In chronic inflammatory rheumatism, certain diet adjustments can help reduce the manifestations of the disease. Others, however, such as exclusionary regimes, are not helpful.
Inflammatory rheumatism is characterized by long-lasting (chronic) inflammation affecting one or more joints, as well as the area around them. The most common types of inflammatory rheumatism are rheumatoid arthritis, ankylosing spondylitis (Bechterew’s disease), and psoriatic arthritis. The classic symptoms affecting the joint are pain, swelling, heat, loss of strength and stiffness.
To the state of medical knowledge, a complete cure is not possible, but a series of drugs can reduce the activity and severity of the disease. In this context, many patients are asking for recommendations on the most suitable diet.
1. Weight loss
This is the first goal for overweight or obese patients. Several studies have shown a reduction in the activity of chronic inflammatory rheumatism with weight loss. This is undoubtedly explained by the link between inflammation and overweight, while weight loss has beneficial effects on the cardiometabolic and psychological levels.
2. Exclusion diets
A significant proportion of patients adhere to a gluten-free or lactose-free diet. However, these food exclusions have not demonstrated their benefit in inflammatory rheumatism. On the contrary, they can lead to deficiencies. Regarding lactose, fermented dairy products, yogurts and cheeses are a good source of probiotics, associated with a lower cardiovascular risk. Calcium intakes are also important against the risk of osteoporosis and fractures.
Unless there is a proven deficiency, supplementation with vitamins (B9, D, E, K) or minerals (selenium, zinc) is not useful. The protection of the joints with iron, magnesium, manganese, or tea is a preconceived idea.
Good quality studies have shown that a diet rich in polyunsaturated fatty acids, mainly omega-3s from fatty fish and their oils, can help reduce stiffness and pain.
5. The Mediterranean diet
This diet has been shown to benefit joint symptoms, as well as protective cardiometabolic effects. The main principles: abundance of fruits and vegetables, whole grains, moderate consumption of fish and dairy products, strict limitation of meat (especially red and processed).