Diet and rheumatoid arthritis: a review of the literature.
BACKGROUND
Rheumatoid arthritis is a common inflammatory condition. A large number of patients seek alternative or complementary therapies of which diet is an important component. This article reviews the evidence for diet in rheumatoid arthritis along with the associated concept of oral tolerization.


METHODS
References were taken from Medline from 1966 to September 2004. The keywords, rheumatoid arthritis, diet, n-3 fatty acids, vitamins, and oral tolerization, were used.


RESULTS
Randomized controlled trials (RCTs) indicate that dietary supplementation with n-3 fatty acids provides modest symptomatic benefit in groups of patients with rheumatoid arthritis. Epidemiological studies and RCTs show cardiovascular benefits in the broader population and patients with ischemic heart disease. A number of mechanisms through which n-3 fats may reduce inflammation have been identified. In a small number of patients with rheumatoid arthritis, other dietary manipulation such as fasting, vegan, and elimination diets may have some benefit. However, many of these diets are impractical or difficult to sustain long term.


CONCLUSIONS
Dietary manipulation provides a means by which patients can a regain a sense of control over their disease. Dietary n-3 supplementation is practical and can be easily achieved with encapsulated or, less expensively, bottled fish oil.
Stamp
Lisa K
LK
Department of Medicine, Christchurch School of Medicine and Health Sciences, University of Otago, New Zealand. lisa.stamp@cdhb.govt.nz
James
Michael J
MJ
Cleland
Leslie G
LG
D001172:Arthritis, Rheumatoid / Q000178:diet therapy*; D004032:Diet; D004042:Dietary Fats, Unsaturated / Q000627:therapeutic use; D006801:Humans; D012189:Retrospective Studies; D016896:Treatment Outcome
D004042:Dietary Fats, Unsaturated