Diet
Many foods are known to be inflammatory and may contribute to the development of inflammation.
A balanced Mediterranean diet, emphasizing the traditional flavors and cooking methods of southern European countries bordering the Mediterranean Sea, has been shown to be heart healthy. This diet includes daily consumption of vegetables, fruits, whole grains and healthy fats, such as olive oil; weekly intake of fish, poultry, beans and eggs; moderate portions of dairy products; and limited intake of red meat.
Dr. Tesser
“Patients ask me specifically what to eat. I tend to dissuade them from supplements in general,” says John R.P. Tesser, MD, a rheumatologist with Arizona Arthritis and Rheumatology Associates, Phoenix, and adjunct professor at the Arizona College of Osteopathic Medicine. “I try to keep it simple. I say there’s good research showing the Mediterranean diet, with its focus on fish, poultry, vegetables, fruit, nuts and olive oil, can be anti-inflammatory.”
Movement & exercise
Any kind of physical movement, as tolerated, will help patients with rheumatic conditions, and the benefits of simple exercise can’t be overstated, Dr. Tesser says. “I say exercise is a key to life. If you move, you’ll live longer and better. When we think of exercise, the first thing that often comes to mind is running. But walking is excellent, easy and free.”
Stress reduction, including sleep hygiene
Stress is an important contributor to inflammatory conditions—and moderating it can help patients manage pain and other symptoms. A related issue is sleep hygiene (i.e., sticking to a sleep schedule, creating a restful environment, including physical activity in your daily schedule and limiting naps), which is critical to overall health.
Focusing on these three areas—diet, movement and stress—will give the most bang for the buck, and should not be controversial for rheumatologists, Dr. Cotter says. Mindfulness meditation and mindfulness-based stress reduction (MBSR) are also emerging as important strategies in disease and wellness management. Mindfulness, described as non-judgmental, present moment awareness, is a learned skill that can be taught and practiced.1
The rheumatology clinic at Johns Hopkins Medicine, Baltimore, has launched a mindfulness initiative in collaboration with psychiatry and behavioral sciences. The clinic is offering classes by a certified MBSR psychologist and a smartphone app-based program to enhance rheumatology patients’ quality of life.