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.