Mediterranean diet and quality of life in Rheumatoid Arthritis patients

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory disease associated with various comorbidities and systemic manifestations. RA is the most common type of autoimmune arthritis, affecting 0.5-1% of the adult population worldwide. While the primary line of treatment for RA includes pharmacological therapies, people living with the condition often seek non-pharmacological therapies such as diet and exercise in an attempt to attenuate their symptoms. Nutrition plays a crucial role in managing RA symptoms, and the Mediterranean diet (MeD) has been suggested to have potential benefits. The MeD includes a variety of fruits, vegetables, whole grains, nuts, seeds, legumes, olive oil, and fish. It also includes moderate dairy (yogurt and cheese) and low amounts of red and processed meats and sweets. The MeD contains anti-inflammatory compounds in olive oil (like oleic acid and hydroxytyrosol), fruits, vegetables, and fish. These compounds can help mitigate the inflammatory processes associated with RA. Furthermore, several studies indicate that the MeD can improve physical function in RA patients by reducing pain and stiffness and increasing overall mobility. Nevertheless, by potentially reducing pain and improving physical function, the MeD may contribute to an overall improvement in the quality of life for individuals with RA. Studies suggest increased adherence to a MeD can reduce disease activity and pain and improve physical function and vitality. RA patients are at increased risk of cardiovascular disease, and the MeD has been associated with a reduced risk of cardiovascular disease, which is an added benefit for this population. Maintaining a healthy weight is crucial for RA patients, as excess weight can put additional strain on the joints. The MeD, typically high in fiber and low in processed foods, can support healthy weight management, reduce the joint burden, and improve the quality of life in these patients. Several studies, including randomized controlled trials, have shown promising results regarding the effectiveness of the MeD in managing RA symptoms and improving patient outcomes. Recent evidence suggests that dietary interventions, particularly Mediterranean diets, may synergistically enhance the therapeutic effects of conventional pharmacological treatments such as NSAIDs and DMARDs in RA management. Adherence to a MeD may positively influence inflammatory markers and gut microbiota composition, potentially augmenting the efficacy of pharmacologic agents and improving overall patient outcomes. RA patients can benefit from the MeD in terms of both disease activity and disease-related complications. Due to its anti-inflammatory and antioxidant effects and its role in maintaining body weight, the MD could be a helpful adjunct in treating RA. Therefore, integrating targeted nutritional strategies alongside standard drug therapy may offer a more comprehensive approach to controlling RA progression and symptoms. In summary, the Mediterranean diet, emphasizing anti-inflammatory foods and healthy fats, has shown potential benefits for RA patients by reducing inflammation, improving physical function, and enhancing overall quality of life.