Description
- Rheumatoid arthritis is a progressive autoimmune disease of unknown etiology
occurring in approximately 3% of the population. It is characterized by inflammation
of the membranes lining the joint, which in turn causes pain, stiffness, redness
and swelling. Bone and cartilage become damaged and the joint eventually loses
its shape which contributes to pain and stiffness. The synovium becomes inflamed
and painful and usually affects hands, knees, ankles and feet.1
Causes
- The causes of rheumatoid arthritis are not known. It is theorized that endocrine,
infectious, or genetic factors may play a role.
At Risk
- This disease most affects women 2-3 times more often than men. Average age at
onset is 35 years but the disease can also occur in children.
Prevention and Management
- A variety of conventional (non-nutritional) therapies have been used to control
pain and inflammation. Physical therapy, adequate rest, and moist heat are usually
recommended. Surgery may be beneficial in some cases.
- General good nutrition and weight management is recommended; fad diets should
be avoided.
- Antioxidants, minerals and fish oil supplements have been studied and show beneficial
effects. Oxygen free radicals have been implicated as mediators of tissue damage
in rheumatoid arthritis patients and low serum antioxidant levels appear to be
a risk factor for rheumatoid arthritis.2
- Numerous studies on fish oils3,4,5 show decreased tenderness in joints
and decreased morning stiffness with supplementation.
- Vitamin D and calcium supplements were shown to help prevent loss of bone mineral
density in rheumatoid arthritis patients.6
- Supplementation with copper and selenium has been studied, however these results
have been inconclusive.7
Additional Information
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Abstracts
Heliovaara M, Knekt P, Aho K, Aaran RK, Alfthan G, Aromaa A. Serum antioxidants
and risk of rheumatoid arthritis. Ann Rheum Dis 1994 Jan;53(1):51-3. OBJECTIVES--Oxygen
free radicals have been implicated as mediators of tissue damage in patients
with rheumatoid arthritis (RA). Thus it is possible that several micronutrients
acting as antioxidants and free radical scavengers provide protection against
RA. Serum alpha-tocopherol, beta-carotene, and selenium were studied for their
associations with the risk of RA. METHODS--A case control study was nested within
a Finnish cohort of 1419 adult men and women. During a median follow up of 20
years, 14 individuals initially free of arthritis developed RA. Two controls
per each incident case were individually matched for sex, age, and municipality.
Serum alpha-tocopherol, beta-carotene and selenium concentrations were measured
from stored serum samples. An antioxidant index was calculated as the product
of the molar concentrations of these three micronutrients.
Kremer JM, Bigaouette J. Nutrient intake of patients with rheumatoid arthritis
is deficient in pyridoxine, zinc, copper, and magnesium. J Rheumatol 1996 Jun;23(6):990-4 OBJECTIVE:
To determine nutrient intake of patients with active rheumatoid arthritis and
compare it with the typical American diet (TAD) and the recommended dietary allowance
(RDA). METHODS: 41 patients with active RA recorded a detailed dietary history.
Information collected was analyzed for nutrient intake of energy, fats, protein,
carbohydrate, vitamins and minerals, which were then statistically compared with
the TAD and the RDA. RESULTS: Both men and women ingested significantly less
energy from carbohydrates [women 47.4% (6.4) vs 55% RDA. p = 0.0001: men = 48.9%
(7.4). p = 0.025] and more energy from fat [women = 36.8% (4.5) vs 30% RDA. p
= 0.001 and men = 35.2% (5.9) p = 0.02]. Women ingested significantly more saturated
and mono-unsaturated fat than the RDA (p = 0.02 and p = 0.04 respectively) while
men ingested significantly less polyunsaturated fat (PUFA) (p = 0.0001).
References
1 Zeman FJ. Clinical Nutrition and Dietetics. 2nd Ed. New York:MacMillan
Publishing Company; 1991.
2 Heliovaara M, Knekt P, Aho K et al. Serum antioxidants and risk of rheumatoid
arthritis. Ann Rheum Dis 1994; 53:51-3.
3 Kremer JM. Dietary fish oil and olive oil supplementation in patients
with rheumatoid arthritis. Clinical and immunologic effects. Arthritis Rheum. 1990;
33:810-20.
4 Editorial. Fish oil in rheumatoid arthritis. Lancet 1987;2:720-21.
5 Buckley LM, Leib ES, Cartularo KS et al. Calcium and vitamin D3 supplementaion
prevents bone loss in the spine secondary to low-dose corticosteroids in patients with
rhuematoid arthritis. A randomized, double blinded, pacebo controlled trial. Ann Intern
Med. 1996;125:961-8
6 Honkanen VEA. Plasma zinc and copper concentration in rheumatoid arthritis:influence
of dietary factors and disease activity. Am J Clin Nutr 1991;54:1082-6.
