intake and diagnosis of RA [18]. Pathways of inflammation caused by sodium chloride have been recently reviewed [5] bringing back to light the potential deleterious effects of high sodium chloride consumption. In line with this, an increased risk of anti-cyclic citrullinated antibody (ACPA) positivity [19], (suggesting a high risk of imminent RA in those without disease) has been reported among high sodium intake (heavy) smokers [20] .…”

Section: Accepted Manuscriptmentioning

confidence: 99%

“…properties. The MD is a plant-based diet abundant in wholegrains, legumes,5 or more fruit and vegetables per day, preferably seasonal and produced locally, daily consumption of extra-virgin olive oil along with 1-2/week consumption of fatty fish, weekly consumption of other types of fish and poultry, and limited consumption of red meat to 1-2 per month. We advocate avoiding or at least reducing consumption of sugar-sweetened drinks, limiting coffee consumption to 3 cups a day, and if alcohol is consumed, drink in A C C E P T E D M A N U S C R I P T moderation and with meals.…”

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confidence: 99%

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Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis

Philippou

Nikiphorou

2018

Autoimmunity Reviews

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111

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Accumulating research evidence suggests that individual dietary factors and dietary patterns might be implicated in the risk of development of rheumatoid arthritis (RA). This narrative review aims to present this evidence and provide nutritional recommendations for reducing RA risk in susceptible individuals. Overall, a 'Western' type diet rich in energy intake, total and saturated fat, an unbalanced ratio of n-3 to n-6 fatty acids, high in refined carbohydrates and sugar and low in fiber and antioxidants might increase the risk of RA both directly through increasing inflammation and indirectly through increasing insulin resistance and obesity, with the latter being a known risk factor for RA. On the contrary, consumption of long-chain omega-3 polyunsaturated fatty acids, derived from fish and fish oil, is associated with a reduced risk of RA probably due to their anti-inflammatory properties. The Mediterranean diet (MD), rich in plant-based foods such as wholegrains, legumes, fruit, vegetables, extra-virgin olive oil and low in red meat consumption, might have the potential to reduce the risk of RA. Based on current research evidence, it is suggested that adherence to the MD enhanced with an increased consumption of fatty fish, reduced consumption of sugar-sweetened drinks and maintenance of a normal body weight, contributes to reducing the risk of RA. Further research on RA susceptibility will allow for more specific dietary recommendations to be made.

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Section: Dietary Factors As 'Triggers' Of Diseasementioning

confidence: 99%

Section: Accepted Manuscriptmentioning

confidence: 99%

mentioning

confidence: 99%

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Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis

Philippou

Nikiphorou

2018

Autoimmunity Reviews

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111

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“…Various studies have shown that one’s dietary habits play an important role in regulating chronic inflammation [ 4 , 5 ] and demonstrate a “dietary basis” for the inflammatory presentation in rheumatic and musculoskeletal diseases, recommending an organized multidisciplinary approach to manage these conditions [ 6 , 7 ]. An ideal nutritional pattern is essential for regulating inflammation and oxidative stress, which are interrelated with the immune system [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Dietary inflammatory index is associated with pain intensity and some components of quality of life in patients with knee osteoarthritis

et al. 2020

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Objectives We aim to measure dietary inflammatory index (DII) and its association with functional status, pain intensity and quality of life (QOL) in patients with knee osteoarthritis (KOA). Dietary information from 220 qualified patients with KOA was collected by a 168-item food frequency questionnaire. The functional status, pain intensity and QOL were evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, Visual Analogue Scale (VAS) and SF36 questionnaire respectively. Results Linear regression analysis showed that the DII was significantly associated with VAS (p = 0.040; β = 0.151), and physical function (p = 0.039; β = − 0.184), emotional wellbeing (p = 0.048; β = − 0.158) and pain (p = 0.020; β = 0.161) scales and physical health (p = 0.047; β = 0.110) subscale of QOL after adjusting for age, sex, body mass index, and physical activity. There was no significant differences concerning WOMAC across the DII tertiles with and without adjustment to probable confounders (Ptrend = 0.091 and 0.181, respectively). After adjustment, a significantly increased severe pain odds was observed in the highest tertile of DII score in comparison with the lowest tertile (OR tertile 3 vs. 1 = 1.55, 95% CI 1.04–2.31; Ptrend = 0.04).

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“…However, it is up to the person how to mix and match the nutrients and if to complement it with voluptuary habits such as alcohol and coffee drinking. This highlights the huge potential to modulate dietary habits for preventive purposes not only in patients with an established RMD as secondary prevention [2] but also in the general population to reduce the risk of RMD development.…”

Section: Introductionmentioning

confidence: 99%

Nutrition in RMDs: is it really food for thought? Focus on rheumatoid arthritis

et al. 2020

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Background: The relationship between food and health is known since the antiquity and in the field of rheumatic and musculoskeletal diseases (RMDs), mainly rheumatoid arthritis (RA), a large number of studies has been published over the last 50 years encompassing different aspects of nutrition. This led to postulate a role of nutrients for both primary prevention of RMDs in the general population and secondary prevention of disease flares and complications in patients with an established RMD. Main body of abstract: We aimed to summarise and critically discuss current evidence on the role of different nutrients and dietary regimens in RMDs with a focus on RA. Over the last years, some seminal papers proved that some compounds, such as salt, can directly modulate the immune system and large epidemiological studies have been linking dietary patters with the risk to develop RMDs. However, physicians' knowledge about the role of diet in disease prevention and treatment is often poor and ultimately diet is rarely perceived as a companion of pharmacological treatment. Conclusions: Based on the currently available evidence, we are not (yet?) in the phase of putting diet on the same level as pharmacological treatment in RMDs and in particular, RA, but future studies will likely shed additional light on this controversial topic and at least might suggest a value as dietary prevention of risk factors.

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Don’t neglect nutrition in rheumatoid arthritis!

Cited by 38 publications

References 47 publications

Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis

Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis

Dietary inflammatory index is associated with pain intensity and some components of quality of life in patients with knee osteoarthritis

Nutrition in RMDs: is it really food for thought? Focus on rheumatoid arthritis

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