Fri0168 positive Effects of an Anti-Inflammatory Diet in Rheumatoid Arthritis

Abstract

Background:Many patients with rheumatoid arthritis (RA) experience symptom relief of certain foods and earlier research has shown positive effects of food and food components on clinical outcomes of RA. Food components may potentiate each other in their effects on RA, but even so, studies combining foods and food components with probable effects on RA are scarce. Furthermore, comorbidities are common in RA and the risk of cardiovascular disease is elevated in this group. Assumed mechanisms include classical risk factors such as systemic inflammation, dyslipidemia as well as an unfavorable body composition.Objectives:We investigated if a diet combining foods with anti-inflammatory effects, i.e. an anti-inflammatory portfolio diet, could reduce RA disease activity, markers of inflammation, body composition and blood lipid levels compared to a control diet.Methods:In this controlled cross-over trial, 50 patients with RA were randomized to start with either intervention or control diet for ten weeks followed by a wash-out period of four months. The intervention diet was an anti-inflammatory portfolio diet containing foods rich in omega-3 fatty acids, fibers and probiotics. The control diet was a typical Swedish diet. Food equivalent to 50% of daily energy needs was delivered home weekly. For the remaining intake, participants were instructed to consume similar foods as the study diet regimen. Primary outcome measure was change in DAS28, using ESR. Secondary outcomes included changes in blood lipid levels, ESR and CRP as well as body composition.Results:No significant difference in DAS28 between the groups was seen using Mixed Models analyze (p=0.116). However, DAS28 was significantly lower after the intervention diet compared to after control diet (p=0.04) and a significant reduction over time was seen in the intervention group (p=0.012) using Wilcoxon signed rank test. HDL-cholesterol was increased and TG were lowered after intervention compared to control, analyzed using Mixed Models (p=0.046 and p=0.006 respectively). In addition, there was a non-significant trend towards lowered LDL-cholesterol (p=0.077). Comparing after intervention to after control, there were non-significant lower weight, BMI and fat mass after the intervention (p=0.077, p=0.075 and p=0.058 respectively). None of the other outcomes changed significantly between groups.Conclusion:This study showed positive effects on disease activity and blood lipid levels of a diet combining foods with anti-inflammatory properties, but the results must be confirmed in larger studies.References:[1] Agca R, et al. EULAR recommendations for cardiovascular disease risk management in patients with rheumatoid arthritis and other forms of inflammatory joint disorders: 2015/2016 update. Annals of the rheumatic diseases. 2017;76(1):17-28.[2] Piepoli MF, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clin...

An Adjunct Role Of Potassium Rich Vegetarian Diet And A Novel Potassium Food Supplement To Improve Pain In Chronic Rheumatoid Arthritis On Supervised Standard Care: A Randomized Controlled Study

“…Though predominantly vegetarian, the research (MD) was focused on n-3 polyunsaturated fatty acids (fish oils) and none of the other nutrients have been sufficiently evaluated (49). A recent Swedish controlled diet study in RA (ADIRA) showed impressive clinical improvement which was not significant as per a-priori plan-the intervention was mostly a MD like diet (including vegetables) plus probiotics (50).…”

Lipid metabolism and rheumatoid arthritis

“…Therefore, dietary intervention strategy in RA is also a hot spot in RA research. The anti-inflammatory diet has a positive effect on the disease activity of RA (144). It has been found in different systematic reviews of randomized controlled trials that a Mediterranean diet can reduce the disease activity and drug t r e a t m e n t f a i l u r e r a t e o f R A .…”

Dietary biomarkers and food records indicate compliance to study diets in the ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) trial

“…Details on the study design and recruitment can be found elsewhere (26,32). In brief, the ADIRA trial was a randomized, controlled crossover trial investigating the effects of a proposed antiinflammatory diet on symptoms such as disease activity, health related quality of life and risk factors for cardiovascular diseases in patients with RA.…”

“…ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis) was a randomized, controlled crossover trial evaluating the effects of a Mediterranean-like, proposed anti-inflammatory diet rich in whole grain, fruit and vegetables, and fatty fish on disease activity in RA. The trial was finished in 2018, and results on several outcomes have been published (26)(27)(28)(29)(30)(31). So far, compliance to the ADIRA diets has been presented using a compliance scoring system including the study food items from a telephone interview and the nutrient intake from 3-d food records, which both indicated high compliance (26).…”

“…The trial was finished in 2018, and results on several outcomes have been published (26)(27)(28)(29)(30)(31). So far, compliance to the ADIRA diets has been presented using a compliance scoring system including the study food items from a telephone interview and the nutrient intake from 3-d food records, which both indicated high compliance (26). Due to the inherent biases of these dietary assessments, there is a need to further investigate the compliance to the study diets in the ADIRA trial.…”