Re-evaluation of dietary interventions in rheumatoid arthritis: can we improve patient conversations around food choices?

Abstract

Rheumatoid arthritis (RA) is one of over 100 different types of autoimmune conditions. In RA, the cells of the immune system attack the tissue lining the joints, triggering inflammation. A large body of research suggests that the underlying trigger(s) of RA are unique to an individual. For example, increased risk of RA can be driven by smoking tobacco in one individual and mercury exposure in another. Due to the development of next-generation sequencing technology, the critical role of the microbiota in shaping RA risk has been elucidated. Therefore, it is surprising that diet, arguably the most important lever in shaping the gut microbiota, is ineffective in the treatment of RA, even in a sub-set of patients. To attempt to rationalise this apparent paradox, we conducted an umbrella review to address the question as to whether diet can affect outcomes in RA.

Disease activity and fatigue in inflammatory arthritis patients with different dietary preferences: a retrospective exploratory cross-sectional study

“…Our study found no differences between the EAG and the low-carbohydrate group [ 47 ]. Also, we did not find benefits of other elimination diets, which, according to the authors of a recent review [ 48 ], are a powerful tool for reducing inflammation, including due to the effect on the microbiota. However, to date, they are not clearly stated in the guidelines and require predetermining levels of antibodies to dietary proteins.…”