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Research article
Roberto Paganelli
Università degli Studi Gabriele d'Annunzio Chieti Pescara Dipartimento di Scienze: Universita degli Studi Gabriele d'Annunzio Chieti Pescara
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3467-9317
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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 3-months’ diet avoiding meat, gluten, and lactose (privative diet) was evaluated in comparison with a control balanced diet including those foods. Patients choosing the exclusion diet were followed in parallel to an equal number of patients on their normal diet, 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 anthropometric measurements were recorded. 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 following the avoidance diet. Both dietary regimens resulted in the improvement of quality of life compared to baseline values, however the change was significant only for the exclusion diet. With either diet, patients showed significant decreases of body weight and body mass index (BMI), with a reduction of waist and hips circumferences, lower basal glucose and circulating leptin levels. Exclusion diet was also able to significantly reduce systolic (SYS) (p=0.002) and diastolic (DIA) (p=0.027) arterial pressure. The number of circulating leukocytes and neutrophils, and the level of hs-C-Reactive Protein (CRP) were also significantly decreased after 3 months of the meat-, lactose, and gluten-free diet.
Conclusions: Our results suggest that an exclusion diet can result in a better control of inflammation and pain in RA patients under stable optimized drug treatment.
Keywords
Rheumatoid arthritis, Inflammation, Pain, Dietary regimen, Meat- Gluten- and Lactose- exclusion diet, Bioimpedance Analysis, Leptin
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A new preprint design is coming!
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This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Research article
Roberto Paganelli
Università degli Studi Gabriele d'Annunzio Chieti Pescara Dipartimento di Scienze: Universita degli Studi Gabriele d'Annunzio Chieti Pescara
Corresponding Author
ORCiD: https://orcid.org/0000-0003-3467-9317
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 17 May, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Rheumatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
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 3-months’ diet avoiding meat, gluten, and lactose (privative diet) was evaluated in comparison with a control balanced diet including those foods. Patients choosing the exclusion diet were followed in parallel to an equal number of patients on their normal diet, 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 anthropometric measurements were recorded. 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 following the avoidance diet. Both dietary regimens resulted in the improvement of quality of life compared to baseline values, however the change was significant only for the exclusion diet. With either diet, patients showed significant decreases of body weight and body mass index (BMI), with a reduction of waist and hips circumferences, lower basal glucose and circulating leptin levels. Exclusion diet was also able to significantly reduce systolic (SYS) (p=0.002) and diastolic (DIA) (p=0.027) arterial pressure. The number of circulating leukocytes and neutrophils, and the level of hs-C-Reactive Protein (CRP) were also significantly decreased after 3 months of the meat-, lactose, and gluten-free diet.
Conclusions: Our results suggest that an exclusion diet can result in a better control of inflammation and pain in RA patients under stable optimized drug treatment.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Figure 6
Figure 7
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