Role of Nutrition in Rheumatic Diseases Management

Written on 21 October 2016. Posted in Rheumatology News & Perspectives

Eating habits of patients with rheumatic diseases has a great impact on their health and quality of life. There are numerous discussions on the topic that lead to even more numerous recommendations. Different worldview and nutritional forms offer different solutions, most of which are justified.

The fact is that patients with rheumatic disease due to chronic inflammation have a higher nutrient requirements, which should be covered. Compared to healthy people, rheumatic patients with high activity disease have a 20% higher energy requirements due to the inflammation.

As a result, an increased dietary intake is indicated mainly because of muscle wasting. However, an increased supply of energy through the diet should not lead to the build-up of too much body fat. For your patients, living with rheumatic diseases is easier if they maintain a proper height-to-weight ratio, or body mass index. With few exceptions (gout), however, people with rheumatic diseases require no special diet.

Nutrition and arachidonic acid

Arachidonic acid is a unsaturated fatty acid which is obtained exclusively from animal foods. It activates the inflammation. Particularly high amounts of arachidonic acid contain pork loaf, pork liver, liver sausage, egg yolk and pork but also beef and veal, camembert and chicken. Adam et al. in 2003 shows the anti-inflammatory effects of low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. [1]

Vegetable products such as fruit, vegetables, potatoes, nuts and soya products as well as vegetable-derived oils do not contain arachidonic acid. A lacto-vegetarian diet has an extremely favorable effect on inflammatory conditions. [2]

Anti-inflammatory fatty acids

The intake of 50 g of linoleic acid per day, which is abundant in olive oil, can have a positive effect on inflammation. Fish oil fatty acids also reduce inflammatory activity [3]. The recommended intake is 30 mg of omega-3 fish oil fatty acids per kilogram of body weight every day. In addition to sea fish of all kinds, fish oil capsules are also an alternative available on the market. 

Antioxidants in the diet of a patient with rheumatic disease

Large amounts of oxygen radicals are formed by the inflammation. Antioxidants can theoretically neutralize such oxygen radicals and prevent joint damage.

Vitamin C and E, provitamin A, selenium, zinc and copper inhibit the inflammation. In animal models, high doses of vitamin C, vitamin E and N-acetyl-cysteine had antiarthritic effects related to their antioxidative potential [4,5]. Vitamin C is abundant in all types of fresh fruits and vegetables, e.g. in red pepper, broccoli, citrus, spinach and potatoes.

For vitamin E, a dosage of 400 to 800 IU is required. Although Vitamin E is present in most vegetable and animal fats and oils, vitamin supplements must be given for the required daily doses.

Tags: AS, ankylosing spondylitis, rheumatoid arthritis, diet, nutrition, fatty acids, antioxidants

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