Research

11 pages, 657 KiB

Open AccessArticle

Improvements in Body Composition after a Proposed Anti-Inflammatory Diet Are Modified by Employment Status in Weight-Stable Patients with Rheumatoid Arthritis, a Randomized Controlled Crossover Trial

by Erik Hulander, Helen M. Lindqvist, Anna Turesson Wadell, Inger Gjertsson, Anna Winkvist and Linnea Bärebring

Nutrients 2022, 14(5), 1058; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14051058 - 02 Mar 2022

Cited by 5 | Viewed by 2515

Abstract

Rheumatoid Arthritis (RA) is an autoimmune disease affecting peripheral joints. Chronic activation of inflammatory pathways results in decreased function and the development of comorbidities, such as loss of lean mass while retaining total body mass. The objective of this report was to assess [...] Read more.

Rheumatoid Arthritis (RA) is an autoimmune disease affecting peripheral joints. Chronic activation of inflammatory pathways results in decreased function and the development of comorbidities, such as loss of lean mass while retaining total body mass. The objective of this report was to assess whether dietary manipulation affects body composition in patients with RA as a secondary outcome. Fifty patients were included in a randomized controlled crossover trial testing a proposed anti-inflammatory Mediterranean-style diet compared to a Western diet. Body composition was measured by bioelectrical impedance spectroscopy in patients without implants (n = 45). Regardless of treatment, fat-free mass increased and fat mass percentage decreased during weight stability, but no differences between intervention and control in the whole group (n = 42, all p > 0.20) were found. Interaction analysis revealed that participants who were non-employed (n = 15) significantly decreased in fat mass (−1.767 kg; 95% CI: −3.060, −0.475, p = 0.012) and fat mass percentage (−1.805%; 95% CI: −3.024, −0.586, p = 0.008) from the intervention compared to the control period. A Mediterranean-style diet improved body composition in non-employed participants (n = 15). The group as a whole improved regardless of dietary allocation, indicating a potential to treat rheumatoid cachexia by dietary manipulation. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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14 pages, 1004 KiB

Open AccessArticle

Improvement of Inflammation and Pain after Three Months’ Exclusion Diet in Rheumatoid Arthritis Patients

by Maria Teresa Guagnano, Chiara D’Angelo, Daniela Caniglia, Pamela Di Giovanni, Eleonora Celletti, Emanuela Sabatini, Lorenza Speranza, Marco Bucci, Francesco Cipollone and Roberto Paganelli

Nutrients 2021, 13(10), 3535; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13103535 - 09 Oct 2021

Cited by 26 | Viewed by 7662

Abstract

Introduction: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease affecting the synovial joints and causing severe disability. Environmental and lifestyle factors, including diet, have been proposed to play a role in the onset and severity of RA. Dietary manipulation may help to [...] Read more.

Introduction: Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease affecting the synovial joints and causing severe disability. Environmental and lifestyle factors, including diet, have been proposed to play a role in the onset and severity of RA. Dietary manipulation may help to manage the symptoms of RA by lowering inflammation and potentially decreasing pain. Methods: In 40 patients with long-standing RA with stable symptoms and treated with conventional (c-) and biological (b-) disease modifying anti-rheumatic drugs (DMARDs), the effect of a 3-month diet avoiding meat, gluten, and lactose (and all dairy products; privative diet) was evaluated in comparison with a control balanced diet including those foods. Both diets were designed to reduce weight since all patients were overweight or obese. Patients were randomly assigned to one of the diets, and RA was clinically assessed at Time 0 (T0), through the Visual Analogue Scale (VAS), for pain, and the Disease Activity Score of 28 joints (DAS 28) for RA activity. Patients were also administered the Short Form Health survey (SF-36) and the Health Assessment Questionnaire (HAQ). At T0, a blood sample was collected for laboratory tests and adipokines measurements, and anthropometric measurements were compared. These evaluations were repeated at the end of the 3 months’ dietary regimens. Results: A significant decrease in VAS and the improvement of the overall state of physical and mental health, assessed through SF-36, was observed in patients assigned to the privative diet. Both dietary regimens resulted in the improvement of quality of life compared to baseline values; however, the change was significant only for the privative diet. With either diet, patients showed significant decreases in body weight and body mass index, with a reduction in waist and hips circumference and lower basal glucose and circulating leptin levels. A privative diet was also able to significantly reduce systolic (p = 0.003) and diastolic (p = 0.025) arterial pressure. The number of circulating leukocytes and neutrophils, and the level of hs-C-Reactive Protein also decreased after 3 months of the meat-, lactose-, and gluten-free diet. Conclusions: Our results suggest that a privative diet can result in a better control of inflammation in RA patients under stable optimized drug treatment. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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Graphical abstract

11 pages, 617 KiB

Open AccessFeature PaperArticle

Human Leukocyte Antigen (HLA) Typing Study Identifies Maternal DQ2 Susceptibility Alleles among Infertile Women: Potential Associations with Autoimmunity and Micronutrients

by Paola Triggianese, Carlo Perricone, Erica De Martino, Arianna D’Antonio, Maria Sole Chimenti, Paola Conigliaro, Sara Ferrigno, Ilio Giambini, Elisabetta Greco and Caterina De Carolis

Nutrients 2021, 13(9), 3270; https://0-doi-org.brum.beds.ac.uk/10.3390/nu13093270 - 19 Sep 2021

Cited by 4 | Viewed by 3044

Abstract

Background. The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status. Methods. Consecutive women ( [...] Read more.

Background. The interplay between female fertility and autoimmune diseases (AIDs) can involve HLA haplotypes and micronutrients. We analyzed the distribution of HLA-DQ2/-DQ8 in women with infertility or recurrent spontaneous abortion (RSA) and possible associations with AIDs and micronutrient status. Methods. Consecutive women (n = 187) with infertility and RSA, and controls (n = 350) were included. All women were genotyped for HLA-DQ2 (DQA1*0201, A1*05, and B1*02) and -DQ8 (DQA1*03 and DQB1*0302) alleles. Serum 25(OH)D, VB12, folate, and ferritin were evaluated. Results. DQA1*05/B1*02 and the occurrence of at least one DQ2 allele were more prevalent among RSA and infertile women than controls. Infertile women showed lower 25(OH)D and higher prevalence of AIDs than RSA women. In the multivariate analysis, DQA1*05/B1*02 was associated with a significantly higher risk of AIDs in infertile women, and DQA1*05 was independently associated with both 25(OH)D deficiency and AIDs. In RSA women, the presence of AIDs was associated with a significantly higher risk of 25(OH)D deficiency. Conclusion. Our findings showed, for the first time, a higher proportion of DQ2 alleles in infertile and RSA women as compared to controls. Predisposing DQ2 alleles are independent risk factors for AIDs and 25(OH)D deficiency in infertile women and could represent biomarkers for performing early detection of women requiring individually tailored management. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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Review

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17 pages, 1487 KiB

Open AccessReview

Vitamin D Supplementation in Patients with Juvenile Idiopathic Arthritis

by Chao-Yi Wu, Huang-Yu Yang, Shue-Fen Luo, Jing-Long Huang and Jenn-Haung Lai

Nutrients 2022, 14(8), 1538; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14081538 - 07 Apr 2022

Cited by 5 | Viewed by 2606

Abstract

Vitamin D has been implicated in the pathogenesis of skeletal disorders and various autoimmune disorders. Vitamin D can be consumed from the diet or synthesized in the skin upon ultraviolet exposure and hydroxylation in the liver and kidneys. In its bioactive form, vitamin [...] Read more.

Vitamin D has been implicated in the pathogenesis of skeletal disorders and various autoimmune disorders. Vitamin D can be consumed from the diet or synthesized in the skin upon ultraviolet exposure and hydroxylation in the liver and kidneys. In its bioactive form, vitamin D exerts a potent immunomodulatory effect and is important for bone health. Juvenile idiopathic arthritis (JIA) is a collection of inflammatory joint diseases in children that share the manifestation of inflamed synovium, which can result in growth arrest, articular deformity, bone density loss, and disability. To evaluate the potential effect of vitamin D on JIA disease manifestations and outcomes, we review the role of vitamin D in bone metabolism, discuss the mechanism of vitamin D in modulating the innate and adaptive immune systems, evaluate the clinical significance of vitamin D in patients with JIA, and summarize the supplementation studies. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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15 pages, 538 KiB

Open AccessReview

Nutrition in Spondyloarthritis and Related Immune-Mediated Disorders

by Stefan Lucian Popa, Dinu Iuliu Dumitrascu, Vlad Dumitru Brata, Traian Adrian Duse, Maria Delia Florea, Abdulrahman Ismaiel, Laura Mirela Muntean and Simona Grad

Nutrients 2022, 14(6), 1278; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14061278 - 17 Mar 2022

Cited by 4 | Viewed by 5011

Abstract

Recent research on the pathogenesis of spondyloarthritis and related immune-mediated diseases associated with human leukocyte antigen class I molecule B27 (HLA-B27) has led to significant progress in terms of management and prognosis, with multiple treatments being constantly evaluated and implemented. Correlations between the [...] Read more.

Recent research on the pathogenesis of spondyloarthritis and related immune-mediated diseases associated with human leukocyte antigen class I molecule B27 (HLA-B27) has led to significant progress in terms of management and prognosis, with multiple treatments being constantly evaluated and implemented. Correlations between the genetic background of spondyloarthritis and inflammatory bowel diseases and the inflammatory processes involving gut microbiota have been established. This knowledge has allowed progress in pharmacological therapy. The role of diet in the pathogenesis and treatment of diseases pertaining to the HLA-B27 spectrum is of great significance, considering possible future applications in individualized medicine. Diet impacts the composition of gut microbiota, representing a substrate for the synthesis of metabolites affecting the mucosal immune system. Certain pro-inflammatory mediators, such as emulsifiers and microparticles, induce a more profound cytokine response, promoting inflammation. Numerous diets, including the low-starch diet, the Mediterranean diet, diets with low contents of fermentable oligosaccharides, disaccharides, monosaccharides and polyols (low-FODMAP diets), gluten-free diets and fasting, have been analysed and correlated with patients’ symptomatology and dietary adherence. The aim of this review is to provide an extensive perspective on the diets available to patients with spondyloarthritis and related immune-mediated disorders. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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30 pages, 957 KiB

Open AccessReview

The Relationship between Fatty Acids and the Development, Course and Treatment of Rheumatoid Arthritis

by Wojciech Tański, Natalia Świątoniowska-Lonc, Mateusz Tabin and Beata Jankowska-Polańska

Nutrients 2022, 14(5), 1030; https://0-doi-org.brum.beds.ac.uk/10.3390/nu14051030 - 28 Feb 2022

Cited by 10 | Viewed by 3515

Abstract

For this systematic review, a search of the relevant literature was conducted in the EMBASE and PubMed databases. We used the following terms: ‘rheumatoid arthritis’ in conjunction with ‘fatty acid’. The following inclusion criteria had to be satisfied for the studies to be [...] Read more.

For this systematic review, a search of the relevant literature was conducted in the EMBASE and PubMed databases. We used the following terms: ‘rheumatoid arthritis’ in conjunction with ‘fatty acid’. The following inclusion criteria had to be satisfied for the studies to be included in the analysis: an RCT/observational/cohort study published in English. A total of seventy-one studies were analysed. The presented systematic review of the available data indicates that increased consumption of omega-3 fatty acids (FAs) may have a beneficial effect on human health by decreasing pain and disease activity in patients with RA. The beneficial effect of unsaturated FA on the clinical parameters of RA was demonstrated in all 71 studies analysed. The content of omega-3 FAs in the diet and the consumption of fish, which are their main source, may contribute to a reduced incidence of RA. FAs are an essential component in the synthesis of eicosanoids that exhibit anti-inflammatory properties. Due to the documented positive influence of unsaturated FAs on treatment outcomes, the use of a diet rich in long-chain unsaturated FAs should be the standard of care, along with pharmacotherapy, in the treatment of RA patients. An important element in the control of the treatment process should be the routine assessment of the quality of life of RA patients. Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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Other

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2 pages, 176 KiB

Open AccessReply

Reply to Mathieu et al. Omega 3 Fatty Acids Intake Does Not Decrease the Risk of Rheumatoid Arthritis Occurrence: A Meta-Analysis. Comment on “Tański et al. The Relationship between Fatty Acids and the Development, Course and Treatment of Rheumatoid Arthritis. Nutrients 2022, 14, 1030”

by Natalia Świątoniowska-Lonc, Wojciech Tański, Mateusz Tabin and Beata Jankowska-Polańska

Nutrients 2023, 15(3), 540; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15030540 - 20 Jan 2023

Viewed by 1138

Abstract

In response to the comment [...] Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

4 pages, 1654 KiB

Open AccessComment

Omega 3 Fatty Acids Intake Does Not Decrease the Risk of Rheumatoid Arthritis Occurrence: A Meta-Analysis. Comment on Tański et al. The Relationship between Fatty Acids and the Development, Course and Treatment of Rheumatoid Arthritis. Nutrients 2022, 14, 1030

by Sylvain Mathieu, Bruno Pereira, Claire Daïen, Anne Tournadre and Martin Soubrier

Nutrients 2023, 15(3), 539; https://0-doi-org.brum.beds.ac.uk/10.3390/nu15030539 - 20 Jan 2023

Cited by 1 | Viewed by 1770

Abstract

In an article published in Nutrients, Tański et al. performed a systematic review and concluded that omega-3 fatty acids might contribute to a reduced incidence of rheumatoid arthritis (RA) [...] Full article

(This article belongs to the Special Issue Rheumatology: Nutritional Status and Treatment)

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