[Nutrition as adjuvant therapy in chronic polyarthritis]

In the literature many casual observations report an arthritogenic effect of individual nutrients. The discovery of eicosanoids derived from arachidonic acid (AA) as most relevant mediators of joint inflammation allowed to elaborate the basis for a dietary therapy of rheumatoid arthritis. With an average intake of 18 g/d linoleic acid in western societies, linoleic acid is not converted to AA, and plasma levels of AA depend on its dietary intake with meat or meat products. The amount of AA ingested with the diet correlates with the formation of proinflammatory eicosanoids. Additionally, AA levels can be lowered by the ingestion of fish oil fatty acids. In our experiment, we aimed to combine the effect of low AA intake with the known anti-inflammatory effect of fish oil fatty acids. Our results demonstrate that vegetarians have lower AA percentages in erythrocyte lipids compared to the control group. The lower AA levels in plasma lipids coincided with higher percentages of fish oil fatty acids after supplementation, resulting in lower formation of mediators of inflammation. Moreover, the vegetarian group experienced a more pronounced decrease of AA in erythrocyte lipids after supplementation with fish oil fatty acids. These effects are supposed to contribute to the more favorable clinical course and laboratory findings in patients with rheumatoid arthritis on a vegetarian diet.