Cristina Montoya, RD, CDE, splits her time as a clinical dietitian in a hospital seeing a variety of patients and in a private practice with a focus on arthritis. She is passionate about raising the awareness of the role of the dietitian and diet in the field of rheumatology. She has developed a website and a blog to promote diet to help arthritis patients.
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Explore This IssueMay 2016
Ms. Montoya believes that dietitians have more to offer their rheumatology patients than weight loss management. She believes the dietitian has a role in educating patients about nutritional deficiencies, particularly when a patient wants to use an elimination diet to control their symptoms.
Dr. Mangano supports the use of the Mediterranean diet because some literature suggests it can reduce inflammation & help palliate symptoms of rheumatoid arthritis.
In addition to seeing obese patients with osteoarthritis, she also gives guidance to patients who suffer from xerostomia and periodontal disease, and to patients with esophageal dysmotility disorders and dysphagia. According to Ms. Montoya, in these clinical situations, a dietitian can educate patients about foods to avoid or diets of different textures with the goal of ensuring the patient has a nutritionally well-balanced diet. She helps ill patients make better food choices and develop a personalized menu plan.
In her efforts to promote diet as a treatment modality for symptom management, Ms. Montoya has encountered some skepticism regarding the limited amount of scientific data to support her efforts. She believes, however, that the body of evidence is growing in this field.
Education Is Key to Management
In conclusion, the interviewees agreed about the important role of the dietitian in helping educate and manage rheumatology patients, particularly in the specific context of treating obese patients with underlying osteoarthritis, in patients who suffer from xerostomia and its sequelae or in patients with dysphagia and esophageal dysmotility.
Some research exists to suggest that the Mediterranean diet may help arthritis patients control their symptoms, but current studies are too limited to strongly support a specific anti-arthritis diet. All of our interviewees also agree that further basic investigations, as well as new carefully designed clinical trials assessing the relationship of nutrition and rheumatic disease, are needed and would be of great interest.
Deanna Yamamoto is an adult nurse practitioner in rheumatology and a member of the ARHP Practice Committee, which contributed to the article development.