Body composition of rheumatoid arthritis patients and their perceptions and practices regarding diet, nutritional supplements and other treatments

[摘要] ENGLISH ABSTRACT: IntroductionRheumatoid Arthritis (RA) is a chronic, inflammatory, autoimmune disorder characterized by inflammation ofthe joints and surrounding tissue causing pain, swelling and stiffness. Studies suggest that aspects of thediet may alleviate symptoms and decrease the risk of complications. The scientific basis for a role of dietarytherapy in RA has grown although there is still no consensus on the optimum diet. It has been shown thatpersons with RA tend to have a poor nutritional status; and rheumatoid cachexia, the loss of body cell mass,occurs in nearly two-thirds of all patients with RA. The study aimed to establish what RA patients arepracticing and their perceptions regarding the effect of diet, nutritional supplements, medication andcomplementary and alternative medicines (CAM) and therapies on their symptoms as well as determiningtheir body composition and the possible presence of rheumatoid cachexia.MethodologyThe study design was a cross-sectional study with an analytical component. The study population consistedof adult (18 years or older) RA patients in the Cape Metropole from the private and public sector. Aninterviewer-administered questionnaire was used followed by the measurement of weight, height, waistcircumference and skinfold thickness. Information was also gathered from the medical records.ResultsThe sample size comprised of 251 RA patients (n=201 public sector; n=50 private sector). The mean bodymass index (BMI) was 30.3 kg/m2 for females and 26.6 kg/m2 for males. BMI was used to classify obesity(n=133; 45.9%), overweight (n=66; 26.8%), normal weight (n=63; 25.6%) and underweight (n=4; 1.6%).Waist circumference measurement classifications showed a substantially increased risk for metaboliccomplications in 51.8% of participants (n=127) and an increased risk in 21.2% of participants (n=52). Justover half of the participants (n=65; 55.6%) had an unhealthy high body fat percentage classification.Rheumatoid cachexia was seen in 10.3% participants (n=12). Low fat-free mass (Fat-free mass index <10thpercentile) was seen in 21% participants (n=24) and obesity (Fat mass index >90th percentile) was seen in27% of participants (n=31). Twenty nine percent of participants (n=73) believed that certain types of foodcould improve their symptoms of RA and 60% of participants (n=151) believed that certain foods worsenedtheir symptoms. Sixty four percent of participants (n=161) thought that nutritional supplements orcomplementary and alternative medicines and therapies could improve their symptoms of RA and 98%(n=246) of participants used nutritional supplements. The most frequently used supplements included folicacid (n=218; 91.6%), calcium (n=182; 76.5%), vitamin D (n=185; 77.7%), omega-3 fatty acids (n=48; 64.9%)and multivitamin and mineral preparations (n=22; 29.7%).ConclusionThe obesity and waist circumference figures were unacceptably elevated in this population and the bodycomposition of these RA patients should be highlighted as a concern. The high prevalence of risk factors forcardiovascular disease (CVD) need to be urgently addressed since CVD is the leading cause of mortality inRA patients. This study highlights the important role of the intra-professional team, including the dietitian, inthe management of RA patients.

[发布机构] Stellenbosch University