Dietary Options for Rheumatic Diseases (Reprinted)

Meta-analyses attest an IA degree of evidence for the anti-inflammatory effect of fish oil fatty acids. GCP-studies attest an effect of the anti-inflammatory diet on joint inflammation, on the need for NSAID and glucocorticoids, and even for the incidence of sequels of atherosclerosis. Reduction of arachidonic acid intake with a vegetarian oriented diet and optimal supply of antioxidant vitamins, trace elements, plant polyphenols and minerals are components of the anti-inflammatory diet. The intake of arachidonic and eicosapentaenoic acid can be checked by using the nutritional calculator (www.ernaehrungsrechner.de). Additionally, the effect of the diet needs to be verified by determination of fatty acid composition in erythrocyte lipids. Sequels of the rheumatic disease, as osteoporosis, co-morbidities, the social and psychologic burden and physical handicaps have to be addressed, and necessitate cooperation with physical therapy, ergotherapy and psychotherapy. Dietary therapy cannot replace pharmacotherapy, but can support it, as a valuable adjuvant therapy to improve patient's outcome and compliance. It should be initiated as soon as the patient is properly diagnosed.