Abstract
ObjectivesSeveral investigators have reported that clinical improvements of patients with rheumatoid arthritis (RA), from participating in therapeutic diet intervention studies, have been accompanied by loss of body weight. This has raised the question whether weight reduction per se can improve RA. In order to test this hypothesis, three previously conducted diet intervention studies, comprising 95 patients with RA, were pooled. Together with Age, Gender, and Disease Duration, change during the test period in body weight, characterised dichotomously as reduction or no reduction (dichoΔBody Weight), as well as Diet (dichotomously as ordinary diet or test diet), were the independent variables. Dependent variables were the difference (Δ) from baseline to conclusion of the study in five different disease outcome measures. ΔESR and ΔPain Score were both characterised numerically and dichotomously (improvement or no improvement). ΔAcute Phase Response, ΔPhysical Function, and ΔTender Joint Count were characterised dichotomously only. Multiple logistic regression was used to analyse associations between the independent and the disease outcome variables.ResultsStatistically significant correlations were found between Diet and three disease outcome variables i.e. ΔAcute-Phase Response, ΔPain Score, and ΔPhysical Function. Δ Body Weight was univariately only correlated to ΔAcute-Phase Response but not significant when diet was taken into account.ConclusionBody weight reduction did not significantly contribute to the improvement in rheumatoid arthritis when eating lacto-vegetarian, vegan or Mediterranean diets.
Highlights
Statistically significant correlations were found between Diet and three disease outcome variables i.e. ∆Acute-Phase Response, ∆Pain Score, and ∆Physical Function. ∆ Body Weight was univariately only correlated to ∆Acute-Phase Response but not significant when diet was taken into account
We have recently found that patients with rheumatoid arthritis (RA) improved significantly in disease activity from eating a modified Cretan Mediterranean diet (MD) [1]
This unexpected weight loss raised the question whether a reduced energy intake, could have been yet another antiinflammatory factor? That diet intervention studies may induce unexpected weight reduction to patients with RA is a finding shared by others [3,4,5,6,7,8,9]
Summary
We have recently found that patients with rheumatoid arthritis (RA) improved significantly in disease activity from eating a modified Cretan Mediterranean diet (MD) [1]. At the end of the experiment the patients of the MD group, but not the control group, had lost 3 kg in weight (p < 0.001 between groups), our ambition had been to prescribe a diet that was isocaloric compared to the patients' previous food intake. This unexpected weight loss raised the question whether a reduced energy intake, could have been yet another antiinflammatory factor? Some researchers [7,8] have even reported a statistically significant correlation between change in body weight with change in arthritis measurements
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