Food from the sea can make people with rheumatic conditions feel better
Eating foods containing plenty of fish and seafood, plus fruits and vegetables can make people with RA feel better. Good food, plus dug treatments, is very important. This is the conclusion of research at the University of Gothenburg on diet at RA, on which Helen Lindqvist has worked in recent years.
- A major focus area I have worked within recent years is dietary studies in patients who have rheumatoid arthritis (RA). Very little has been done in terms of diet and rheumatism, although people with these conditions often find that diet affects the symptoms of their disease. These people want clear advice on which diet could help relieve their symptoms, but the scientific basis was very thin.
The reason why there is so little scientific evidence regarding specific diets is due, among other things, to the fact that people have different habits and experiences in their diet, Helen says. We simply eat very differently. Just following dietary advice, like eating a regular breakfast, snack, lunch, snack and supper can be difficult for many. Not everyone can cook two meals a day or get enough nutritious food. Many also eat foods with too high an energy content, which can lead to obesity.
- We also see that many people with RA are overweight, which increases the risk of cardiovascular disease. Being overweight has also been shown to increase inflammation, which is a serious issue for people with rheumatic conditions.
Study: mussels and reduced disease activity
One study investigated a diet with the addition of mussels. The study wanted to see if mussels in particular could have an effect on reduced disease activity and improved quality of life in women with RA. The reason for the choice of mussels is that they are rich in Omega 3, selenium, zinc and many other substances that we find difficult to get from other foods. They are also a climate-smart choice, as mussels are cultivated or grown wild and bith filter the water and eat algae. If the seas are eutrophicated (overburdened with nutrients from runoff of fertilizer and other substances) and we start harvesting mussels, we reduce that eutrophication. It is simply an environmentally friendly choice!
In the study, 39 women with RA replaced one cooked meal a day with a ready-made dish containing 75 g of mussels. The control group received 75 g of meat or chicken.
The results of the study, which lasted for eleven weeks, were decreased disease activity (DAS28-CRP) after eating mussels compared to the control diet. There were no clear signs of lower inflammation, but participants felt they felt better and were less tired. The results indicate that fish and seafood in the diet may be beneficial for patients with more severe RA. (1)
New study: composite diet with seafood
A new diet study has been carried out in RA patients where the focus has been a diet with a lot of seafood containing omega 3, as well as fruits and vegetables, which are high in dietary fiber. This was thus a composite diet with all the foods that evidence shown can reduce inflammation and have an effect on rheumatism. Also included were probiotics: beneficial gut bacteria. This diet is similar to the Nordic nutritional recommendations, ie a Mediterranean diet. The control diet consisted of what the average Swede eats, which is quite a lot of meat, a smaller amount of fruit and vegetables, plus white bread and other foods with low dietary fiber content.
The study was conducted so that participants were allowed to test the two different diets during different periods. They did not know which diet was the control diet. They were given half of the food they would eat in the form of a food bag delivered to their door along with recipes.
- The study was recently completed, and the results have been analyzed, says Helen. In this study, too, the effects do not appear to be measurable in terms of reduced inflammation, but they are in other measures. This could be because most participants are being treated with medicines that mean inflammation is already very low. Despite this, many people have pain and feel tired and perhaps this is where the diet has an effect in combination with inflammation-reducing drugs.
The diet brings increased well-being together with medicines
- We all need to think about diet and how it affects how we feel, says Helen. How should I eat? Can I improve my diet so I feel better? If I eat a poorer diet and make a dietary change for the better, I will see clear health results, both in terms of measurable results of blood tests and my experiences of life. If I have a moderate diet and make a change, the results will not be as obvious.
- The media is full of stories about something called an "anti-inflammatory diet". There is really no definition of what an anti-inflammatory diet actually is. In that case, it would contain foods that cause lower inflammation according to studies. The best option for this is a Mediterranean diet, although there is no evidence that it really reduces inflammation. However many scientific studies show that as soon as someone starts to lose weight, inflammation decreases. Therefore studies may have difficulty distinguishing whether it is the weight loss that actually causes the reduced inflammation or whether it is the diet itself.
Tips for feeling better
Eat regular meals
Try eating fish three times a week
Eat meat on fewer days a week
Eat lots of fruits, vegetables and whole grains.
Do not take away foods from your diet without replacing them with something that provides the same nutrients.
Keep a normal weight
Want to know a little more about how you can meet the daily needs of vitamins and minerals in your diet? The Food Agency has good information on how to eat in a healthy way.
Lindqvist, H., Gjertsson, I., Eneljung, T & Winkvist, A. (2018) Influence of Blue Mussel (Mytilus edulis) Intake on Disease Activity in Female Patients with Rheumatoid Arthritis: The MIRA Randomized Cross-Over Dietary Intervention. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden.
The text is based on a telephone interview with Helen Lindqvist 27/8 2019 and the Podcast section Anti-Inflammatory Diet (2019). Heavier Dietitian Podcast, interview Helen Lindqvist.