Mediterranean diet for rheumatoid arthritis

Does the Mediterranean Diet protect against Rheumatoid Arthritis?

Mediterranean diet for rheumatoid arthritis – What is Rheumatoid arthritis (RA)?

RA is a chronic inflammatory autoimmune disease occurring in all ethnic groups and affecting roughly 1% of the world’s population. It is a complex disease with unclear pathogenesis due to both genetic (Unmodifiable) factors and environmental (Modifiable) factors such as smoking, infection, diet, etc. Most of the patients present with pain, swelling, and morning stiffness of the small joints. If it is not controlled well, it may be followed by complications such as osteoporosis and larger impacts on major organs such as the heart, eyes, lungs, brain, and blood vessels. Medications are a mainstay treatment but it can give you unwanted side effects sometimes and are expensive of course! So there is a question you might want to know if there is any non-pharmacological treatment for RA improving symptoms. The answer is YES! Diet, weight loss, and smoking cessation playing a major role in RA treatment which has been reported by multiple studies.

The link between Rheumatoid arthritis and the Mediterranean diet

A Mediterranean diet is based on traditional healthy lifestyle of people living in France, Greece, Italy, Spain, and across the Mediterranean Sea. It is loaded with plenty of vegetables, fruits, grains, legumes, herbs, beans, nuts, seeds, spices, seafood, and unsaturated fats for example olive oil. Eating moderate dairy products, less meat and sugar make your diet more Mediterranean-style. So, the Mediterranean diet mainly consists of –

• Polyphenols (Anti-oxidants) which can lower the level of pro-inflammatory cytokines in RA. Polyphenols are abundantly found in fruit, vegetables, and herbs.
• n-3 Polyunsaturated Fatty Acids (n-3 PUFA) which can reduce inflammation, lower disease activity, and alleviate pain. n-3 PUFA sources are vegetable oil, fish oil, and nuts.

The Mediterranean Diet Pyramid

Does the Mediterranean diet protect against RA?

The subject of the Mediterranean diet in prevention of RA is still controversial. According to a prospective study involving female US healthy adults, it seems to be there is no association between Mediterranean diet and prophylaxis of RA although it has a beneficial role in relieving pain, reducing inflammation, and disease activity.

On the other hand, researchers analyzed high-risk individuals (Women smokers). It showed that women with high adherence to the Mediterranean diet were associated with a lower risk of RA compared to those who had low or no adherence to the Mediterranean diet. Researchers added the opinion that Anti-oxidant effects of Mediterranean diet might counterbalance the Oxidant effects

of smoking. So, it was concluded that Mediterranean diet could prevent RA in women smokers.

Other Health Benefits of the Mediterranean diet

• Prevention of stroke, heart diseases, and Type 2 Diabetes Mellitus
• Reducing the risk of Parkinson’s disease, Alzheimer’s disease, and Dementia
• Maintaining youth, muscle strength, and overall good longevity
• Weight loss

Diet reducing RA Activity

• Mediterranean diet
• Low-magnesium diet
• Low-sodium diet
• High-methionine diet
• Fruits, vegetables, and spices rich in polyphenols
• Fish and marine oil rich in n-3 PUFA alone or together with Vitamin D
• Olive oil and nuts rich in Monounsaturated Fatty Acids (MUFAs)
• Fermented foods such as Kimchi, yogurt, or sauerkraut rich in Bacillus Coagulans Onions, garlic, leek, asparagus, soybeans rich in Inulin

Role of weight control in RA

Many studies showed that obesity can increase the risk of developing RA. Higher levels of all triglycerides level in adipose (fat) tissue promote inflammation of joints. Moreover, overweight increases pressure on weight-bearing joints exacerbating RA symptoms. Doing exercise regularly can furthermore prevent other diseases such as obesity, hypertension, Type 2 DM, and heart diseases. Yoga and massage can also relax muscles so that pain on joints is alleviated.

References

https://www.elsevierhealth.com.au/davidsons-principles-and-practice-of-medicine-9780702070280.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6142028/

https://www.sciencedaily.com/releases/2020/09/200910090046.htm