Diet and Rheumatoid Arthritis
An anti-inflammatory diet and fish oil supplements are both helpful for people with rheumatoid arthritis (RA), but combining them has an even greater effect according to a new study in Rheumatology International (2002;23:27–36).
RA is an autoimmune disease, a condition in which the immune system attacks the joints and other tissues. It is characterized by joint pain and swelling and high levels of inflammation. Fats from animal foods enhance the production of certain chemicals in the body that produce inflammation, and several studies have shown that people with RA improve on a vegetarian diet. Anti-inflammatory substances are produced in the body from the fats in fish oil (omega-3 fatty acids), and a number of trials have demonstrated that supplemental fish oil or omega-3 fatty acids reduces inflammation and pain in people with RA.
The medical treatment of RA involves the use of cortisone-like medications and nonsteroidal anti-inflammatory drugs (NSAIDs), as well as drugs that block the functioning of the immune system. Long-term use of NSAIDs can lead to gastritis and stomach ulcers, and long-term steroid use may impair adrenal function, cause mood changes, produce problems with the immune system, impair sugar metabolism, and cause osteoporosis. The drugs that interfere with the immune system are strong medications, each with a host of possible serious side effects. Improvement that can be achieved without drugs is, therefore, very desirable.
In this study, 62 people with RA were randomly assigned to one of two groups. One group ate a normal Western diet during the entire eight-month trial, while the other group ate an anti-inflammatory diet, in which the fats were obtained primarily from plant sources such as nuts, seeds, and liquid oils. Egg yolks were not permitted, only low-fat dairy foods were allowed, and four-ounce servings of meat were consumed no more than twice per week. During the first three months of the trial, each dietary group was again randomly divided into two groups, one receiving fish oil supplements and the other a placebo (corn oil). The oils were given in amounts determined by body weight; for example, a person weighing 150 pounds would receive about 2,000 mg of omega-3 fatty acids in seven capsules of fish oil daily. No supplements were given during months four and five, and the fish oil and placebo groups were reversed during the last three months of the trial.
The anti-inflammatory diet improved joint pain, swelling, and overall ability to function by 14%, while the Western diet did not improve symptoms or functioning. Benefits were observed with the addition of fish oil, bringing total improvement to 17% in those eating a Western diet and 37% in those eating the anti-inflammatory diet. Furthermore, the need for anti-inflammatory medications was significantly reduced for those receiving fish oil on both diets, although the group eating the anti-inflammatory diet had greater medication reduction. Medication usage increased for those on the Western diet plus placebo.
The results of this study demonstrate the cumulative effect of altering the fats stored in the body through both dietary changes and dietary supplements.
Another dietary approach to RA and other autoimmune diseases involves identifying specific food allergens and eliminating them from the diet. While some individuals experience marked improvement from eating a low-allergen diet, research suggests that food allergy is an important factor in only a minority of people with RA. The value of combining the low-allergen and anti-inflammatory diets along with supplemental fish oil has yet to be determined.
Maureen Williams, ND, received her bachelor’s degree from the University of Pennsylvania and her Doctorate of Naturopathic Medicine from Bastyr University in Seattle, WA. She has a private practice in Quechee, Vermont, and does extensive work with traditional herbal medicine in Guatemala and Honduras. Dr. Williams is a regular contributor to Healthnotes Newswire.
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