Recent research has revealed that dietary intervention in conjunction with omega-3 PUFAs supplementation resulted in significant improvements in patients with RA compared with diet alone.
In a recent publication in the journal Nutrients, researchers conducted a systemic review and evaluated the effects of different dietary interventions, with or without omega-3 supplementation, for the management of RA. The research included 20 studies with 1,063 participants. More than 80% of participants in these studies were women (average age 48.5 years), and they represented nine countries—Sweden, United Kingdom, Italy, Norway, Denmark, Finland, the Netherlands, the United States, and Germany.
Only two studies evaluated omega-3 PUFAs supplementation in combination with dietary intervention. The results demonstrated that supplementation with omega-3 PUFAs resulted in significant improvements in the duration of early morning stiffness (EMS), pain levels, erythrocyte sedimentation rate, physical function, grip strength, joint tenderness, and levels of leukotriene B4 (LTB4) among those with RA.
In one study, investigators reported significant decreases in C-reactive protein, tumor necrosis factor-α, and doses of corticosteroids in participants who followed both an anti-inflammatory diet and a Western diet with fish oil supplements. They found notable improvements in tender joints and LTB4 levels among the anti-inflammatory diet group only when omega-3 PUFAs were supplemented.
In a separate study, a diet rich in PUFAs (P:S ratio 5:0) in combination with omega-3 supplementation (1.6 g EPA/day and 1.1 g DHA/day) led to significant benefits in EMS, Ritchie's index, and grip strength.
The authors noted, "This indicates that the anti-inflammatory benefits of a diet in combination with omega 3 PUFAs may be superior to the diet alone."
The review also discovered that a vegetarian diet significantly improved several parameters of RA, such as pain, physical function, grip strength, EMS, number of tender and swollen joints, as well as inflammation. The researchers noted that significant improvements in disease activity score, physical function, and overall health were found with a Mediterranean diet.
The authors also indicated that the review had several study limitations, such as the heterogeneity among the included studies and the presence of various levels/qualities of evidence. Moreover, the lack of standardization of outcome measures, variety of dietary interventions, comparators, and methodologies created difficulties with drawing conclusions. Lastly, the majority of studies were considered to be unclear or have a high risk of bias, and they did not control for confounding variables.
The authors wrote, "Dietary interventions with an anti-inflammatory basis may be an effective way for adults with RA seeking complementary treatments, potentially leading to improvements in certain parameters. However, there is a need for longer duration studies that are well-designed and sufficiently powered to investigate the influence of diet on RA."
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