Nutrition is Important in the Fight Against RA and Chronic Disease
Do you know the common saying - eat an apple a day keeps the doctor away? I grew up hearing phrase this often. Perhaps my grandmother, the nurse, helped to spread this medicinal proverb from 19th century Wales. Apples contain several nutrients which promote health including vitamin C, pectin (soluble fiber), boron, quercetin (a flavonoid), and a number of phytonutrients including vitamin A, vitamin E, and beta carotene.
Eating brightly colored fruits and vegetables are actually very good for your health and can help to prevent disease. In fact, a new study published earlier this year suggested that eating foods containing colorful carotenoids, particularly beta carotene and lutein, may prevent or delay the onset of ALS (amyotrophic lateral sclerosis or Lou Gehrig’s disease).
Another study published in the European Journal of Nutrition (Boeing, 2012) provides a critical review of the role of fruit and vegetable consumption in the prevention of chronic diseases including rheumatoid arthritis. Researchers undertook a comprehensive analysis of prior studies evaluating fruit and vegetable intake in regard to several chronic diseases including obesity, type 2 diabetes mellitus, hypertension, coronary heart disease (CHD), stroke, cancer, chronic inflammatory bowel disease (IBD), rheumatoid arthritis (RA), chronic obstructive pulmonary disease (COPD), asthma, osteoporosis, eye diseases, and dementia. The level of evidence, number and size of studies, and quality of the studies were considered.
The analysis showed that for hypertension, CHD (for which RA patients are at increased risk), and stroke, there is convincing evidence that eating more fruits and vegetables reduces the risk of disease. Increased consumption protected against weight gain, however it did not directly affect the incidence of type 2 diabetes. Possible evidence suggests that eating more fruits and vegetables lowers the risk of certain eye diseases, dementia, and osteoporosis.
The data also suggests that increased consumption may contribute to the prevention of asthma, COPD, and RA. For IBD, glaucoma, and diabetic retinopathy, there was insufficient evidence regarding an association between eating fruits and vegetables and disease risk.
Although the cause of RA is largely unknown, it is affected by genetic factors, smoking, being overweight, and the food we eat to a certain extent. Regarding RA and nutrition, the risk of disease seems to be increased by the consumption of red meat, protein, and coffee, while it is lowered by oily fish and olive oil.
In 4 prospective cohort studies identified involving RA, most showed a reduced risk of disease with a high consumption of fruits and vegetables. The one study which did not find an inverse association did not include details regarding the actual amount of fruits and vegetables consumed, making it difficult to compare to the other studies.
In a case-control study (the only one available), eating more servings of cooked vegetables (2.9 servings/day) significantly lowered the risk of RA, while eating raw vegetables was not effective (Linos, 1999). Daily vegetable, but not daily fruit, consumption was associated with more favorable arterial function in patients with RA (Crilly 2012).
In a pilot study in women suffering from RA, a long-lasting improvement of symptoms was achieved by a small increase in the consumption of fruit, vegetables, and legumes (an increase from 3.4 to 3.7 total servings/day) (McKellar, 2007).
Two additional studies highlight the beneficial effects of consuming fish oil by reducing cholesterol levels (Ghorbanihaghjo, 2012) and disease activity. Intakes of polyunsaturated fatty acids, fish oil, and monounsaturated fatty acid have a positive effect on disease activity presumably by decreasing inflammation (Hayashi, 2012).
What does this mean for you? As a person living with RA, it is still very important to eat a sufficient amount of fruits and vegetables, fish oil, and unsaturated fatty acids to help reduce disease activity and pain. If you are not diagnosed with RA, these studies suggest that it is even more important to “eat your fruits and vegetables” to protect yourself against chronic diseases including RA.
Boeing H, Bechthold A, Bub A, et al. Critical review: vegetables and fruit in the prevention of chronic diseases. Eur J Nutr 2012 Sep;51(6):637–663. DOI 10.1007/s00394-012-0380-y. Epub 2012 Jun 9.
Crilly MA, McNeill G. Arterial dysfunction in patients with rheumatoid arthritis and the consumption of daily fruits and daily vegetables. Eur J Clin Nutr 2012 Mar;66:345-352. doi:10.1038/ejcn.2011.199
Ghorbanihaghjo A, Kolahi S, Seifirad S, et al. Effect of fish oil supplements on serum paraoxonase activity in female patients with rheumatoid arthritis: a double-blind randomized controlled trial. Arch Iran Med 2012 Sep;15(9):549-52. doi: 012159/AIM.007
Hayashi H, Satoi K, Sato-Mito N, et al. Nutritional status in relation to adipokines and oxidative stress is associated with disease activity in patients with rheumatoid arthritis. Nutrition 2012 Nov-Dec;28(11-12):1109-14. doi: 10.1016/j.nut.2012.02.009.
Linos A, Kaklamani VG, Kaklamani E, et al. Dietary factors in relation to rheumatoid arthritis: a role for olive oil and cooked vegetables? Am J Clin Nutr 1999 Dec;70(6):1077–1082.
McKellar G, Morrison E, McEntegart A, et al. A pilot study of Mediterranean-type diet intervention in female patients with rheumatoid arthritis (RA) living in areas of social deprivation in Glasgow. Ann Rheum Dis 2007 Sep;66:1239–1243. Epub 2007 Jul 5.