• Does diet play a role in the alleviation of rheumatoid arthritis symptoms?

      Fallows, Stephen; Lee, Claire E. (University of Chester, 2007-10)
      This systematic review of scientific literature was undertaken to investigate the possibility of a role for diet in the alleviation of rheumatoid arthritis (RA) symptoms, with an objective of highlighting specific nutrients and/or certain food groups and diets that may impact upon the symptoms of RA. Studies displaying conflicting evidence (i.e. show diets that have no effect on RA symptom alleviation) were also reviewed. A comprehensive literature search to identify relevant papers was carried out with the use of criteria, in an attempt to identify as many studies as possible, but also to minimise selection bias for those that were found. Electronic databases, library catalogues and internet search engines played key parts in paper identification. A total of 31 papers were identified after meeting selection criteria and summaries and critical appraisals were compiled for comparison. Some studies show that fish oil supplementation displayed the greatest benefits through a reduction in the number of tender joints and morning stiffness. One paper offers a dosage figure for improvement in clinical symptoms as 40mg/kg body weight/day of oil containing n-3 fatty acids (FAs) combined with <10g/day of dietary (n-6) FAs. Periods of fasting with a vegetarian diet promotes a reduction in RA symptoms. Several studies identify Gammalinolenic Acid as capable of decreasing pro-inflammatory products of Arachidonic Acid. Similarly, elemental diets and foods devoid of allergens may benefit RA activity parameters, however improvements in RA symptoms seen in response to elemental diets are not sustained on individualised diets. Many researchers recognised the influence of a Mediterranean diet, rich in anti-oxidant containing vegetables, n-3 FAs and a lower ratio of n-6 to n-3 FAs as sources of inflammation reduction. Vitamin E treatment was shown to provide a small analgesic property compared to placebo, the mechanism of which and identification of additional vitamins and food sources with such potential require further study. Further work is required on establishing most beneficial supplement dosage, duration and length of treatment interval. Knowledge of correlations of food allergies in RA sufferers to immune responses compared to food antigens in the fluid of blood and joints would be useful.