Diet intervention improves cardiovascular profile in patients with rheumatoid arthritis: results from the randomized controlled cross-over trial ADIRA

Erik Hulander, Linnea Bärebring, Anna Turesson Wadell, Inger Gjertsson, Philip C Calder, Anna Winkvist, Helen M Lindqvist, Erik Hulander, Linnea Bärebring, Anna Turesson Wadell, Inger Gjertsson, Philip C Calder, Anna Winkvist, Helen M Lindqvist

Abstract

Background: The chronic inflammation in patients with rheumatoid arthritis (RA) increases the risk for cardiovascular diseases (CVD). The contribution of diet as a risk factor for CVD among these patients is however not fully understood. The aim of this study is to investigate if a proposed anti-inflammatory diet improves cardiovascular profile in weight stable patients with RA.

Methods: Patients (n = 50) with RA were included in a cross-over trial. They were randomized to either a diet rich in whole grain, fatty fish, nuts, vegetables and fruit and supplemented with probiotics, or a control diet resembling average nutritional intake in Sweden, for ten weeks. After a 4-month washout they switched diet. Participants received food bags and dietary guidelines. Primary outcome was triglyceride (TG) concentration. Secondary outcomes were total-, high density lipoprotein- (HDL) and low density lipoprotein- (LDL) cholesterol, Apolipoprotein-B100 and -A1, lipoprotein composition, plasma phospholipid fatty acids and blood pressure.

Results: Forty-seven patients completed at least one period and they remained weight stable. There was a significant between-dietary treatment effect in TG and HDL-cholesterol concentration in favor of intervention (p = 0.007 and p = 0.049, respectively). Likewise, Apolipoprotein-B100/A1 ratio shifted toward a less atherogenic profile in favor of the intervention (p = 0.007). Plasma fatty acids increased in polyunsaturated- and decreased in monounsaturated- and saturated fatty acids between diet periods in favor of the intervention period.

Conclusion: Blood lipid profile improved indicating cardioprotective effects from an anti-inflammatory dietary intervention in patients with RA.

Trial registration: This trial is registered at ClinicalTrials.gov as NCT02941055 .

Keywords: Apolipoproteins B; Cardiovascular Diseases; Cross-Over Studies; Diet Therapy; Lipoproteins; Rheumatoid Arthritis.

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1
Fig. 1
Flow chart of subject recruitment in the ADIRA trial reported according to CONSORT

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Source: PubMed

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