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Food for Thought: On Eating & Inflammation in Rheumatic Disease

Susan Bernstein  |  November 14, 2020

Women who enjoy a small glass of wine after work may be at lower risk for rheumatic diseases too. “Moderate alcohol use, equating to half of a standard drink per day, was associated with about a 25% lower risk for RA compared to rarely or never drinking alcohol,” Dr. Tedeschi said.7 The same amount of drinking was also associated with a significantly decreased risk of systemic lupus erythematosus (SLE) in women.8

Women should cut back on sugar-sweetened soda. Data from the Nurses’ Health Study found that “women who drank one or more servings of sugar-sweetened soda per day had a 33% increased risk of RA and a 63% increased risk of seropositive RA compared to women who drank less than one serving per month,” said Dr. Tedeschi. Diet soda was not associated with RA risk.9

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Mediterranean Diet = Positive Results
Dietary patterns, such as following a Mediterranean or standard Western diet, may affect RA risk too. In a study of women age 55 or younger, those with unhealthier dietary pattern scores, or having either high inflammatory index or low healthy eating scores, had a 33% increased risk of RA.10 Women who were current or past smokers also had a 9% decreased risk of RA for every one-point increase in their Mediterranean diet scores.11 No dietary pattern scores were associated with SLE risk in women.12

Fish oil may improve symptoms and disease activity in patients diagnosed with RA. A double-blind, randomized controlled trial of 140 patients with recent-onset RA took either high- or low-dose fish oil supplements for 12 months. All patients received triple disease-modifying anti-rheumatic drug (DMARD) therapy. After a year, achieving remission was more likely and therapy failure was less likely in those who took high-dose supplements.13 Low-dose omega-3 supplements showed some improvements in disease activity scores in patients with SLE as well.14

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In a review of 14 different diet trials focused on people with RA, pain scores improved with two interventions: a fasting period followed by a vegetarian diet for 13 months, and eating a Mediterranean diet for 12 weeks.15 In another trial of 51 patients with long-standing RA who ate either a Mediterranean-type diet or standard hospital food for 12 weeks, those on the Mediterranean diet had significantly greater reductions in Disease Activity Score 28 (DAS28) scores (–0.6 compared with –0.1).16 “Mean weight loss was also significant with the Mediterranean diet (a loss of 3 kg), but not with the control diet, and weight loss may have driven the observed decreases in disease activity,” Dr. Tedeschi said.

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Filed under:ACR ConvergenceConditionsMeeting ReportsRheumatoid ArthritisSystemic Lupus Erythematosus Tagged with:ACR Convergence 2020ACR Convergence 2020 – RADietdietary intervention

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