“Patients with rheumatoid arthritis occasionally encounter various problems due to either the disease itself or the side effects of medications. These problems require a nutritional intervention may be summarized as follows:
* Changes in body composition. The human body is composed of three main masses: the fat, muscle and bone mass. Studies have shown that a substantial proportion of patients with rheumatoid arthritis have a loss of muscle mass due to disease, while fat mass increased occurs in all parts of the body other than the feet, diverting the breakdown of fat in most central (and therefore more dangerous) . For mass of bone, and this appears to be reduced because of corticosteroids, the immobility of certain patients, decreased uptake of calcium and vitamin D, and finally because of increased because of the disease _ _ levels of certain substances called cytokines.
- Side effects of medication. Medication often imposes some constraints or changes in the diet of patients with rheumatoid arthritis.
- Violation joints. The joint involvement of small and large joints may reduce the ability of a person to perform daily activities such as shopping and cooking. Also the attack joint, can affect the ability to chew and swallow food.
The nutritional intervention is modified depending on the problem to be addressed.
Changes in Body Composition
The patient with rheumatoid arthritis should follow a diet that provides sufficient amounts of protein of high biological value (e.g. low-fat milk, egg whites, poultry and fish) and balance of all nutrients (especially calcium and vitamin D, which is important for bone health).
If the patient is overweight should start a weight loss effort in collaboration with a dietitian, so the loss is slow and gradual (about half a pound a week) and diet adequate in all essential nutrients. Popular or extreme diets for weight loss can significantly worsen body composition of these patients and increase morbidity and hence should not be applied in patients with rheumatoid arthritis. Weight loss is usually a long and tedious process, since physical exercise in patients with rheumatoid arthritis is very limited and cannot contribute significantly to weight loss.”
Side Effects of Medicine
- If the patient is receiving cyclosporine should avoid consuming grapefruit juice and they increase the activity and toxicity of the drug.
- Taking anti-inflammatory drugs causes fluid retention and therefore requires reduction in sodium intake, the main source of which is the salt and foods containing it in large quantities. The long-term use of corticosteroids is an important parameter in the nutritional management of patients with rheumatoid arthritis as they variously affect nutrition.
More specifically, the receiving cortisone requires the reduction of sodium to avoid water retention and creation edemas. So, add salt to food, salty snacks, salted nuts, olives, salty cheeses and meats or canned foods should be absent from the diet of the patient to minimize fluid retention. Additionally, often large doses of corticosteroids cause an increase in blood sugar, making it necessary to limit simple carbohydrates (sugar, honey, jam, sweets and soft drinks with sugar), and in some cases must design a diet based on the principles of diet diabetics.”
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