Diet and Rheumatoid Arthritis: A Review of the Literature

Royal Adelaide Hospital, Tarndarnya, South Australia, Australia
Seminars in Arthritis and Rheumatism (Impact Factor: 3.93). 11/2005; 35(2):77-94. DOI: 10.1016/j.semarthrit.2005.05.001
Source: PubMed


Rheumatoid arthritis is a common inflammatory condition. A large number of patients seek alternative or complementary therapies of which diet is an important component. This article reviews the evidence for diet in rheumatoid arthritis along with the associated concept of oral tolerization.
References were taken from Medline from 1966 to September 2004. The keywords, rheumatoid arthritis, diet, n-3 fatty acids, vitamins, and oral tolerization, were used.
Randomized controlled trials (RCTs) indicate that dietary supplementation with n-3 fatty acids provides modest symptomatic benefit in groups of patients with rheumatoid arthritis. Epidemiological studies and RCTs show cardiovascular benefits in the broader population and patients with ischemic heart disease. A number of mechanisms through which n-3 fats may reduce inflammation have been identified. In a small number of patients with rheumatoid arthritis, other dietary manipulation such as fasting, vegan, and elimination diets may have some benefit. However, many of these diets are impractical or difficult to sustain long term.
Dietary manipulation provides a means by which patients can a regain a sense of control over their disease. Dietary n-3 supplementation is practical and can be easily achieved with encapsulated or, less expensively, bottled fish oil.

Download full-text


Available from: Leslie Cleland
  • Source
    • "Rheumatoid arthritis is a systemic autoimmune illness characterized by chronic inflammation of synovial joints leading to destruction of cartilage and bone, and affects about 1% of world's total population (Borchers et al., 2004; Chunxia et al., 2011; Maini and Taylor, 2000; Sanchez-Fidalgo et al., 2010; Stamp et al., 2005). A great number of patients suffering from rheumatoid arthritis have been looking for alternative or complementary therapies of which diet is one of the most important factors. "
    [Show abstract] [Hide abstract]
    ABSTRACT: The present study was carried out to investigate the effects of nanopowdered peanut sprout-added Caciocavallo cheese (NPCC) on the prevention and treatment of rheumatoid arthritis in DBA/IJ mice immunized with type II collagen. After the induction of arthritis, the mice were being divided into five groups: (1) normal, no immunization; (2) CIA, collagen-induced arthritis; (3) MTX, collagen-induced arthritis treated with methotrexate (0.3 mg/kg body weight); (4) CC, collagen-induced arthritis treated with Caciocavallo cheese (0.6 g/d); (5) NPCC, collagen-induced arthritis treated with nanopowdered peanut sprout-added Caciocavallo cheese (0.6 g/d). Nanopowdered peanut sprout was ranged from 300 to 350 nm, while regular powdered peanut sprouts were ranged from 50 to . The NPCC group had considerable reductions of clinical scores and paw thicknesses at the end of experiment as compared to the CIA group. In the serum analysis, the TNF-, IL-, IL-6 and levels in the NPCC group have decreased by 69.4, 75.9, 66.6, and 61.9%, respectively, when compared to the CIA group. The histological score and spleen index of the NPCC group were significantly lower than the CIA group. In conclusion, the feeding NPCC method could delay and/or prevent the rheumatoid arthritis in the collagen-induced arthritis mouse model. Based on this study, nanopowdered peanut sprouts could be applied to various functional cheeses.
    Preview · Article · Feb 2014 · Hangug chugsan sigpum haghoeji = Korean journal for food science of animal resources
  • Source
    • "It has already been shown that bioactive peptides isolated from fish protein hydrolysates, algal fucans, galactans and alginates possess anticoagulant, anticancer and hypocholesterolemic activities [10]. Fish oils and marine bacteria are known to be excellent sources of omega-3 fatty acids (whose importance in the treatment of arthritis has been extensively investigated [11,12], assessing their analgesic effects in joint pain), while seaweeds and crustaceans contain powerful antioxidants, such as carotenoids and phenolic compounds [13]. In this respect, new marine bioactives, such as COX inhibitors (Pacifenol, Epitaondiol and Stypotriol triacetate), marine steroids (Contignasterol, Xestobergesterol, Clathriol B), molecules interfering with NF-κB (Cycloprodigiosine, Hymenialdisine and Cycloamphilectenes), macrolides, peptides (Cyclomarins, Salinamides and Halipeptins), other metabolites (Scytonemin and Petrocortyne) and many antioxidant agents (phenols and marine carotenoids, such as astaxanthin, fucoxanthin) have been recently discovered and characterized, in order to assess their potential role in contrasting inflammatory diseases. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Inflammation is a hot topic in medical research, because it plays a key role in inflammatory diseases: rheumatoid arthritis (RA) and other forms of arthritis, diabetes, heart diseases, irritable bowel syndrome, Alzheimer's disease, Parkinson's disease, allergies, asthma, even cancer and many others. Over the past few decades, it was realized that the process of inflammation is virtually the same in different disorders, and a better understanding of inflammation may lead to better treatments for numerous diseases. Inflammation is the activation of the immune system in response to infection, irritation, or injury, with an influx of white blood cells, redness, heat, swelling, pain, and dysfunction of the organs involved. Although the pathophysiological basis of these conditions is not yet fully understood, reactive oxygen species (ROS) have often been implicated in their pathogenesis. In fact, in inflammatory diseases the antioxidant defense system is compromised, as evidenced by increased markers of oxidative stress, and decreased levels of protective antioxidant enzymes in patients with rheumatoid arthritis (RA). An enriched diet containing antioxidants, such as vitamin E, vitamin C, β-carotene and phenolic substances, has been suggested to improve symptoms by reducing disease-related oxidative stress. In this respect, the marine world represents a largely untapped reserve of bioactive ingredients, and considerable potential exists for exploitation of these bioactives as functional food ingredients. Substances such as n-3 oils, carotenoids, vitamins, minerals and peptides provide a myriad of health benefits, including reduction of cardiovascular diseases, anticarcinogenic and anti-inflammatory activities. New marine bioactives are recently gaining attention, since they could be helpful in combating chronic inflammatory degenerative conditions. The aim of this review is to examine the published studies concerning the potential pharmacological properties and application of many marine bioactives against inflammatory diseases.
    Full-text · Article · Apr 2012 · Marine Drugs
  • Source
    • "Sometimes fishy halitosis or fishy body odour (Cleland et al., 2003) so as nausea and moderate gastrointestinal disorder (Gissi-HF Investigators et al., 2008; Ross et al., 2007) occur. Moreover, the additionally applied dietary manipulation provides a resource enabling patients to regain the perception of controlling their disease (Stamp et al., 2005). The major barrier for a broad therapeutic use of fish oil in inflammatory diseases, though, constitutes the delayed onset of efficacy (Cleland et al., 2006) that may last up to more than three months. "
    [Show abstract] [Hide abstract]
    ABSTRACT: ABSTRACT: The n-3 polyunsaturated fatty (PUFA) acids and among them the n-3 PUFAs from fish oil – eicosapentaenoic acid and docosahexaenoic acid - own potent immunomodulatory potential. This can be beneficially utilized in cardiovascular disease or depression as well as in rheumatoid arthritis. A commonly accepted opinion about the minimum dosage to gain a therapeutic effect has not been formed yet. In order to achieve an amelioration of symptoms in RA the concluding recommendation is to consume dietary supplements containing three to six gram n-3 fatty acids daily for > 12 weeks. Following these suggestions patients taking dietary supplements of fish oil show improvements in clinical parameters including the number of tender joints, the duration of morning stiffness as well as the patient´s evaluation of global arthritis activity. Finally, the intake of n-3 PUFAs can only be recommended as an add-on therapy and must not replace the standard therapeutic regimes. A large research agenda remains to be worked on in order to be able to determine the role of therapeutic effects of n-3 PUFAs in RA. KEY WORDS: Fish oil, n-3 PUFA, n-6 PUFA, Rheumatoid arthritis
    Full-text · Article · Jan 2008 · Current Topics in Nutraceutical Research
Show more