A
member of my family was recently diagnosed with Rheumatoid Arthritis (RA). I
previously did not realize that Rheumatoid Arthritis was any different from the
arthritis usually associated with wear-and-tear on the joints. In fact, RA
actually has very little to do with wear-and-tear and is actually an autoimmune
disorder in which the immune system begins to attack its own tissues (Mayo Clinic, 2019). More specifically, the immune system attacks
the synovium, which comprises the outer layer of the membrane surrounding
joints (Mayo Clinic, 2019). The joints thus become inflamed, and if not
addressed in sufficient time the underling cartilage and bone can actually degrade
(Mayo Clinic, 2019). This results in joint pain, stiffness, and
swelling, and at its worst can be so debilitating that an inflicted individual
can barely move.
Sadly,
the cause of RA is mostly unknown apart from having a genetic component (Mayo Clinic, 2019). There is no cure, but there are medications
that can keep the symptoms at bay and can even put RA into remission. In
addition to using the standard prescribed RA medications, the affected
individual in my family has also experimented with eliminating certain inflammatory
foods from their diet. They decided to focus on gluten, and have been avoiding
it for the last 6 months. I was curious as to whether any research has
investigated manipulating diet to keep RA at bay.
From
what I could find, it appears that there has been no significant correlation
made between diet and the development of RA. However, studies have demonstrated
the potential for diet to change the inflammation experienced by an inflicted
individual (Paolino et al., 2019). Particularly, increasing the
intake of anti-inflammatory foods such as those rich in omega-3 fatty acids,
fruits, and vegetables may lessen the symptoms of RA (this is essentially the
Mediterranean diet) (Paolino et al., 2019). While more research needs to
be done, a few trials have demonstrated a gluten-free diet resulted in lessened
pain and other RA symptoms, but it is too early to establish the significance of
the correlation (Lerner, Green, & Lebwohl, 2019). Thus, though it is not known
with certainty whether avoiding gluten specifically can alleviate RA, it can’t
hurt to try.
As stated, more research is needed
to fully establish the significance of dietary influences on RA. In fact, a
2019 systematic review found little-to-no evidence that the Mediterranean diet
improves disease symptoms and outlooks for RA patients at all (Porras, Rada, & Duran, 2019). However, because there is a
chance that certain diets potentially alleviate RA, for the sake of beneficence
researchers should certainly focus on diet in order to definitively establish
whether this avenue can provide another component of treatment for this
terrible disease.
Cited Literature
Lerner, B. A., Green, P. H. R., & Lebwohl, B.
(2019). Going Against the Grains: Gluten-Free Diets in Patients Without Celiac
Disease-Worthwhile or Not? Dig Dis Sci,
64(7), 1740-1747. doi:10.1007/s10620-019-05663-x
Mayo Clinic. (2019). Rheumatoid arthritis. Retrieved from
https://www.mayoclinic.org/diseases-conditions/rheumatoid-arthritis/symptoms-causes/syc-20353648
Paolino, S., Pacini, G., Patane, M., Alessandri, E.,
Cattelan, F., Goegan, F., . . . Cutolo, M. (2019). Interactions between
microbiota, diet/nutrients and immune/inflammatory response in rheumatic
diseases: focus on rheumatoid arthritis. Reumatologia,
57(3), 151-157. doi:10.5114/reum.2019.86425
Porras, M., Rada, G., & Duran, J. (2019). Effects
of Mediterranean diet on the treatment of rheumatoid arthritis. Medwave, 19(5), e7640.
doi:10.5867/medwave.2019.05.7639
Thanks for sharing, Alex! I too didn’t recognize until now that rheumatoid arthritis was different from standard arthritis, and that’s an interesting concept to try and limit the intake of things that cause inflammation in the diet to help mediate the symptoms. It seems to make logical sense, but it’s intriguing that there currently is no significant correlation between diet and development of RA.
ReplyDeleteI looked a bit more into RA after your post and I noticed exercise plays a big role in mediating the effects of RA. I originally thought this wouldn’t be so because previously when I took exercise physiology in undergrad, we learned that exercise increases the amount of antibodies and white blood cells (part of the immune system) traveling through the blood, and clearly with RA the immune system is the problem in this disorder.
Turns out, exercise reverses cachexia (a condition 2/3 of RA patients have that causes muscle deterioration), improving function without increasing the negative immune effects involved with RA, and bonus (!) it decreases cardiovascular risk, the #1 killer of people in the U.S (Cooney et. Al, 2011).
Diet and exercise, it appears, are beneficial in the prevention and management of so many conditions, rheumatoid arthritis being yet another one.
This is a really interesting, I had no idea that Rheumatoid Arthritis was in fact an autoimmune disease. What an incredibly painful condition where our own bodies attack our joint membranes causing normal movements to be excruciating.
ReplyDeleteI can see why diet could aid in relieving some of the pain associated with this condition, in fact, today it seems as if just about everything can be monitored by a change in diet. I began doing some research over diets that proved to be the most beneficial for individuals with RA. I found that the typical western diet can cause more harm because it relies on a lot of high-fat, high-sugar, and processed foods. As you mentioned the most successful diet has been associated with the Mediterranean diet because it integrates so many healthy RA-friendly foods. These foods include raw or lightly cooked vegetables, fruits, whole grains and healthy fatty acids. However, the article did mention that this diet is not a cure and will mostly like not work for everyone so each individual with RA must experiment with different diet plans (Vann, 2018).
I found it very interesting that Gluten-Free is a diet plan associated to work with relieving joint pain. But I can understand why due to the fact that gluten is very difficult to digest and often is associated with inflammation in the gut. As someone with Celiac disease I know how challenging yet rewarding the process of Gluten-Free can be. I found one woman with RA that said it wasn’t about necessarily buying gluten free packaged foods but switching from cereal in the morning to smoothies or from pasta at night to stir-fry (Kubala. 2019).
What I found was that most people with RA consuming different diet variations lack enough nutrients in Vitamin B6, B12, C, D, E, Calcium, Floic acid, and magnesium. So whatever diet individuals are trying it is important to keep up with maintaining necessary nutrients (Freeman, 2018).
Reference:
Vann, M. R. (2018, September 14). Can a Special Diet Help Rheumatoid Arthritis? Retrieved November 14, 2019, from https://www.everydayhealth.com/hs/rheumatoid-arthritis-treatment-management/special-diets.
Freeman, J. (2018, October 27). RA Diet: What Foods to Eat if You Have Rheumatoid Arthritis? Retrieved November 14, 2019, from https://www.rheumatoidarthritis.org/living-with-ra/diet/.
Kubala, J. (2019, March 6). Is Gluten Bad for you? A Critical Look. Retrieved November 13, 2019, from https://www.healthline.com/nutrition/is-gluten-bad
This is a really interesting topic! I think that the interplay between diet and autoimmune disease is definitely something that needs to be studied more in the long term, especially with the rise of autoimmune disease in Westernized societies over the last 30 years with a strong indication of environmental factors playing a huge role as compared to genetic predispositions (Lerner, Jeremias, & Matthias, 2015). I have two family members with autoimmune diseases, one with Multiple Sclerosis and one with Rheumatoid Arthritis, so diet change to alleviate symptoms has definitely been a hot topic within my family.
ReplyDeleteAfter doing some research on diet and RA, I found some really interesting articles. Growing up, my aunt who was diagnosed with RA was ALWAYS drinking regular Coke, which is why an article regarding soda and RA caught my attention. This study found that particularly in women, regular consumption of sugar-sweetened soda increased the risk of seropositive RA (Hu et al., 2014). After reading this I can't help but wonder if this love for sugary soda may have influenced the onset of RA in my aunt. How many other long-term dietary habits might contribute to the onset of autoimmune disease? Since treatments for autoimmune diseases are so scarce and the causes are fairly unknown, there need to be more long-term studies into preventative measures for these diseases; diet is a relatively trackable factor that ought to be more heavily researched.
References:
Lerner, A., Jeremias, P., & Matthias, T. (2015). The World Incidence and Prevalence of Autoimmune Diseases is Increasing. https://doi.org/10.12691/ijcd-3-4-8
Hu, Y., Costenbader, K. H., Gao, X., Al-Daabil, M., Sparks, J. A., Solomon, D. H., … Lu, B. (2014). Sugar-sweetened soda consumption and risk of developing rheumatoid arthritis in women. The American Journal of Clinical Nutrition, 100(3), 959–967. https://doi.org/10.3945/ajcn.114.086918