Rheumatoid arthritis is a chronic autoimmune and inflammatory disease characterized by joint involvement, with progressive destruction of cartilage and bones. In recent years, an increasing number of studies have suggested that diet plays a central role in the risk and progression of the disease. Several nutrients, such as polyunsaturated fatty acids, have anti-inflammatory and antioxidant properties, presenting a protective role for development. But can diet influence rheumatoid arthritis?
Red meat and salt have harmful effect. In addition, alteration of the intestinal microbiota and changes in composition are indirect mechanisms of how diet influences the onset and progression of rheumatoid arthritis. Possible protective effects of some dietary patterns and supplements such as mediterranean diet, vitamin D and probiotics may be a possible future adjuvant therapy.
Diet can influence rheumatoid arthritis?
Eating habits can represent both disease risk and protective factor, based on specific food properties. Specific dietary choices may, in fact, show pro-inflammatory effects (e.g. red meat, salt, excessive caloric intake) or, on the contrary, reduce inflammation (oil, fatty fish, fruit and others). The prevalence distribution of rheumatoid arthritis shows a higher number of patients in Western countries, as opposed to the eastern and developing countries. The Western diet, characterized by a high intake of red meat, saturated and trans fats, a low proportion of omega-3:omega-6 and high consumption of refined carbohydrates, has been associated with an increased risk. Since, there is an increase in inflammation and an induction of insulin resistance and obesity. In addition, diet represents an important factor that influences the composition of the microbiota, which was involved in the development of the disease.
Considering evidence, healthy eating habits may represent a useful tool for reducing the risk of rheumatoid arthritis. As well as related comorbidities and progression, disease activity. The Mediterranean diet is the most encouraged food standard, combined with a high consumption of fish (sardines, salmon, sea bass and trout) for its well-known anti-inflammatory properties. The intake of red meat should be limited (1-2/month), the consumption of olive oil should be daily, together with the consumption of 1–2/week of fatty fish, weekly and high consumption of whole grains, legumes, 5 or more fruits and vegetables per day, preferably seasonal. Sugary drinks, salt, alcohol and coffee should be avoided or only consumed moderately. In addition, physical activity and a healthy lifestyle should be combined with eating patterns, to achieve an ideal body weight. Vitamin D supplementation is important for bone health, for its anti-inflammatory properties and potentially for its beneficial effect on disease activity.
The evidence of the impact of diet on rheumatoid arthritis activity, along with the role of the microbiota in the pathogenesis of the disease and the beneficial effects of nutrients on inflammation and immunity, underscore the importance of defining the best nutritional lifestyle in affected patients. The first manifestations can be potentially delayed with dietary interventions, based on the beneficial effect of polyunsaturated fatty acids/oleic acid. The long-term effects of these dietary manipulations can help in reducing disease activity by slowing progression.
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Arthritis – Gioia, C.; Lucchino, B.; Tarsitan, M.G.; Iannuccelli, C.; Di Franco, M. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients 2020, 12, 1456. https://doi.org/10.3390/nu12051456