Review of Dietary Therapy for Rheumatoid Arthritis

Abstract

There are now sufficient good scientific studies, from the UK and abroad, to suggest that, at least in some patients with RA, dietary therapy may influence at least the symptoms and possibly the progression of the disease. Since dietary treatment is safe and may reduce or avoid the need for drugs, it is appealing to patients, who are increasingly anxious about potential drug toxicity. It must, however, be medically supervised to avoid misinterpretation of results, to avoid patients taking diets to extremes, with resultant malnutrition, particularly in children, and to prevent patients from persisting with ineffective diets when they should be receiving drug treatment. Medical interest in dietary treatment also ensures that patients discuss their diets with orthodox practitioners rather than being driven by our scepticism into the hands of unqualified people who may exploit patients' interest in the subject.

Dietary manipulation in musculoskeletal conditions

“…These may be absorbed in quantities sufficient to produce immunological responses leading to overt expression of RA [5]. Highly spiced foods, cereal grains, lectins (from legumes/cereals) strong coffee or tea and alcohol can increase gut permeability.…”

“…Foods such as beans, wheat, peanuts, peas and lentils, contain lectins and indeed foods commonly associated with food allergy such as peanuts and wheat are particularly rich in lectins [5].…”

Vitamin E uncouples joint destruction and clinical inflammation in a transgenic mouse model of rheumatoid arthritis

“…Many therapeutic trials have assessed the clinical value of antioxidants in RA (1,(8)(9)(10)(11), administered in an effort to restore a normal pool of ROS scavengers and modulate eicosanoic acid production. The results are controversial, mainly because of the heterogeneity of the patients studied (5,11).…”

“…The results are controversial, mainly because of the heterogeneity of the patients studied (5,11). One clinical trial, testing the benefit of vitamin E combined with the nonsteroidal antiinflammatory drug (NSAID) diclofenac, showed good tolerability and analgesic effects of vitamin E, allowing the doses of the NSAID to be tapered.…”

“…), and the concomitant use of steroids was allowed. The potential long-term benefit of antioxidants in RA remains unknown (11,13), particularly in terms of clinically relevant end points, such as bone erosion, steroid sparing, disability, and survival.…”