Key clinical point: An anti-inflammatory diet showed signs of improving disease activity in adults with rheumatoid arthritis.

Major finding: In an unadjusted analysis, adults with RA showed significant decrease in Disease Activity Score in 28 joints using erythrocyte sedimentation rate (DAS28-ESR) while following an intervention diet of anti-inflammatory foods, compared with a period on a standard diet (3.05 vs. 3.27; P = 0.04).

Study details: The data come from a single-blinded crossover trial of 50 adults with RA.

Disclosures: The study was supported by the Swedish Government and a variety of foundations. The researchers had no financial conflicts to disclose.

Commentary

“People who are diagnosed with RA often ask their physicians about the effects of dietary changes on their arthritis, as well as about anti-inflammatory supplements and the benefits of vitamins and probiotics. Much of the research in this area, while promising in terms of interventions, involves relatively small numbers of patients and difficulty in causation analysis. This Swedish single-blind crossover study, while small, investigates an anti-inflammatory portfolio diet (high in fiber, probiotics, and n-3 fatty acids) compared to a typical Swedish diet. Patients were given food (either from the intervention or control arm) to prepare 5 days a week for 10 weeks followed by a washout period and switched to the other arm. RA patients using anti-inflammatory diet did indeed seem have lower indices of RA activity than those following the control diet, but the differences were small and not uniform, as tender and swollen joint counts did improve among patients during both the control and intervention diet periods. From a practical standpoint, this study parallels the pitfalls and findings of earlier research; while the anti-inflammatory diet used here appears to not cause any deterioration in RA, whether it actually is beneficial is unclear.”

Arundathi Jayatilleke, MD

Lewis Katz School of Medicine, Temple University