title: Nutritional management of rheumatoid arthritis: a review of the evidence.
abstract: Rheumatoid arthritis (RA) is a debilitating disease and is associated with increased risk of cardiovascular disease and osteoporosis. Poor nutrient status in RA patients has been reported and some drug therapies, such as nonsteroidal anti-inflammatory drugs (NSAIDs), prescribed to alleviate RA symptoms, may increase the requirement for some nutrients and reduce their absorption. This paper reviews the scientific evidence for the role of diet and nutrient supplementation in the management of RA, by alleviating symptoms, decreasing progression of the disease or by reducing the reliance on, or combating the side-effects of, NSAIDs. Supplementation with long-chain n-3 polyunsaturated fatty acids (PUFA) consistently demonstrates an improvement in symptoms and a reduction in NSAID usage. Evidence relating to other fatty acids, antioxidants, zinc, iron, folate, other B vitamins, calcium, vitamin D and fluoride are also considered. The present evidence suggests that RA patients should consume a balanced diet rich in long-chain n-3 PUFA and antioxidants. More randomized long-term studies are needed to provide evidence for the benefits of specific nutritional supplementation and to determine optimum intake, particularly for n-3 PUFA and antioxidants.
authors.affiliation: MRC Human Nutrition Research, Elsie Widdowson Laboratory, Fulbourn Road, Cambridge, UK. kirsten.rennie@mrc-hnr.cam.ac.uk
authors.forename: K L
authors.initials: KL
authors.lastname: Rennie
authors.forename: J
authors.initials: J
authors.lastname: Hughes
authors.forename: R
authors.initials: R
authors.lastname: Lang
authors.forename: S A
authors.initials: SA
authors.lastname: Jebb
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000975:Antioxidants / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000178:diet therapy* / Q000188:drug therapy; D002136:Calcium, Dietary / Q000008:administration & dosage; D019587:Dietary Supplements; D005229:Fatty Acids, Monounsaturated / Q000008:administration & dosage; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage; D005492:Folic Acid / Q000008:administration & dosage; D006801:Humans; D009747:Nutritional Physiological Phenomena; D009752:Nutritional Status; D014803:Vitamin B Complex / Q000008:administration & dosage; D014807:Vitamin D / Q000008:administration & dosage
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000975:Antioxidants; D002136:Calcium, Dietary; D005229:Fatty Acids, Monounsaturated; D015525:Fatty Acids, Omega-3; D014803:Vitamin B Complex; D014807:Vitamin D; D005492:Folic Acid