World Arthritis Day is celebrated every year on the 12th of October, to raise awareness of issues affecting people with rheumatic and musculoskeletal diseases(RMDs). The overall goal is to highlight it as a major public health concern and to educate people that early diagnosis and timely treatment can prevent further damage.
Significance of early diagnosis important?
To avoid the severity or progression of the disorder, it is important to be aware of the symptoms and consult a healthcare professional.
Rheumatoid arthritis (RA) is a chronic autoimmune disease, mainly characterised by systemic inflammation and joint damage which means it can affect the whole body. The disease severely impacts the quality of life and may lead to reduced life expectancy.
What may lead to it?
Dietary changes can impact the human intestinal microbiome leading to local inflammation, increased permeability and can cause a systemic spread of inflammation.
Studies have shown that a positive relationship between the gastrointestinal microbiome and immune system can influence the activity of the other. This state of mucosal permeability of the gut may play a role in the pathogenesis of the inflammatory disease. As per studies, filamentous bacteria in the gut can cause autoimmune arthritis through their influence on the T helper cells.
Changes in the microbiome influenced by changing lifestyle and imbalanced dietary habits have led to an immunological imbalance.
- Dietary modifications
- Disease-modifying agents
Diet In RA
Coloured fruits and vegetables offer a wide spectrum of anti-inflammatory properties due to the presence of flavonoids, omega 3 fatty acids and vitamins.
Genistein, the major active compound in soybean has anti-proliferative, immunomodulatory, pain relief, and joint protection properties. Similarly, oleic acid in olives exhibits the same effect.
Epigallocatechin-3-gallate (EGCG) in tea may help alleviate the inflammatory markers.
Bioactive compounds found in herbs may help improve the condition.
Polyunsaturated Fatty Acids
In a prospective study carried out in females with RA, dietary intake of long- chain n-3 PUFAs showed a 35% decreased risk of developing RA. Many studies support the role of omega 3 fatty acid supplementation or intake of fish daily to improve the symptoms.
The current study has shown the supplementation of probiotic “Lactobacillus- casei” in women for 8 weeks, has helped decrease serum C- reactive protein (a marker of inflammation), swollen joints along with alleviation of other symptoms.
Vitamin D supplements
Vitamin D has an important role in the pathophysiology of RA. It is seen that low levels of vitamin D are associated with increased disease activity and corticosteroid dosage. However, vitamin D supplementation does not have a disease-modifying effect but it has potent anti-inflammatory effects. Elderly patients with active RA under steroid treatment might need calcium and vitamin D supplements to prevent changes of having osteoporosis and to alleviate the symptoms of anxiety and depression.
In conclusion, Dysbiosis (impaired microbiota) is a key factor in RA and diet can influence the gut microbiome, although RA activity can be manipulated through diet and alteration of gut bacteria. Supplements of probiotics, vitamin D, calcium, or fish oils could be useful as evidence for this is limited.
- Badsha. H. (2018).Role of Diet in Influencing Rheumatoid Arthritis Disease Activity.The Open Rheumatology Journal, 12, 19-28
- Wu H-J, Ivanov II, Darce J, et al. Gut-residing segmented filamentous bacteria drive autoimmune arthritis via T helper 17 cells. Immunity 2010; 32(6): 815-27.
[http://dx.doi.org/10.1016/j.immuni.2010.06.001] [PMID: 20620945]
- Li S, Micheletti R. Role of diet in rheumatic disease. Rheum Dis Clin North Am 2011; 37(1): 119-33. [http://dx.doi.org/10.1016/j.rdc.2010.11.006] [PMID: 21220091]
- Darlington LG, Ramsey NW, Mansfield JR. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986; 1(8475): 236-8.
[http://dx.doi.org/10.1016/S0140-6736(86)90774-9] [PMID: 2868255]