A patient with rheumatoid arthritis (RA) asks if diet can help ease their symptoms. Or maybe a patient with severe knee osteoarthritis (OA) seeks diet advice because they want to lose weight and relieve pressure on their joints. Although there’s no specific nutrition plan for patients with rheumatic diseases, research has shown many dietary factors can help ease symptoms associated with arthritis, including pain caused from inflammation.1
By meeting with patients and their families, dietitians with a background in rheumatic diseases can answer specific nutritional questions, offer advice on how to successfully manage weight loss or gain, and advise on the best nutritional plan for those who have multiple chronic health conditions.
The Rheumatologist recently spoke to several dietitians with experience counseling patients with rheumatic disease to learn how including dietitians on the interdisciplinary team can ensure better patient outcomes.
Access to Nutrition
Despite the old adage “food is medicine,” medical students typically receive very little training in nutrition. Studies have shown medical schools devote fewer than 20 hours to nutrition, and continuing education classes on the topic aren’t widely available.
Laura Gibofsky, MS, RD, CSP, CDN, a clinical nutritionist at the Hospital for Special Surgery, New York, says proper nutrition doesn’t replace the need for medications, but rather enhances a patient’s overall care plan.
“[Although] there are no medications that can cure RA or prevent flares, following a plan, such as the Mediterranean diet, can help prevent and better manage an RA flare,” Ms. Gibofsky says. “As dietitians, we work to help patients get the nutrients they need through a healthy diet, as opposed to supplements that can interfere with medications.”
Dietitians can also help patients who have food insecurity issues and don’t have access to sufficient quantities of affordable, nutritious foods. These can include the elderly, children, patients living in rural communities and others.
“We can refer patients to local public health professionals and food assistance programs to ensure patients who may be struggling have access to good nutrition,” Ms. Gibofsky says.
Medication Side Effects
“Eating a well-balanced diet can help combat some of the side effects of medications and also alleviate symptoms of the disease,” Ms. Gibofsky says. “For example, steroids, such as prednisone, can cause weight gain and increase a patient’s glucose, cholesterol and triglyceride levels.” To help patients maintain a healthy weight and avoid fluid retention caused by prednisone, Ms. Gibofsky recommends a low sodium diet, featuring fresh, lean meats, seafood and poultry, as well as vegetables and whole grains.
For patients experiencing medication side effects, such as nausea, Ms. Gibofsky recommends such strategies as eating five small meals a day. She also frequently answers questions about food sensitivities and how to prepare meals for picky eaters.
“We want to ensure patients don’t have any nutritional deficiencies that exacerbate their health condition,” Ms. Gibofsky says.