title: A pilot study of a Mediterranean-type diet intervention in female patients with rheumatoid arthritis living in areas of social deprivation in Glasgow.
abstract: BACKGROUND
  A Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats has been associated with health benefits, including improved cardiovascular profile and benefit in RA.
  
  
  OBJECTIVE
  To overcome obstacles to healthy eating by a community-based intervention promoting a Mediterranean-type diet in patients with RA living in socially deprived areas of Glasgow.
  
  
  METHODS
  130 female patients with RA aged 30-70 years (median 55), disease duration 8 years were recruited from three hospital sites. The intervention group (n = 75) attended weekly 2-hour sessions for 6 weeks in the local community, including hands-on cooking classes backed up with written information. The control group (n = 55) were given dietary written information only. Both groups completed food frequency questionnaires (FFQs), and clinical and laboratory measures were assessed at baseline, 3 and 6 months.
  
  
  RESULTS
  Significant benefit was shown in the intervention group compared with controls for patient global assessment at 6 months (p = 0.002), pain score at 3 and 6 months (p = 0.011 and 0.049), early morning stiffness at 6 months (p = 0.041) and Health Assessment Questionnaire score at 3 months (p = 0.03). Analysis of the FFQs showed significant increases in weekly total fruit, vegetable and legume consumption and improvement in the ratio of monounsaturated:saturated fat intake and systolic BP in the intervention group only. The cooking classes were positively received by patients and tutors; cost/patient for the 6 week course was 84 pounds (124 euro).
  
  
  CONCLUSIONS
  Results demonstrate that a 6 week intervention can improve consumption of healthier foods. If implemented more widely it may prove a popular, inexpensive and useful adjunct to other RA treatment.
authors.affiliation: Glasgow Royal Infirmary Castle Street, G4 0SF Glasgow, UK. gayle_mckellar@hotmail.com
authors.forename: G
authors.initials: G
authors.lastname: McKellar
authors.forename: E
authors.initials: E
authors.lastname: Morrison
authors.forename: A
authors.initials: A
authors.lastname: McEntegart
authors.forename: R
authors.initials: R
authors.lastname: Hampson
authors.forename: A
authors.initials: A
authors.lastname: Tierney
authors.forename: G
authors.initials: G
authors.lastname: Mackle
authors.forename: J
authors.initials: J
authors.lastname: Scoular
authors.forename: J A
authors.initials: JA
authors.lastname: Scott
authors.forename: H A
authors.initials: HA
authors.lastname: Capell
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000178:diet therapy*; D001794:Blood Pressure; D016022:Case-Control Studies; D003296:Cooking; D038441:Diet, Mediterranean; D005260:Female; D006798:Housing; D006801:Humans; D008875:Middle Aged; D010865:Pilot Projects; D011610:Psychosocial Deprivation; D012606:Scotland; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D015431:Weight Loss