Evaluation of serum total antioxidant level, nutritional status and Mediterranean diet adherence of adult women with rheumatoid arthritis: a case-control study

Rheumatoid arthritis (RA) is characterised by chronic inflammation in joints. Obesity, stress, being women and dietary pattern are important in pathogenesis. The joint damage in RA is accelerated by oxidative stress. The aim of this study was to examine the serum total antioxidant level, nutritional status and Mediterranean diet adherence of adult women with RA. Thirty-five adult women RA patients and thirty-five healthy control participated in this study (45<middle dot>4 +/- 11<middle dot>61 and 42<middle dot>5 +/- 8<middle dot>50 years, respectively). Nutritional status, physical activity levels and adherence to the Mediterranean diet were questioned. Physicians assessed the disease activity score of patients with RA. Serum total antioxidant and oxidant status were analysed. The serum total antioxidant status of the control group was higher, whereas the oxidative stress index and total oxidant status were lower than that of the RA group. Dietary protein, fibre, EPA, retinol, Fe, Zn and total antioxidant intake in the RA group were lower than in the control group (P < 0<middle dot>05). Individuals with higher fibre intake showed a significantly lower risk for RA after adjusting for potential confounding factors (OR = 0<middle dot>845, 95 % CI = 0<middle dot>773-0<middle dot>923, P < 0<middle dot>001). The mean physical activity level of the control group was higher than that of the RA group (1<middle dot>59 +/- 0<middle dot>10 and 1<middle dot>53 +/- 0<middle dot>13, respectively) (P = 0<middle dot>01). In conclusion, serum antioxidant parameters and dietary antioxidant intake are decreased in patients with RA. Therefore, medical treatment for these patients should be supplemented with medical nutrition therapy to achieve optimal nutritional status.