Video: Every Case Tells a Story| Webinar: ACR/CHEST ILD Guidelines in Practice

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Lifestyle Medicine Interventions Can Benefit Patients with Rheumatic Disease

  |  Issue: May 2024  |  

SAN DIEGO—Lifestyle interventions, such as diet, exercise and mindfulness, can benefit patients with rheumatic disease. Although the benefits of lifestyle medicine have been shown in many studies, how best to put these strategies to use for rheumatology patients is still far from being fully explored, an expert said during a session at ACR Convergence 2023.

“The application of lifestyle medicine in the rheumatic diseases is critically important to people who are living with these conditions,” said Sarah Patterson, MD, assistant professor of medicine at the University of California, San Francisco (UCSF), and integrative rheumatologist at UCSF’s Osher Center for Integrative Health.

Dr. Patterson

These interventions can make a difference for patients when conventional therapies are not completely effective or are poorly tolerated. Lifestyle medicine can help ease persistent symptoms, while offering additional benefits, such as lowering cardiovascular disease risk.

Diet

Studies dating back to the 2000s demonstrated the benefit of the Mediterranean diet in patients with active rheumatoid arthritis (RA) compared with control. The diet consists of vegetables, nuts, fish and has very limited red meat, added sugar and processed food. In the study, these patients experienced improvements from baseline in pain and function when simply taking Mediterranean-diet cooking classes. A 2022 study comparing a Mediterranean diet with a low-fat diet and a regular diet among obese and overweight patients with RA found the greatest improvements were seen in patients using the Mediterranean diet.1

ADVERTISEMENT
SCROLL TO CONTINUE

In a recent study, 20 patients with active RA who were put on an anti-inflammatory diet—known as the ITIS diet—had significant improvement in pain after the intervention compared with baseline. Also, the fecal microbiome and metabolome were different in patients with at least 50% pain improvement compared with those who had a lesser response.2

In patients with lupus, in which diet has been studied less, researchers found that most patients who made dietary changes after diagnosis perceived a benefit from that change.3 Other research has found an independent association between sugar intake and disease activity.4

Studies have also demonstrated the benefits for omega-3 supplementation in patients with RA and lupus.5,6 Dr. Patterson pointed the audience to a UCSF Web site (http://tiny.ucsf.edu/rheumnutrition) with evidence-based information on diet and people with rheumatic conditions.

Movement

Physical activity has been repeatedly found to improve with patient-reported outcomes in RA, Dr. Patterson said. In a study, a 10-week, high-intensity walking program significantly improved disease activity and immune function among previously physically inactive patients.7

Related Articles

    Food, Diet, Nutrition & Rheumatic Diseases—Are They Really Related?

    “‘I didn’t say there was nothing better,’ the King replied. ‘I said there was nothing like it.’” —Lewis Carroll, Through the Looking Glass “Why did I get this? Was it because of my diet? What should I eat now? What diet should I follow? Are there any natural treatments I can take instead of medications?”…

    Food for Thought: On Eating & Inflammation in Rheumatic Disease

    Certain nutrients or dietary patterns may affect inflammation and rheumatic disease risk in certain populations. Recommended nutrients include omega-3 fatty acids found in fish, poultry or nuts. Following a Mediterranean or standard Western diet may affect RA risk too.

    Diet May Help Reduce Inflammation in RA

    In a small study, an anti-inflammatory diet helped reduce pain and swelling in a subset of people with rheumatoid arthritis (RA). Diet changes are complementary to standard treatment. Diet-related research can be challenging, but many patients with RA are motivated to try healthy changes.

    The 2020 ARP Merit Awards & ACR Distinguished Fellows

    During ACR Convergence 2020 in early November, the ACR and ARP honored a group of distinguished individuals who have made significant contributions to rheumatology research, education and patient care. This month, The Rheumatologist speaks with the winners of the ARP Merit Awards and the ACR’s Distinguished Fellows. In addition, we bring you the first ever…