Doctor's Review: Medicine on the Move

December 6, 2021
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Rheumatoid arthritis + diet?

In 2003, arthritis and rheumatism were the third most common conditions affecting Canadians, ahead of high blood pressure, heart disease, diabetes and cancer.(1) According to Statistics Canada, it’s projected that by 2026 up to 6.4 million Canadians will suffer from these conditions.

While the current treatment for rheumatoid arthritis (RA) includes taking medications to reduce the symptoms and delay the progress of the disease, many of these medications have negative side effects, such as GI bleeding associated with NSAIDs, hypertension, insulin resistance and bone loss that is associated with taking corticosteroids and folic-acid deficiency with DMARDs. Patients and medical professionals are looking to diet and supplements to reduce the use of medications that manage the disease. Here are some highlights of the latest research:

Omega-3 fatty acids

Studies have found that Omega-3 fatty acids decreased the symptoms associated with RA such as morning stiffness and tender and swollen joints.(2) As well, a dose of 2.2 grams a day was found to reduce NSAID requirements by more than 30 percent.(3) It’s difficult to achieve this dose of omega-3 by diet alone, so a supplement might be required.

Mediterranean diet

Research has found that participants in a study who followed a Mediterranean diet (rich in fruits, vegetables, mono-unsaturated fatty acids and poly-unsaturated fatty acids) for three months had a reduction in inflammatory activity, improved physical function and vitality, as well as improvements in pain score and morning stiffness.(4) The Mediterranean diet has also been associated with a decreased risk of cardiovascular disease which is a common comorbidity of RA.(5)

Vitamin D

Patients recently diagnosed with RA were found to have lower levels of vitamin D metabolites. It was found that patients deficient in vitamin D had worse disease activity and severity, both at baseline and at their one-year follow-up.(6) People with RA are at a higher risk of developing osteopenia and osteoporosis. Therefore it is prudent to measure blood levels of both calcium and vitamin D (25-OH-D) and then advise patients on taking supplements accordingly.

Alternative therapies

Currently it is estimated that between 28 and 90 percent of patients with RA are interested in or are already using some form of complimentary or alternative therapy.(7) These include acupuncture, pulsed electromagnetic field and herbal medicines. It’s essential to be aware of these treatments and their possible positive or negative impacts on conventional medical treatments. Some recent research has focused on Indian herbal medicines’ anti-inflammatory and antioxidant properties. The herbs that were found to have a positive effect on RA’s symptoms were ginger, bromelain (an extract from pineapple stem), turmeric and saffron.(8) In addition, green-tea polyphenols and cat’s claw also present with substantial evidence of efficacy for the treatment of RA symptoms.(9)

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