The role of diet in rheumatoid arthritis
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Submission date: 2018-04-27
Final revision date: 2018-07-13
Acceptance date: 2018-07-18
Online publication date: 2018-08-31
Publication date: 2018-08-31
Reumatologia 2018;56(4):259-267
Rheumatoid arthritis (RA) is a systemic connective tissue disease which develops in the course of an autoimmune inflammatory process triggered by environmental factors in a genetically predisposed person. One of the environmental factors is the diet. RA patients’ adherence to a healthy diet remains low, despite plentiful data confirming positive effects of some foods, e.g. fish rich in n-3 polyunsaturated fatty acids (PUFAs), as well as the negative influence of unhealthy eating patterns, such as high consumption of fats and sugars, on RA incidence, activity and treatment response. In this review, we present current knowledge on the role of diet in rheumatoid arthritis, including dietary factors’ preventive/promoting influence on RA development, as well as their impact on RA activity. We hope this article will aid and encourage clinicians to recommend a relevant dietary intervention to their RA patients.
Tsuda R, Ozawa T, Kobayashi E, et al. Monoclonal Antibody Against Citrullinated Peptides Obtained From Rheumatoid Arthritis Patients Reacts With Numerous Citrullinated Microbial and Food Proteins. Arthritis Rheumatol 2015; 67: 2020-2031.
Gong T, Wang X, Yang Y, et al. Plant Lectins Activate the NLRP3 Inflammasome To Promote Inflammatory Disorders. J Immunol 2017; 198: 2082-2092.
Lerner A, Matthias T. Rheumatoid arthritis–celiac disease relationship: Joints get that gut feeling. Autoimmun Rev 2015; 14: 1038-1047.
Abhari K, Shekarforoush SS, Hosseinzadeh S, et al. The effects of orally administered Bacillus coagulans and inulin on prevention and progression of rheumatoid arthritis in rats. Food Nutr Res 2016; 60: 30876.
Feng J, Chen Q, Yu F, et al. Body Mass Index and Risk of Rheumatoid Arthritis. Medicine (Baltimore) 2016; 95: e2859.
Lee YH, Bae SC. Circulating leptin level in rheumatoid arthritis and its correlation with disease activity: a meta-analysis. Z Rheumatol 2016; 75: 1021-1027.
Liu Y, Hazlewood GS, Kaplan GG, et al. Impact of Obesity on Remission and Disease Activity in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Arthritis Care Res (Hoboken) 2017; 69: 157-165.
Kim S, Chen Z, Essani AB, et al. Differential impact of obesity on the pathogenesis of RA or preclinical models is contingent on the disease status. Ann Rheum Dis 2017; 76: 731-739.
Na HS, Kwon J-E, Lee SH, et al. Th17 and IL-17 Cause Acceleration of Inflammation and Fat Loss by Inducing  2-Glycoprotein 1 (AZGP1) in Rheumatoid Arthritis with High-Fat Diet. Am J Pathol 2017; 187: 1049-1058.
DeChristopher LR, Uribarri J, Tucker KL. Intake of high-fructose corn syrup sweetened soft drinks, fruit drinks and apple juice is associated with prevalent arthritis in US adults, aged 20–30 years. Nutr Diabetes 2016; 6: e199.
Sundström B, Johansson I, Rantapää-Dahlqvist S. Diet and alcohol as risk factors for rheumatoid arthritis: a nested case–control study. Rheumatol Int 2015; 35: 533-539.
Hu Y, Sparks JA, Malspeis S, et al. Long-term dietary quality and risk of developing rheumatoid arthritis in women. Ann Rheum Dis 2017; 76: 1357-1364.
He J, Wang Y, Feng M, et al. Dietary intake and risk of rheumatoid arthritis – a cross section multicenter study. Clin Rheumatol 2016; 35: 2901-2908.
Pattison DJ, Symmons DPM, Lunt M, et al. Dietary beta-cryptoxanthin and inflammatory polyarthritis: results from a population-based prospective study. Am J Clin Nutr 2005; 82: 451-455.
Gan RW, Demoruelle MK, Deane KD, et al. Omega-3 fatty acids are associated with a lower prevalence of autoantibodies in shared epitope-positive subjects at risk for rheumatoid arthritis. Ann Rheum Dis 2017; 76: 147-152.
Abdulrazaq M, Innes JK, Calder PC. Effect of -3 polyunsaturated fatty acids on arthritic pain: A systematic review. Nutrition 2017; 39-40: 57-66.
Senftleber NK, Nielsen SM, Andersen JR, et al. Marine Oil Supplements for Arthritis Pain: A Systematic Review and Meta-Analysis of Randomized Trials. Nutrients 2017; 9. pii: E42.
Tedeschi SK, Bathon JM, Giles JT, et al. The relationship between fish consumption and disease activity in rheumatoid arthritis. Arthritis Care Res (Hoboken) 2018; 70: 327-332.
Veselinovic M, Vasiljevic D, Vucic V, et al. Clinical Benefits of n-3 PUFA and g-Linolenic Acid in Patients with Rheumatoid Arthritis. Nutrients 2017; 9: 325.
Navarini L, Afeltra A, Gallo Afflitto G, Margiotta DPE. Polyunsaturated fatty acids: any role in rheumatoid arthritis? Lipids Health Dis 2017; 16: 197.
Jeffery L, Fisk HL, Calder PC, et al. Plasma Levels of Eicosapentaenoic Acid Are Associated with Anti-TNF Responsiveness in Rheumatoid Arthritis and Inhibit the Etanercept-driven Rise in Th17 Cell Differentiation in Vitro. J Rheumatol 2017; 44: 748-756.
Jiang J, Li K, Wang F, et al. Effect of Marine-Derived n-3 Polyunsaturated Fatty Acids on Major Eicosanoids: A Systematic Review and Meta-Analysis from 18 Randomized Controlled Trials. Sampson AP, ed. PLoS One 2016; 11: e0147351.
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: 1920-1925.
Scrivo R, Massaro L, Barbati C, et al. The role of dietary sodium intake on the modulation of T helper 17 cells and regulatory T cells in patients with rheumatoid arthritis and systemic lupus erythematosus. PLoS One 2017; 12: e0184449.
Brenner M, Laragione T, Gulko PS. Short-term low-magnesium diet reduces autoimmune arthritis severity and synovial tissue gene expression. Physiol Genomics 2017; 49: 238-242.
Li M, Zhai L, Wei W. High-Methionine Diet Attenuates Severity of Arthritis and Modulates IGF-I Related Gene Expressions in an Adjuvant Arthritis Rats Model. Mediators Inflamm 2016; 2016: 9280529.
Franco AS, Freitas TQ, Bernardo WM, Pereiria RMR. Vitamin D supplementation and disease activity in patients with immune-mediated rheumatic diseases A systematic review and meta-analysis. Medicine (Baltimore) 2017; 96: e7024.
Lourdudoss C, Wolk A, Nise L, et al. Are dietary vitamin D, omega-3 fatty acids and folate associated with treatment results in patients with early rheumatoid arthritis? Data from a Swedish population-based prospective study. BMJ Open 2017; 7: e016154.
Jalili M, Kolahi S, Aref-Hosseini S-R, et al. Beneficial role of antioxidants on clinical outcomes and erythrocyte antioxidant parameters in rheumatoid arthritis patients. Int J Prev Med 2014; 5: 835-840.
Yu N, Han F, Lin X, et al. The Association Between Serum Selenium Levels with Rheumatoid Arthritis. Biol Trace Elem Res 2016; 172: 46-52.
Mirza F, Lorenzo J, Drissi H, et al. Dried plum alleviates symptoms of inflammatory arthritis in TNF transgenic mice. J Nutr Biochem 2018; 52: 54-61.
Lin I-C, Yamashita S, Murata M, et al. Equol suppresses inflammatory response and bone erosion due to rheumatoid arthritis in mice. J Nutr Biochem 2016; 32: 101-106.
Aparicio-Soto M, Sánchez-Hidalgo M, Rosillo MÁ, et al. Extra virgin olive oil: a key functional food for prevention of immune-inflammatory diseases. Food Funct 2016; 7: 4492-4505.
Ahmed S. Green tea polyphenol epigallocatechin 3-gallate in arthritis: progress and promise. Arthritis Res Ther 2010; 12: 208.
Daily JW, Yang M, Park S. Efficacy of Turmeric Extracts and Curcumin for Alleviating the Symptoms of Joint Arthritis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. J Med Food 2016; 19: 717-729.
Cai H, Zheng Z, Sun Y, et al. The effect of curcumin and its nanoformulation on adjuvant-induced arthritis in rats. Drug Des Devel Ther 2015; 9: 4931.
Ramadan G, Al-Kahtani MA, El-Sayed WM. Anti-inflammatory and Anti-oxidant Properties of Curcuma longa (Turmeric) Versus Zingiber officinale (Ginger) Rhizomes in Rat Adjuvant-Induced Arthritis. Inflammation 2011; 34: 291-301.
Ramadan G, El-Menshawy O. Protective effects of ginger-turmeric rhizomes mixture on joint inflammation, atherogenesis, kidney dysfunction and other complications in a rat model of human rheumatoid arthritis. Int J Rheum Dis 2013; 16: 219-229.
Ghavipour M, Sotoudeh G, Tavakoli E, et al. Pomegranate extract alleviates disease activity and some blood biomarkers of inflammation and oxidative stress in Rheumatoid Arthritis patients. Eur J Clin Nutr 2017; 71: 92-96.
Javadi F, Ahmadzadeh A, Eghtesadi S, et al. The Effect of Quercetin on Inflammatory Factors and Clinical Symptoms in Women with Rheumatoid Arthritis: A Double-Blind, Randomized Controlled Trial. J Am Coll Nutr 2017; 36: 9-15.
Islam MA, Alam F, Solayman M, et al. Dietary Phytochemicals: Natural Swords Combating Inflammation and Oxidation-Mediated Degenerative Diseases. Oxid Med Cell Longev 2016; 2016: 5137431.
Dragos D, Gilca M, Gaman L, et al. Phytomedicine in Joint Disorders. Nutrients 2017; 9. pii: E70.
Bloomfield HE, Koeller E, Greer N, et al. Effects on Health Outcomes of a Mediterranean Diet With No Restriction on Fat Intake. Ann Intern Med 2016; 165: 491.
Hu Y, Costenbader KH, Gao X, et al Mediterranean diet and incidence of rheumatoid arthritis in women. Arthritis Care Res (Hoboken) 2015; 67: 597-606.
Forsyth C, Kouvari M, D’Cunha NM, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int 2018; 38: 737-747.
Matsumoto Y, Sugioka Y, Tada M, et al. Monounsaturated fatty acids might be key factors in the Mediterranean diet that suppress rheumatoid arthritis disease activity: The TOMORROW study. Clin Nutr 2018; 37: 675-680.
Berube LT, Kiely M, Yazici Y, Woolf K. Diet quality of individuals with rheumatoid arthritis using the Healthy Eating Index (HEI)-2010. Nutr Health 2017; 23: 17-24.
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