Die Auswirkungen der Ernährung auf das Erkrankungsrisiko und den Verlauf der rheumatoiden Arthritis

Zusammenfassung

Die Art der Ernährung trägt möglicherweise zur Ätiologie der rheumatoiden Arthritis bei. Dies legt die Assoziation der RA-Inzidenz mit kindlicher Unterernährung und niedrigem Geburtsgewicht nahe. Die Bedeutung einzelner Nahrungskomponenten ist am besten belegt für den protektiven Effekt von geringen Alkoholmengen und möglicherweise auch vom vermehrten Konsum von Seefisch mit hohem Fettgehalt. Interventionsstudien, welche den Nutzen einzelner Kostformen bei etablierter RA untersuchen sollten, sind in ihrer Qualität und Aussagekraft unbefriedigend geblieben. Eine an den Prinzipien der Mittelmeerkost ausgerichtete Ernährung ist wahrscheinlich von Nutzen für RA-Patienten, auch wenn die positiven Auswirkungen am ehesten die Reduktion des kardiovaskulären Risikos betreffen. Aus den Daten zum Einfluss von Nahrungsergänzungsmitteln auf den Verlauf der RA lassen sich positive Effekte nur für Fischölkapseln in ausreichend hoher Dosierung von Omega-3-Fettsäuren ableiten. Die Zufuhr von Eisenpräparaten und Vitamin D sollte an objektiven Kriterien und aktuellen Leitlinien ausgerichtet sein.

Abstract

Nutritional factors may contribute to the etiology of rheumatoid arthritis (RA). This is illustrated by the association of RA with malnutrition in infancy and with low birth weight. The contribution of single components of our daily diet to the risk of RA was demonstrated with respect to the protective effects of low- to moderate alcohol consumption and probably to an above-average intake of fish with a high content of fish oil. So far, interventional studies that have investigated the impact of definite dietary regimens on the course of RA have been disappointing with respect to quality and reliability. A Mediterranean diet may be helpful for RA patients, especially regarding the reduction of cardiovascular risks. Data demonstrating a benefit of nutritional supplements are scant. Fish oil capsules with a high content of omega-3-fatty acids may offer a mild therapeutic effect. Iron and vitamin D should be prescribed if indicated according to objective criteria and current guidelines.

Schlüsselwörter

Rheumatoide Arthritis - Ernährung - Ätiologie - Review

Key words

rheumatoid arthritis - nutrition - etiology - review

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