Current nutritional approaches on rheumatoid arthritis

Year 2023, Volume: 4 Issue: 3, 96 - 103, 30.12.2023

Miray Buse Aksu , Başak Öney

https://doi.org/10.58208/cphs.1261860

Abstract

The aim of this study is to investigate and evaluate the application of nutritional therapy in patients with rheumatoid arthritis and its effects observed as a result. Rheumatoid arthritis is an autoimmune disease that mostly occurs in people >40 years of age, especially in small joints. Rheumatoid arthritis is seen in many countries, including in our country, and is increasing over time. This disease meets the diagnostic criteria published by the American Society of Rheumatology, and after going to a doctor and being diagnosed, medication and nutritional treatments are started. Both genetic and environmental factors play an important role in the formation of rheumatoid arthritis. In addition, among the factors affecting rheumatoid arthritis disease, many of them have been found to have a relationship with nutrition. Although a diet rich in antioxidants is recommended especially for rheumatoid arthritis patients, attention should also be paid to vitamin and mineral supplements in these patients. However, although no definitive evidence has been reached yet, it has been found that omega-3 fatty acids are good for rheumatoid arthritis. For this reason, a diet rich in omega-3 fatty acids is also recommended. Among the most commonly applied diets for Rheumatoid Arthritis disease; Mediterranean diet, Elimination, Vegan and Vegetarian are included. According to the research results of the applied dietary treatments, most of them have positive results, but definite conclusions have not yet been reached. In general, nutritional therapy has been found to reduce joint pain and reduce swelling in rheumatoid arthritis patients. As a result, rheumatoid arthritis patients should be fed regularly, appropriate diets should be recommended to the patient, and despite joint pain, they should not lack physical activity.

Keywords

rheumatoid arthritis, risk factors, nutritional therapy, diet

Romatoid artrite güncel beslenme yaklaşımları

Abstract

Bu çalışmanın amacı romatoid artritli hastalarda beslenme tedavisi uygulanması ve bunun sonucunda görülen etkilerini araştırmak ve değerlendirmektir. Romatoid artrit çoğunlukla 40 yaş üstü bireylerde, özellikle küçük eklemlerde görülen otoimmün bir hastalıktır. Romatoid artrit, bizim ülkemizde dahil olmak üzere birçok ülkede görülen ve zamanla artmaktadır. Bu hastalık Amerikan Romatoloji Derneği tarafından yayınlanan tanı kriterlerini karşılaması ile bir doktora gidip teşhis konulduktan sonra ilaç ve beslenme tedavilerine başlanılmaktadır. Ayrıca romatoid artrit hastalığını etkileyen faktörler arasında birçoğu da beslenme ile ilişkisi olduğu görülmüştür. Romatoid artrit hastalarında özellikle antioksidanlardan zengin beslenme önerilmekle beraber bu hastalarda vitamin ve mineral takviyelerine de dikkat edilmelidir. Bununla beraber henüz kesin kanıtlara varılmasa da omega-3 yağ asitlerinin romatoid artrite iyi geldiği görülmüştür. Bu yüzden omega-3 yağ asidinden zengin bir beslenme düzeni de tavsiye edilmektedir. Romatoid artrit hastalığına yönelik en çok uygulanan diyetler arasında; akdeniz diyeti, eliminasyon, vegan ve vejetaryen diyetleri bulunmaktadır. Uygulanan diyet tedavilerinin araştırma sonuçlarına göre çoğu olumlu sonuçlanmakla beraber henüz kesin kanılara varılamamıştır. Genel olarak beslenme tedavisinin romatoid artrit hastalarında eklem ağrıları azalttığı ve şişmeleri indirdiği görülmüştür. Sonuç olarak romatoid artrit hastalarının düzenli beslenmesi, hastaya uygun diyetler tavsiye edilmesi gerekmektedir.

Keywords

romatoid artrit, risk faktörleri, beslenme tedavisi, diyet

References

• Bozbulut R, İşgüzar Y, Akbulut G. Romatolojik ve Kemik Eklem Hastalıklarında Tıbbi Beslenme Tedavisi. Editör: Akbulut, G. Tıbbi Beslenme Tedavisinde Güncel Uygulamalar. Ankara: Ankara Nobel Tıp Kitabevleri; 2019:300-378.
• Mahan LK, Raymond JL. Krause Besin ve Beslenme Bakım Süreci. Ankara: Ankara Nobel Tıp Kitabevleri; 2019.
• Lin YJ, Anzaghe M, Schülke S. Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells. 2020;9(4):880.
• van der Woude D, van der Helm-van Mil AHM. Update on the epidemiology, risk factors, and disease outcomes of rheumatoid arthritis. Best Pract Res Clin Rheumatol. 2018;32(2):174-187.
• Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis. Eur J Radiol. 1998;27(1):18-24.
• Jeffery RC. Clinical features of rheumatoid arthritis. Medicine. 2014;42(5):231-236.
• Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum. 1988;31(3):315-324.
• Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Ann Rheum Dis. 2010;69(9):1580-1588.
• Gioia C, Lucchino B, Tarsitano MG, Iannuccelli C, Di Franco M. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations?. Nutrients. 2020;12(5):1456.
• Philippou E, Nikiphorou E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018;17(11):1074-1077.
• Rondanelli M, Perdoni F, Peroni G, Caporali R, Gasparri C, Riva A, et al. Ideal food pyramid for patients with rheumatoid arthritis: A narrative review. Clin Nutr. 2021;40(3):661-689.
• Tedeschi SK, Frits M, Cui J, et al. Diet and Rheumatoid Arthritis Symptoms: Survey Results From a Rheumatoid Arthritis Registry. Arthritis Care Res (Hoboken). 2017;69(12):1920-1925.
• He J, Wang Y, Feng M, et al. Dietary intake and risk of rheumatoid arthritis-a cross section multicenter study. Clin Rheumatol. 2016;35(12):2901-2908.
• A. Linos, V. Kaklamani, E. Kaklamani, Y. Koumantaki, E. Giziaki, S. Papazoglou, et al. Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables? Am J Clin Nutr. 1999;70:1077-1082.
• Khanna S, Jaiswal KS, Gupta B. Managing Rheumatoid Arthritis with Dietary Interventions. Front Nutr. 2017;4:52.
• Athanassiou P, Athanassiou L, Kostoglou-Athanassiou I. Nutritional Pearls: Diet and Rheumatoid Arthritis. Mediterr J Rheumatol. 2020;31(3):319-324.
• Philippou E, Petersson SD, Rodomar C, Nikiphorou E. Rheumatoid arthritis and dietary interventions: systematic review of clinical trials. Nutr Rev. 2021;79(4):410-428.
• Badsha H. Role of Diet in Influencing Rheumatoid Arthritis Disease Activity. Open Rheumatol J. 2018;12:19-28.
• Tedeschi SK, Costenbader KH. Is There a Role for Diet in the Therapy of Rheumatoid Arthritis?. Curr Rheumatol Rep. 2016;18(5):23.
• Alwarith J, Kahleova H, Rembert E, Yonas W, Dort S, Calcagno M, et al. Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review. Front Nutr. 2019;6:141.
• Karatay S, Erdem T, Yildirim K, et al. The effect of individualized diet challenges consisting of allergenic foods on TNF-alpha and IL-1beta levels in patients with rheumatoid arthritis. Rheumatology (Oxford). 2004;43(11):1429-1433.
• Cutolo M, Otsa K, Uprus M, Paolino S, Seriolo B. Vitamin D in rheumatoid arthritis. Autoimmun Rev. 2007;7(1):59-64.
• Meena N, Singh Chawla SP, Garg R, Batta A, Kaur S. Assessment of Vitamin D in Rheumatoid Arthritis and Its Correlation with Disease Activity. J Nat Sci Biol Med. 2018;9(1):54-58.
• Harrison SR, Li D, Jeffery LE, Raza K, Hewison M. Vitamin D, Autoimmune Disease and Rheumatoid Arthritis. Calcif Tissue Int. 2020;106(1):58-75.
• Kostoglou-Athanassiou I, Athanassiou P, Lyraki A, Raftakis I, Antoniadis C. Vitamin D and rheumatoid arthritis. Ther Adv Endocrinol Metab. 2012;3(6):181-187.
• Prescha A, Zabłocka-Słowińska K, Płaczkowska S, Gorczyca D, Łuczak A, Majewska M, et al. Diet Quality and Its Relationship with Antioxidant Status in Patients with Rheumatoid Arthritis. Oxid Med Cell Longev. 2018;2018:8506343.
• Bala A, Mondal C, Haldar PK, Khandelwal B. Oxidative stress in inflammatory cells of patient with rheumatoid arthritis: clinical efficacy of dietary antioxidants. Inflammopharmacology. 2017;25(6):595-607.
• Kou H, Qing Z, Guo H, Zhang R, Ma J. Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis. European Journal of Clinical Nutrition. 2023;77(2):166-172.
• Silva BN, Araújo ÍL, Queiroz PM, Duarte AL, Burgos MG. Intake of antioxidants in patients with rheumatoid arthritis. Rev Assoc Med Bras (1992). 2014;60(6):555-559.
• Xin L, Yang X, Cai G, Fan D, Xia Q, Liu L, et al. Serum Levels of Copper and Zinc in Patients with Rheumatoid Arthritis: a Meta-analysis. Biol Trace Elem Res. 2015;168(1):1-10.
• Frangos T, Maret W. Zinc and Cadmium in the Aetiology and Pathogenesis of Osteoarthritis and Rheumatoid Arthritis. Nutrients. 2020;13(1):53.
• Qamar N, John P, Bhatti A. Emerging role of selenium in treatment of rheumatoid arthritis: An insight on its antioxidant properties. J Trace Elem Med Biol. 2021;66:126737.
• Jaswal S, Mehta HC, Sood AK, Kaur J. Antioxidant status in rheumatoid arthritis and role of antioxidant therapy. Clin Chim Acta. 2003;338(1-2):123-129.
• Lee YH, Bae SC, Song GG. Omega-3 polyunsaturated fatty acids and the treatment of rheumatoid arthritis: a meta-analysis. Arch Med Res. 2012;43(5):356-362.
• Veselinovic M, Vasiljevic D, Vucic V, Arsic A, Petrovic S, Tomic-Lucic A, et al. Clinical Benefits of n-3 PUFA and ɤ-Linolenic Acid in Patients with Rheumatoid Arthritis. Nutrients. 2017;9(4):325.
• Goldberg RJ & Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain 2007; 129: 210–233.
• Kostoglou-Athanassiou I, Athanassiou L, Athanassiou P. The Effect of Omega-3 Fatty Acids on Rheumatoid Arthritis. Mediterr J Rheumatol. 2020;31(2):190-194.