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Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis.

Abstract

BACKGROUND

Patients with rheumatoid arthritis (RA) improve on a vegetarian diet or supplementation with fish oil. We investigated the effects of both dietary measures, alone and in combination, on inflammation, fatty acid composition of erythrocyte lipids, eicosanoids, and cytokine biosynthesis in patients with RA.

METHODS

Sixty-eight patients with definitive RA were matched into two groups of 34 subjects each. One group was observed for 8 months on a normal western diet (WD) and the other on an anti-inflammatory diet (AID) providing an arachidonic acid intake of less than 90 mg/day. Patients in both groups were allocated to receive placebo or fish oil capsules (30 mg/kg body weight) for 3 months in a double-blind crossover study with a 2-month washout period between treatments. Clinical examination and routine laboratory findings were evaluated every month, and erythrocyte fatty acids, eicosanoids, and cytokines were evaluated before and after each 3-month experimental period.

RESULTS

Sixty patients completed the study. In AID patients, but not in WD patients, the numbers of tender and swollen joints decreased by 14% during placebo treatment. In AID patients, as compared to WD patients, fish oil led to a significant reduction in the numbers of tender (28% vs 11%) and swollen (34% vs 22%) joints (P<0.01). Compared to baseline levels, higher enrichment of eicosapentaenoic acid in erythrocyte lipids (244% vs 217%) and lower formation of leukotriene B(4) (34% vs 8%, P>0.01), 11-dehydro-thromboxane B(2) (15% vs 10%, P<0.05), and prostaglandin metabolites (21% vs 16%, P<0.003) were found in AID patients, especially when fish oil was given during months 6-8 of the experiment.

CONCLUSION

A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation.

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  • Authors+Show Affiliations

    ,

    Medizinische Klinik Innenstadt der LMU, Ziemssenstrasse 1, 80336 Munich, Germany. olaf.adam@lrz.uni-muenchen.de

    , , , , , , ,

    Source

    Rheumatology international 23:1 2003 Jan pg 27-36

    MeSH

    Arachidonic Acid
    Arthritis, Rheumatoid
    Case-Control Studies
    Cytokines
    Diet, Vegetarian
    Dietary Fats, Unsaturated
    Dietary Supplements
    Eicosanoids
    Fatty Acids
    Female
    Fish Oils
    Follow-Up Studies
    Humans
    Male
    Multivariate Analysis
    Pain Measurement
    Patient Satisfaction
    Probability
    Prospective Studies
    Recovery of Function
    Severity of Illness Index
    Statistics, Nonparametric
    Treatment Outcome

    Pub Type(s)

    Clinical Trial
    Comparative Study
    Controlled Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    12548439

    Citation

    Adam, Olaf, et al. "Anti-inflammatory Effects of a Low Arachidonic Acid Diet and Fish Oil in Patients With Rheumatoid Arthritis." Rheumatology International, vol. 23, no. 1, 2003, pp. 27-36.
    Adam O, Beringer C, Kless T, et al. Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatol Int. 2003;23(1):27-36.
    Adam, O., Beringer, C., Kless, T., Lemmen, C., Adam, A., Wiseman, M., ... Forth, W. (2003). Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. Rheumatology International, 23(1), pp. 27-36.
    Adam O, et al. Anti-inflammatory Effects of a Low Arachidonic Acid Diet and Fish Oil in Patients With Rheumatoid Arthritis. Rheumatol Int. 2003;23(1):27-36. PubMed PMID: 12548439.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Anti-inflammatory effects of a low arachidonic acid diet and fish oil in patients with rheumatoid arthritis. AU - Adam,Olaf, AU - Beringer,Corinna, AU - Kless,Thomas, AU - Lemmen,Christa, AU - Adam,Alexander, AU - Wiseman,Michael, AU - Adam,Patrick, AU - Klimmek,Reinhard, AU - Forth,Wolfgang, Y1 - 2002/09/06/ PY - 2002/04/10/received PY - 2002/07/19/accepted PY - 2003/1/28/pubmed PY - 2003/5/31/medline PY - 2003/1/28/entrez SP - 27 EP - 36 JF - Rheumatology international JO - Rheumatol. Int. VL - 23 IS - 1 N2 - BACKGROUND: Patients with rheumatoid arthritis (RA) improve on a vegetarian diet or supplementation with fish oil. We investigated the effects of both dietary measures, alone and in combination, on inflammation, fatty acid composition of erythrocyte lipids, eicosanoids, and cytokine biosynthesis in patients with RA. METHODS: Sixty-eight patients with definitive RA were matched into two groups of 34 subjects each. One group was observed for 8 months on a normal western diet (WD) and the other on an anti-inflammatory diet (AID) providing an arachidonic acid intake of less than 90 mg/day. Patients in both groups were allocated to receive placebo or fish oil capsules (30 mg/kg body weight) for 3 months in a double-blind crossover study with a 2-month washout period between treatments. Clinical examination and routine laboratory findings were evaluated every month, and erythrocyte fatty acids, eicosanoids, and cytokines were evaluated before and after each 3-month experimental period. RESULTS: Sixty patients completed the study. In AID patients, but not in WD patients, the numbers of tender and swollen joints decreased by 14% during placebo treatment. In AID patients, as compared to WD patients, fish oil led to a significant reduction in the numbers of tender (28% vs 11%) and swollen (34% vs 22%) joints (P<0.01). Compared to baseline levels, higher enrichment of eicosapentaenoic acid in erythrocyte lipids (244% vs 217%) and lower formation of leukotriene B(4) (34% vs 8%, P>0.01), 11-dehydro-thromboxane B(2) (15% vs 10%, P<0.05), and prostaglandin metabolites (21% vs 16%, P<0.003) were found in AID patients, especially when fish oil was given during months 6-8 of the experiment. CONCLUSION: A diet low in arachidonic acid ameliorates clinical signs of inflammation in patients with RA and augments the beneficial effect of fish oil supplementation. SN - 0172-8172 UR - https://www.unboundmedicine.com/medline/citation/12548439/full_citation L2 - https://dx.doi.org/10.1007/s00296-002-0234-7 DB - PRIME DP - Unbound Medicine ER -