Weight reduction is not a major reason for improvement in rheumatoid arthritis from lacto-vegetarian, vegan or Mediterranean diets

Abstract

Objectives: Several investigators have reported that clinical improvements of patients with rheumatoid arthritis (RA), from participating in therapeutic diet intervention studies, have been accompanied by loss of body weight. This has raised the question whether weight reduction per se can improve RA. In order to test this hypothesis, three previously conducted diet intervention studies, comprising 95 patients with RA, were pooled. Together with Age, Gender, and Disease Duration, change during the test period in body weight, characterised dichotomously as reduction or no reduction (dicho∆Body Weight), as well as Diet (dichotomously as ordinary diet or test diet), were the independent variables. Dependent variables were the difference (∆) from baseline to conclusion of the study in five different disease outcome measures. ∆ESR and ∆Pain Score were both characterised numerically and dichotomously (improvement or no improvement). ∆Acute Phase Response, ∆Physical Function, and ∆Tender Joint Count were characterised dichotomously only. Multiple logistic regression was used to analyse associations between the independent and the disease outcome variables.Results: Statistically significant correlations were found between Diet and three disease outcome variables i.e. ∆Acute-Phase Response, ∆Pain Score, and ∆Physical Function. ∆ Body Weight was univariately only correlated to ∆Acute-Phase Response but not significant when diet was taken into account. Conclusion:Body weight reduction did not significantly contribute to the improvement in rheumatoid arthritis when eating lacto-vegetarian, vegan or Mediterranean diets.

Changes in plasma levels of fat-derived hormones adiponectin, leptin, resistin and visfatin in patients with rheumatoid arthritis

“…At any rate, the efficacy of weight reduction strategies that include prolonged reduction of energy intake have little, if any, influence on inflammation in rheumatoid arthritis. 19 Perhaps, the potential suppressive effect of a low-energy diet and starvation is not surprising with regard to what is already known from research on leptin physiology. Indeed, starvation is characterised by low leptin levels.…”

Counting the cost of healthy eating: a Swedish comparison of Mediterranean‐style and ordinary diets

“…In our study, the Mediterranean group consumed less energy than the control group and also lost on average 2.5 kg over the 3‐month intervention period. This weight loss was not an aim of the study, but rather a consequence of changing dietary habits (Skoldstam et al ., 2005). In the cost comparison between the Mediterranean group and the control group, there was no significant difference when comparing the total cost unadjusted for energy intake.…”

The Mediterranean Diet and Arthritis

“…Although the patients in the MD group had a significant weight loss during the trial, there was no correlation between the improvement in disease activity and weight loss [43].…”