Arthritis and colitis
In 1989, Arthritis Care(ref 1) noted that greater than 50% of the Arthritis Care members who were surveyed, had invested in "unorthodox medicines, substances, or treatments (including diets), during the prior six months". arthritis and colitis Pain and suffering. Since the 1930's researchers have been exploring the link between diet and arthritis. We continue to hear claims that special diets, foods and supplements may help to cure or alleviate symptoms of arthritis, but most claims are unproven. Many experts speculate that claims of nutritional remedies and cures with food or dietary supplements are related to the "placebo affect". arthritis and colitis Joint pain diagnosis. The placebo effect is the patient's perception of improved symptoms and well being, resulting from new therapy, regardless of evidence for actual physical improvement. Because there is little scientific evidence confirming the benefits of modified diets for patients with arthritis, health care providers are apprehensive to recommend these types of dietary manipulations to their patients. Unfortunately, people with limited or no medical backgrounds have filled this void by advising patients about the benefits of diets and arthritis. arthritis and colitis Rheumatoid arthritis prevention. The advice given is often questionable, expensive and can be dangerous. Due to the lack of controlled studies and clinical trials, many investigators feel that we are still no closer to knowing whether food components cause or cure arthritis than we were seventy years ago. In reviewing the literature it becomes clear that there are few objective studies that examine the benefits of dietary manipulation and arthritis. This discussion will focus on diet and Rheumatoid Arthritis (RA) only since most of the available medical literature has focused on this type of arthritis. (top of page) A Healthy Diet Until we have access to more conclusive data regarding the benefits of dietary manipulation and RA, patients are encouraged to follow a healthy, balanced diet that fosters a healthy weight. It is important to avoid elimination diets and fad nutritional practices and to be cautious of claims of miracle cures. The fourth edition of Nutrition and Your Health: Dietary Guidelines for Americans(ref 2) outlines some basic dietary advice for all healthy Americans ages 2 years and above about food choices that promote health and prevent disease. The main messages are as follows: Eat a variety of foods Balance the food you eat with physical activity, maintain or improve your weight Choose a diet with plenty of grain products and vegetables, and fruits Choose a diet low in fat, saturated fat and cholesterol Choose a diet moderate in sugars If you drink alcoholic beverages, do so in moderation (top of page) Malnutrition Patients with RA are considered to be at nutritional risk for many reasons. One cause of poor nutritional status in this patient population is thought to be the result of the weight loss and cachexia linked to cytokine production. (ref 3) In patients experiencing chronic inflammation, the production of cytokines, such as interleukin-1 and tumor necrosis factor, increases resting metabolic rate and protein breakdown. The patient then is faced with the challenge of increasing both calorie and protein intake to meet the nutritional requirements of the increased metabolic rate. This is frequently difficult secondary to the pain and swelling associated with RA which frequently make food preparation and purchasing difficult for those who live alone or have limited resources. The effects of arthritis medications that are frequently taken long-term may also compound these nutritional problems. One example of this is observed in patients receiving methotrexate, where patients are frequently identified with folic acid deficiency.
Arthritis and colitis
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