Die Bedeutung der Ernährung für die Entstehung und Behandlung der rheumatoiden Arthritis

Zusammenfassung

Ein ernährungsbedingter Einfluss auf die Entstehung einer rheumatoiden Arthritis (RA) wurde vielfach vermutet, ist aber nur für wenige Faktoren reproduzierbar nachgewiesen worden. Diätetische Interventionen, die den Anforderungen an eine klinische Studie entsprechen, sind bei der RA methodisch schwierig und in ihren Aussagen widersprüchlich. Diätempfehlungen, die auf die Reduktion kardiovaskulärer Risikofaktoren gerichtet sind, lassen auch für die RA positive Effekte vermuten.

Summary

The assumption that nutritional factors may contribute to the pathogenesis of rheumatoid arthritis has been verified for a few dietary items only. Dietary interventions that fulfill the criteria of a clinical study in RA encounter methodological problems and lead to contradictory results. Dietary recommendations aimed at the reduction of cardiovascular risk factors are valid for patients with RA as well.

Schlüsselwörter

Rheumatoide Arthritis - Inzidenz - Diät - Fasten

Keywords

Rheumatoid arthritis - incidence - diet - fasting

• Literatur

• 1 Hagen KB, Byfuglien MG, Falzon L. et al. Dietary interventions for rheumatoid arthritis. Cochrane database of systematic reviews (Online). 2009 CD006400.
• 2 Costenbader KH, Feskanich D, Mandl LA, Karlson EW. Smoking intensity, duration, and cessation, and the risk of rheumatoid arthritis in women. The American journal of medicine 2006; 119: 503-503e9.
• 3 Lee DM, Phillips R, Hagan EM. et al. Quantifying anti-cyclic citrullinated peptide titres: clinical utility and association with tobacco exposure in patients with rheumatoid arthritis. Annals of the rheumatic diseases 2009; 68: 201-208.
• 4 Kallberg H, Jacobsen S, Bengtsson C. et al. Alcohol consumption is associated with decreased risk of rheumatoid arthritis: results from two Scandinavian case-control studies. Annals of the rheumatic diseases 2009; 68: 222-227.
• 5 Pattison DJ, Symmons DP, Young A. Does diet have a role in the aetiology of rheumatoid arthritis?. The Proceedings of the Nutrition Society 2004; 63 (01) 137-143.
• 6 Benito-Garcia E, Feskanich D, Hu FB. et al. Protein, iron, and meat consumption and risk for rheumatoid arthritis: a prospective cohort study. Arthritis research & therapy 2007; 9: R16.
• 7 Pedersen M, Stripp C, Klarlund M. et al. Diet and risk of rheumatoid arthritis in a prospective cohort. The Journal of rheumatology 2005; 32: 1249-1252.
• 8 Cerhan JR, Saag KG, Merlino LA. et al. Antioxidant micronutrients and risk of rheumatoid arthritis in a cohort of older women. American journal of epidemiology 2003; 157: 345-354.
• 9 Pattison DJ, Symmons DP, Lunt M. et al. Dietary beta-cryptoxanthin and inflammatory polyarthritis: results from a population-based prospective study. The American journal of clinical nutrition 2005; 82: 451-455.
• 10 Merlino LA, Curtis J, Mikuls TR. et al. Vitamin D intake is inversely associated with rheumatoid arthritis: results from the Iowa Women's Health Study. Arthritis and rheumatism 2004; 50: 72-77.
• 11 Kjeldsen-Kragh J, Haugen M, Borchgrevink CF. et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 1991; 338: 899-902.
• 12 Muller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scandinavian journal of rheumatology 2001; 30: 1-10.
• 13 Kitas GD, Gabriel SE. Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Annals of the rheumatic diseases 2011; 70: 8-14.
• 14 Westhoff G, Rau R, Zink A. Radiographic joint damage in early rheumatoid arthritis is highly dependent on body mass index. Arthritis and rheumatism 2007; 56: 3575-3582.
• 15 Skoldstam L, Hagfors L, Johansson G. An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. Annals of the rheumatic diseases 2003; 62: 208-214.
• 16 Shai I, Schwarzfuchs D, Henkin Y. et al. Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet. The New England journal of medicine 2008; 359: 229-241.
• 17 Maxwell JR, Gowers IR, Moore DJ, Wilson AG. Alcohol consumption is inversely associated with risk and severity of rheumatoid arthritis. Rheumatology (Oxford, England) 2010; 49: 2140-2146.
• 18 Nissen MJ, Gabay C, Scherer A, Finckh A. The effect of alcohol on radiographic progression in rheumatoid arthritis. Arthritis and rheumatism 2010; 62: 1265-1272.
• 19 Goldberg RJ, Katz J. A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain. Pain 2007; 129: 210-223.
• 20 Remans PH, Sont JK, Wagenaar LW. et al. Nutrient supplementation with polyunsaturated fatty acids and micronutrients in rheumatoid arthritis: clinical and biochemical effects. European journal of clinical nutrition 2004; 58: 839-845.
• 21 Miller ER, 3^rd Pastor-Barriuso R, Dalal D. et al. Meta-analysis: high-dosage vitamin E supplementation may increase all-cause mortality. Annals of internal medicine 2005; 142 (01) 37-46.