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Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating dieffects on disease activity

Artikel i vetenskaplig tidskrift
Författare Anna K. E. Vadell
Linnea Bärebring
Erik Hulander
Inger Gjertsson
Helen Lindqvist
Anna Winkvist
Publicerad i American Journal of Clinical Nutrition
Volym 111
Nummer/häfte 6
Sidor 1203-1213
ISSN 0002-9165
Publiceringsår 2020
Publicerad vid Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning
Institutionen för medicin, avdelningen för invärtesmedicin och klinisk nutrition
Sidor 1203-1213
Språk en
Länkar dx.doi.org/10.1093/ajcn/nqaa019
Ämnesord anti-inflammatory, rheumatoid arthritis, diet, inflammation, omega-3, fatty acids, probiotics, dietary fiber, DAS28, Sweden, double-blind, mediterranean diet, symptoms, supplementation, intervention, reduction, Nutrition & Dietetics
Ämneskategorier Näringslära

Sammanfattning

Background: Many patients with rheumatoid arthritis (RA) report symptom relief from certain foods. Earlier research indicates positive effects of food and food components on clinical outcomes in RA, but insufficient evidence exists to provide specific dietary advice. Food components may interact but studies evaluating combined effects are lacking. Objectives: We aimed to investigate if an anti-inflammatory diet reduces disease activity in patients with RA. Methods: In this single-blinded crossover trial, 50 patients with RA were randomly assigned to an intervention diet containing a portfolio of suggested anti-inflammatory foods, or a control diet similar to the general dietary intake in Sweden, for 10 wk. After a 4-mo washout period the participants switched diet. Food equivalent to similar to 50% of energy requirements was delivered weekly to their homes. For the remaining meals, they were encouraged to consume the same type of foods as the ones provided during each diet. Primary outcome was change in Disease Activity Score in 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR). Secondary outcomes were changes in the components of DAS28-ESR (tender and swollen joints, ESR, and visual analog scale for general health) and DAS28-C-reactive protein. Results: In the main analysis, a linear mixed ANCOVA model including the 47 participants completing =1 diet period, there was no significant difference in DAS28-ESR between the intervention and control periods (P = 0.116). However, in unadjusted analyses, DAS28-ESR significantly decreased during the intervention period and was significantly lower after the intervention than after the control period in the participants who completed both periods (n = 44; median: 3.05; IQR: 2.41, 3.79 compared with median: 3.27; IQR: 2.69, 4.28; P = 0.04, Wilcoxon's Signed Rank test). No significant differences in the components were observed. Conclusions: This trial indicates positive effects of a proposed antiinflammatory diet on disease activity in patients with RA. Additional studies are required to determine if this diet can cause clinically relevant improvements.

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