REVIEW - Effectiveness and safety of dietary interventions for RA

February 16, 2011

J Am Diet Assoc. 2010 May;110(5):727-35.

Effectiveness and safety of dietary interventions for rheumatoid

arthritis: a systematic review of randomized controlled trials.

Smedslund G, Byfuglien MG, Olsen SU, Hagen KB.

National Resource Centre for Rehabilitation in Rheumatology,

Diakonhjemmet Hospital, Oslo, Norway.

Abstract

This systematic review assesses the effectiveness and safety of

dietary interventions for rheumatoid arthritis. Randomized controlled

trials comparing any dietary manipulation with an ordinary diet were

included. Eight randomized controlled trials with a total of 366

patients were included.

One trial found that fasting, followed by 13 months on a vegetarian

eating plan, might reduce pain (mean difference on a zero to 10 scale

-1.89, 95% confidence interval [CI] -3.62 to -0.16). Another single

trial found that a 12-week Cretan Mediterranean eating plan might

reduce pain (mean difference on a 0 to 100 scale -14.00, 95% CI -23.6

to -4.37).

Due to inadequate data reporting, the effects of vegan eating plans

and elimination diets are uncertain.

When comparing any dietary manipulation with an ordinary diet we found

a higher total drop-out of 8% (risk difference 0.08, 95% CI -0.01 to

0.17), higher treatment-related drop-out of 5% (risk difference 0.05,

95% CI -0.03 to 0.14) and a significantly higher weight loss (weighted

mean difference -3.24, 95% CI -4.81 to -1.67 kg) in the diet groups

compared to the control groups.

The effects of dietary manipulation, including vegetarian,

Mediterranean, and elemental eating plans, and elimination diets on

rheumatoid arthritis are still uncertain due to the included studies

being small, single trials with moderate to high risk of bias.

We conclude that higher dropout rates and weight loss in the groups

with dietary manipulation indicate that potential adverse effects

should not be ignored.

PMID: 20430134

Not an MD

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