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Rheumatoid Arthritis and Nutrition

What is Rheumatoid Arthritis (RA)?

Rheumatoid Arthritis (RA) is defined by the Center for Disease Control and Prevention as a systemic inflammatory disease which manifests itself in multiple joints of the body and primarily affects the lining of the joints (synovial membrane).

The inflamed synovium leads to erosions of the cartilage and bone and sometimes joint deformity. The inflammation can also affect other organs. Pain, swelling, and redness are common symptoms of RA.

The causes of RA are still unknown. Although there is no cure for RA, new effective drugs are increasingly available to treat the disease and prevent deformed joints.

Risk factors of RA

It is believed that the condition is the result of interaction between genetic factors and environmental exposures. Some of the risk factors of RA are socio-demographics, genetics, modifiable, such as smoking, reproductive and breastfeeding history, tobacco use, dietary factors, and microbial exposures.

Nutritional risks in patients with RA

RA patients are at risk of weight loss and cachexia due to cytokine production, which increases resting metabolic rate and protein breakdown. Patients with the pain and swelling find it difficult for frequent food purchasing and preparation.

Some vitamin and mineral deficiencies are very common in RA patients, such as folic acids, vitamin C, vitamin D, vitamin B6, vitamin B12, vitamin E, and calcium.

Nutritional advice

Even though there has not been a conclusive therapeutic diet for RA, patients with RA are encouraged to follow a balanced and healthy diet that helps maintain a healthy weight. A healthy diet also helps reduce the risk of heart disease, high blood pressure and diabetes. These are some main recommendations:

  • Choose a variety of foods
  • Balance your meals with grain products, vegetables, fruits and protein
  • Choose food items that low in fat, saturated fat and cholesterol
  • Balance healthy eating with physical activity, maintain or improve weight
  • Keep it moderate in alcoholic beverage consumption if any
  • Increase intake of antioxidants such as vitamin E and selenium; antioxidants may decrease free-radical damage to joint linings, swelling and pain.

If there is any concern of not consuming enough vitamins and minerals through foods, patients with RA can add a multiple vitamin-mineral supplements that contains 100% of the RDA to their diet. Patients should consult with health care providers before taking any individual vitamin or mineral supplement.

Benefits of exercise in RA patients

Exercise brings in specific health benefits in RA patients, who usually have co-morbidity of cardiovascular disease (CVD) and at risk of losing weight and muscle mass. Physical activity, exercise training, and cardio-respiratory fitness are important cardiovascular disease prevention methods. High intensity resistance exercise has been shown to safely reverse cachexia in patients with RA. As a consequence of this restoration of muscle mass, it improves physical function and reduce disability in RA patients. In additional, exercise promotes the joint health in patients with RA.

Lynne Truong, MS, RD, is a Dietician at Garfield Medical Center.

References

1. Cooney, K, et all. Benefits of Exercise in Rheumatoid Arthritis. Journal of Aging Research Volume 2011, Article ID 681640.

2. Koch, C. Nutrition & Rheumatoid Arthritis. Johns Hopkins Arthritis Center, 2011.

3. Rheumatoid Arthritis

http://www.cdc.gov/arthritis/basics/rheumatoid.htm

This article contains general information about medical conditions and treatments. The information is not advice and should not be treated as such. The information is not intended to replace the advice or diagnosis of a physician.

If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider.