Nutrition in RMDs: is it really food for thought? Focus on rheumatoid arthritis

Alunno, Alessia; Nikiphorou, Elena; Philippou, Elena; Daïen, C.; Wiek, Dieter; Kouloumas, Marios; Cutolo, Maurizio

doi:10.1186/s41927-020-0113-4

Cited by 15 publications

(12 citation statements)

References 37 publications

(39 reference statements)

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“…The beneficial effects of the MD in health and disease have been widely reported, but only a small number of trials have focused on RA [ 98 ]. Although research in the field of diet–health relationships is changing its paradigm, and the study of whole dietary patterns is becoming more pertinent [ 130 ], more relevance has been given to the impact of specific components in RA-related outcomes [ 98 ].…”

Section: Mediterranean Diet As a Modulator Of Gut Microbiota In Rhmentioning

confidence: 99%

Diet as a Modulator of Intestinal Microbiota in Rheumatoid Arthritis

et al. 2020

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Rheumatoid arthritis (RA) is a chronic immune-driven inflammatory disease characterised by synovial inflammation, leading to progressive cartilage and bone destruction, impacting patients’ functional capacity and quality of life. Patients with RA have significant differences in gut microbiota composition when compared to controls. Intestinal dysbiosis influences the intestinal barrier strength, integrity and function, and diet is considered the main environmental factor impacting gut microbiota. Over the last few years, researchers have focused on the influence of single components of the diet in the modulation of intestinal microbiota in RA rather than whole dietary patterns. In this review, we focus on how the Mediterranean diet (MD), a whole dietary pattern, could possibly act as an adjuvant therapeutic approach, modulating intestinal microbiota and intestinal barrier function in order to improve RA-related outcomes. We also review the potential effects of particular components of the MD, such as n-3 polyunsaturated fatty acids (PUFAs), polyphenols and fibre.

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Section: Mediterranean Diet As a Modulator Of Gut Microbiota In Rhmentioning

confidence: 99%

Diet as a Modulator of Intestinal Microbiota in Rheumatoid Arthritis

et al. 2020

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“…In addition, there is a report that the intake of micro-nutrients such as curcumin (present in turmeric), which has anti-inflammatory effects, can reduce disease activity in RA patients [ 6 ]. Therefore, dietary therapy focusing on the function of nutrients in RA patients is attracting attention [ 7 ]. However, it is also true that there are very few studies reporting findings that have used evidence-based methods for assessing exposure.…”

Section: Introductionmentioning

confidence: 99%

Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

et al. 2021

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Background The dietary inflammatory index (DII®), a quantitative measure of the inflammatory potential of daily food and nutrient intake, and associations between a variety of health outcomes have been reported. However, the association between DII score and disease activity of rheumatoid arthritis (RA) is unclear. Therefore, this study was designed to test whether higher DII score contributes to disease activity and as a corollary, whether reducing DII score helps to achieve or maintain low disease activity or remission in patients with RA. Methods We performed a cross-sectional and longitudinal analysis using 6 years of data (from 2011 to 2017) in TOMORROW, a cohort study consisting of 208 RA patients and 205 gender- and age-matched controls started in 2010. Disease activity of RA patients was assessed annually using DAS28-ESR (disease activity score 28 joints and the erythrocyte sedimentation rate) as a composite measure based on arthritic symptoms in 28 joints plus global health assessment and ESR. Dietary data were collected in 2011 and 2017 using the brief-type self-administered diet history questionnaire (BDHQ). Energy-adjusted DII (E-DII™) score was calculated using 26 nutrients derived from the BDHQ. Data were analyzed with two-group comparisons, correlation analysis, and multivariable logistic regression analysis. Results One hundred and seventy-seven RA patients and 183 controls, for whom clinical and dietary survey data were available, were analyzed. RA patients had significantly higher E-DII (pro-inflammatory) score compared to controls both in 2011 and 2017 (p < 0.05). In RA patients, E-DII score was not a factor associated with significant change in disease activity. However, anti-inflammatory change in E-DII score was associated maintaining low disease activity (DAS28-ESR ≤ 3.2) or less for 6 years (OR 3.46, 95% CI 0.33–8.98, p = 0.011). Conclusions The diets of RA patients had a higher inflammatory potential than controls. Although E-DII score was not a factor associated with significant disease activity change, anti-inflammatory change in E-DII score appeared to be associated with maintaining low disease activity in patients with RA. Trial registration UMIN Clinical Trials Registry, UMIN000003876. Registered 7 Aug 2010—retrospectively registered.

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“…In the context of the current evidence [ 31 ], we will provide an overall picture of DPs identified in this large sample of RA patients from northern Italy, and we will assess the effect of each actual DP on RA activity, after controlling for the remaining DPs, as well medication, disease history, lifestyle habits, and anthropometric data.…”

Section: Introductionmentioning

confidence: 99%

A Posteriori Dietary Patterns and Rheumatoid Arthritis Disease Activity: A Beneficial Role of Vegetable and Animal Unsaturated Fatty Acids

et al. 2020

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To our knowledge, no studies have investigated the relationship between a posteriori dietary patterns (DPs)—representing current dietary behavior—and disease activity in patients with rheumatoid arthritis (RA). We analyzed data from a recent Italian cross-sectional study including 365 RA patients (median age: 58.46 years, 78.63% females). Prevalent DPs were identified through principal component factor analysis on 33 nutrients. RA activity was measured according to the Disease Activity Score on 28 joints (DAS28) and the Simplified Disease Activity Index (SDAI). Single DPs were related to disease activity through linear and logistic regression models, adjusted for the remaining DPs and confounders. We identified five DPs (~80% variance explained). Among them, Vegetable unsaturated fatty acids (VUFA) and Animal unsaturated fatty acids (AUFA) DPs were inversely related to DAS28 in the overall analysis, and in the more severe or long-standing RA subgroups; the highest score reductions (VUFA: 0.81, AUFA: 0.71) were reached for the long-standing RA. The SDAI was inversely related with these DPs in subgroups only. This Italian study shows that scoring high on DPs based on unsaturated fats from either source provides independent beneficial effects of clinical relevance on RA disease activity, thus strengthening evidence on the topic.

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Nutrition in RMDs: is it really food for thought? Focus on rheumatoid arthritis

Cited by 15 publications

References 37 publications

Diet as a Modulator of Intestinal Microbiota in Rheumatoid Arthritis

Diet as a Modulator of Intestinal Microbiota in Rheumatoid Arthritis

Change in dietary inflammatory index score is associated with control of long-term rheumatoid arthritis disease activity in a Japanese cohort: the TOMORROW study

A Posteriori Dietary Patterns and Rheumatoid Arthritis Disease Activity: A Beneficial Role of Vegetable and Animal Unsaturated Fatty Acids

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