Nutritional impact on health in patients with Rheumatoid Arthritis

Sammanfattning: Objective: Rheumatoid Arthritis (RA) is the most common autoimmune rheumatic disease, affecting around 0.5-1% of the population. The aim of this thesis was to study dietary impact on markers of health in patients with RA. Methods: Data from the randomized controlled crossover trial Antiinflammatory diet in Rheumatoid Arthritis (ADIRA) is used. The trial compares a Mediterranean-like diet intervention with a typical western diet in patients with RA (n = 47). Additionally, cross-sectional analyses were done on data obtained at screening pooled from the ADIRA-trial and a postprandial meal challenge trial in patients with RA (n = 30). Results: In the ADIRA-trial, apolipoprotein-B100/A1 ratio was improved, high density bound cholesterol increased and triglycerides decreased in the intervention compared to the control. Proinflammatory chemokines decreased compared to control, as well as erythrocyte sedimentation rate in participants with high compliance and no major medication changes. Body composition improved over time during both the intervention and the control diet periods. Developments in nutritional quality differed between the intervention and control diet periods, indicating a successful implementation of the dietary regimens. There was no relation between habitual nutritional quality and health outcomes in a pooled cross-sectional analysis. Conclusions: Comparing a Mediterranean-like diet to a typical western diet, dietary intake improved cardiovascular risk profile, and in a per protocol analysis, reduced inflammation. Further studies in more diverse populations are required to determine effects on long-term health outcomes.