Can diet changes and dietary supplements improve symptoms in patients with rheumatoid arthritis?

This study investigated the impact of dietary supplements and diet changes on disease activity score (DAS) in patients with rheumatoid arthritis (RA).

The study showed that some diet types like the Mediterranean diet, some spices and supplements may have positive effects on RA symptoms.

RA causes inflammation that affects the whole body. This causes swelling, pain, and limited function in several joints as well as overall fatigue and even depression. These symptoms increase when the disease is more active and decrease when it is less active. DAS28 considers 28 different joints as well as signs of inflammation in the blood and generates a score of disease activity. The less active the RA, the lower the score will be. 

It is reported that patients respond well to adjustments in diet and to additional dietary supplements. It is assumed that these measures positively impact DAS28, reduce symptoms, and improve the quality of life for the patients. Dietary supplements that aim to lower the systemic inflammation and lower DAS28 are for example probiotics, prebiotics, a combination of both (synbiotics) and antioxidants like Vitamin C or E. Diets that aim reduce disease activity include fruits and vegetables, omega-3 fatty acids, and Mediterranean diet. All of these include a high intake of fruit, berries, vegetables, whole grains, and healthy oils. 

There is not yet enough data to support these hypotheses and how effective each measure is on disease activity in patients with RA.

This study collected data from 27 selected studies. The authors rated each study according to their scientific significance, their strength of general relevance, as either low, moderate, or high. Different types of diets, spices and antioxidants were evaluated in relation to RA disease activity.

There was a significant improvement in DAS28 with 3 months of Mediterranean diet, compared to a control diet. There was no strong data to support the hypothesis that a raw or vegan diet lowers DAS28 in patients with RA. Also, blue mussels and cranberry juice substitutes were not proven to have a significant effect on RA.

There was a significant improvement of DAS28 in patients with RA related to the use of spices as capsules. Ginger, cinnamon, and saffron lowered DAS28 compared to placebo. Regarding omega-3 fatty acids and vitamin D supplements, there was moderate strength data, but it did not show that the supplements improve symptoms of RA.

Some antioxidants like quercetin and ubiquinone were shown to improve DAS28. Also, probiotic Lactobacillus Casei positively impacted DAS28, supported by medium strength data.  

The authors concluded on the basis of moderate strength data that a Mediterranean diet, spice supplements like ginger, saffron and cinnamon, antioxidants quercetin and ubiquinone, and L.Casei can reduce DAS28 in patients with RA. 

The numbers of patients in the examined publications were comparably low. Altering factors like age, gender, time of application and additional medicine have to be taken into consideration.

Ask your doctor for information about a suitable diet and/or dietary supplement.