Vegetarisk kost - ett möjligt behandlingskomplement för symtomlindring vid reumatoid artrit?
Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: A vegetarian diet, a possible treatment complement for relief of symptoms ofrheumatoid arthritis? A systematic review.Author: Alexandra Ahlsén and Caroline ForsbergSupervisor: Mette AxelsenExaminer: Anna WinkvistProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: May 22, 2012Background: Rheumatoid arthritis (RA) is a chronic remitting polyarthritis that is relapsing.Symptoms are inflammation of the joints with pain, stiffness and degradation of joint tissue.In some cases, also other parts of the body are involved. The treatment consists ofmedications to reduce pain, inflammation and degradation of joint tissue. Today, the offerednutritional treatment is primarily focused on meeting energy requirements and nutrient needs.The diet has also been discussed as symptomatic treatment, and one of the factors believed toinfluence the symptoms is meat.Objective: To assess the evidence as to whether a vegetarian diet affects the symptoms ofrheumatoid arthritis, and if so, to suggest how it can be implemented in practical dieteticswork.Search strategy The databases used in the literature search was PubMed, Scopus, and AMED.The search words used were: "rheumatiod arthritis", "vegetarian", "vegan", "diet", "meat" and"animal protein".Selection criteria: Studies investigating a vegetarian diet on the symptoms of RA wereincluded. Only RCT, clinical trial, controlled clinical trial, human studies and original articlesin English or Swedish were included. Studies that only studied fasting or elemental diet wereexcluded.Data collection and analysis: Two studies matched the above mentioned inclusion criteriaand had moderate study quality. The conclusions were graded according to GRADE on thefollowing outcome measures: pain, number of tender joints, duration of morning stiffness, andthe inflammation markers ESR and CRP.5Main results:? There is no basis for the effect of vegetarian diet on pain in patients with RA (verylow evidence strength).? A vegetarian diet might perhaps reduce the number of tender joints, the duration ofmorning stiffness nor the inflammation markers ESR and CRP in people with RAcompared to an omnivore diet (low evidence strength).Conclusions: As one study points to significant positive effect, and another study oninsignificant results of vegetarian diet on symptoms of RA, it is concluded that vegetarian dietmay affect the symptoms. However, based on the documentary evidence, this is notrecommended as a general treatment for all patients with RA, but should not be discouraged ifthe patient is interested in this as a complement to traditional treatment.