Resumen
Objetivo: Realizar una revisión de la literatura para comprender los efectos de las intervenciones dietéticas en la artritis reumatoide. Métodos: Revisión de la literatura de los últimos 10 años, de acuerdo con las recomendaciones PRISMA (Preference Reporting Items for Systematic Reviews and Meta-analysis) mediante búsqueda electrónica en las bases de datos PubMed, Lilacs y SciELO, utilizando los descriptores de salud reumatoide artritis AND dieta y artritis reumatoide AND dieta, siendo seleccionados a través de ensayos clínicos con adultos y/o personas mayores. Resultados: Los estudios han demostrado que los pacientes con artritis reumatoide que consumieron una dieta mediterránea o una dieta que contiene alimentos que son fuentes de nutrientes con propiedades antiinflamatorias y/o antioxidantes, así como suplementos dietéticos, mostraron una mejora en los índices de actividad de la enfermedad como DAS-28 (Disease Activity Score), marcadores inflamatorios como PCR (proteína C reactiva), VSG (tasa de homosedimentación) y anti-CCP (péptido citrulinado anticíclico) y calidad de vida. Consideraciones finales: Las intervenciones dietéticas y la suplementación nutricional pueden contribuir a mejorar la condición clínica y la calidad de vida de los pacientes con AR. Sin embargo, son necesarios estudios adicionales.
Referencias
BORZI RM, et al. Flow cytometric analysis of intracellular chemokines in chondrocytes in vivo: constitutive expression and enhancement in osteoarthritis and rheumatoid arthritis. FEBS Lett. 1999; 455(3): 238–42.
CASSOTTA M, et al. Nutrition and Rheumatoid Arthritis in the ‘Omics’ Era. Nutrients. 2021; 13(3): 763.
CHERMONT GC, et al. Resource utilization and the cost of rheumatoid arthritis in Brazil. Clin Exp Rheumatol. 2008; 26(1): 24-31.
CUTOLO M e NIKIPHOROU E. Nutrition and Diet in Rheumatoid Arthritis. Nutrients. 2022; 14 (4): 888.
DEMORUELLE MK, et al. When and where does inflammation begin in rheumatoid arthritis? Curr Opin Rheumatol. 2014; 26 (1): 64–7.
GARNER S, et al. Personalized diet and exercise recommendations in early rheumatoid arthritis: A feasibility trial. Musculoskeletal Care. 2018; 16(1): 167-172.
GENEL F, et al. Health effects of a low-inflammatory diet in adults with arthritis: A systematic review and meta-analysis. J. Nutr. Sci. 2020; 9: 37.
GHASEMINASAB-PARIZI M, et al. The effect of flaxseed with or without anti-inflammatory diet in patients with rheumatoid arthritis, a randomized controlled trial. Eur J Nutr. 2022; 61(3): 1377-1389.
GIOIA C, et al. Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Nutrients. 2020; 12 (5) :1456.
GIOXARI A, et al. Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition. 2018; 45: 14-124.
GUAGNANO MT, et al. Improvement of Inflammation and Pain after Three Months' Exclusion Diet in Rheumatoid Arthritis Patients. Nutrients. 2021; 13(10): 3535.
HÄGER J, et al. The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study. Nutrients. 2019; 11(10): 2392.
HOU SM, et al. CXCL1 contributes to IL-6 expression in osteoarthritis and rheumatoid arthritis synovial fibroblasts by CXCR2, c-Raf, MAPK, and AP-1 pathway. Arthritis Res Ther. 2020; 22(1): 251.
HULANDER E, et al. Proposed Anti-Inflammatory Diet Reduces Inflammation in Compliant, Weight-Stable Patients with Rheumatoid Arthritis in a Randomized Controlled Crossover Trial. J Nutr. 2021;1 51(12): 3856–3864.
ISHIDA S, et al. The interaction of monocytes with rheumatoid synovial cells is a key step in LIGHT-mediated inflammatory bone destruction. Immunology. 2009; 128(12): 315–24.
KOCH AE, et al. Epithelial neutrophil activating peptide-78: a novel chemotactic cytokine for neutrophils in arthritis. J Clin Invest. 1994; 94(3): 1012–8.
KOCH AE, et al. Growth-related gene product alpha. A chemotactic cytokine for neutrophils in rheumatoid arthritis. J Immunol. 1995; 155(7): 3660–6.
LINDQVIST HM, et al. Influence of Blue Mussel (Mytilus edulis) Intake on Disease Activity in Female Patients with Rheumatoid Arthritis: The MIRA Randomized Cross-Over Dietary Intervention. Nutrients. 2018; 10(4): 481.
LOURDUDOSS C, et al. Dietary intake of polyunsaturated fatty acids and pain in spite of inflammatory control among methotrexate treated early rheumatoid arthritis patients. Arthritis Care Res (Hoboken). 2018; 70(2): 205-2012.
MCKAY DL e BLUMBERG JB. Cranberries (Vaccinium macrocarpon) and cardiovascular disease risk factors. Nutr Rev. 2007; 65(11): 490–502.
MEDEIROS MM das C, et al. Correlação dos indices de atividade da artrite reumatoide (Disease Activity Score 28 medidos com VHS, PCR, Simplifield Disease Activity Index e Clinical Disease Activity Index) e concordância dos estados de atividade da doença com vários pontos de corte numa população do nordeste brasileiro. Rev Bras Reumatol. 2015; 55 (6): 477-484.
MOHAMMED AT, et al. The therapeutic effect of probiotics on rheumatoid arthritis: a systematic review and meta-analysis of randomized control trials. Clin Rheumatol. 2017; 36(12): 2697–2707.
MOHER D, et al. The PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA Statement. BMJ. 2009; 339: 2535.
MOTA LMH, et al. Consenso 2012 da Sociedade Brasileira de Reumatologia para o tratamento da artrite reumatoide. Rev Bras Reumatol. 2012; 52(2): 135-174.
NIJVELDT RJ, et al. Flavonoids: a review of probable mechanisms of action and potential applications. Am J Clin Nutr. 2001; 74 (4): 418.
NIKIPHOROU E, et al. The association of obesity with disease activity, functional ability and quality of life in early rheumatoid arthritis: Data from the Early Rheumatoid Arthritis Study/Early Rheumatoid Arthritis Network UK prospective cohorts. Rheumatology (Oxford). 2018; 57(7): 1194–1202.
OLIVIERO F, et al. How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis. Swiss Med. Wkly. 2015; 145: 14190.
OLIVOTTO E, et al. Chondrocyte hypertrophy and apoptosis induced by GROalpha require three-dimensional interaction with the extracellular matrix and a co-receptor role of chondroitin sulfate and are associated with the mitochondrial splicing variant of cathepsin B. J Cell Physiol. 2007; 210(2): 417–27.
PAPANDREOU P, et al. Mediterranean Diet and Physical Activity Nudges versus Usual Care in Women with Rheumatoid Arthritis: Results from the MADEIRA Randomized Controlled Trial. Nutrients. 2023; 15(3): 676.
PELÁEZ-BALLESTAS I, et al. Epidemiology of the rheumatic diseases in Mexico. A study of 5 regions based on the COPCORD methodology. J Rheumatol Suppl. 2011; 86: 3-8.
PHILIPPOU E e NIKIPHOROU E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018; 17(11): 1074–1077.
SCHÖNENBERGER KA, et al. Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis. Nutrients. 2021;13(12): 4221.
SHISHAVAN NG, et al. Effects of Vitamin K on Matrix Metalloproteinase-3 and Rheumatoid Factor in Women with Rheumatoid Arthritis: A Randomized, Double-Blind, Placebo-Controlled Trial. J Am Coll Nutr. 2016: 35(5): 392-8.
SINGH JA, et al. Adverse effects of biologics: a network meta-analysis and Cochrane overview. Cochrane Database Syst Rev. 2011; 16(2): CD008794.
SMOLEN JS, et al. Rheumatoid arthritis. Nat. Rev. Dis. Primers. 2018; 4: 18001 2018.
SOCIEDADE BRASILEIRA DE REUMATOLOGIA. Cartilha para pacientes: Artrite reumatoide. São Paulo: Comissão de Artrite Reumatoide da Sociedade Brasileira de Reumatologia, 2011. Cartilha (20 p.). [Acesso em: 17 jan. 2023]. Disponível em: https ://www.reumatologia.org.br/cartilhas/.
THIMÓTEO NSB, et al. Cranberry juice decreases disease activity in women with rheumatoid arthritis. Nutrition. 2019; 60: 112-117.
TURESSON WADELL A, et al. Effects on health-related quality of life in the randomized, controlled crossover trial ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis). PLoS One. 2021; 16(10): 0258716.
Vadell AKE, et al. Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity. Am J Clin Nutr. 2020; 111(6): 1203-1213.
WALRABENSTEIN W, et al. A multidisciplinary lifestyle program for rheumatoid arthritis: the 'Plants for Joints' randomized controlled trial. Rheumatology (Oxford). 2023; 62(8): 2683-2691.
