Omega-3s and Rheumatoid Arthritis – A Potential Intervention

Rheumatoid arthritis (RA), like other autoimmune diseases, is the result of the immune system working against its own body. Aside from inflammation and pain, the damage caused by RA can destroy the joints.

While over-the-counter and prescription drugs are often used to combat the condition, there are other factors to consider. One is diet: eliminating refined carbohydrates and other omega-6 rich foods can go a long way to reducing the inflammatory load on the body. The other factor is supplementation. And omega-3s may provide a partial answer.

A review of human clinical studies found that omega-3 intake significantly improved disease markers of RA and reduced inflammatory leukotriene B4.

One challenge of omega-3 supplementation can be convenience and consistent dosage. Fish oil as a liquid or in capsules typically requires fairly high levels before positive benefits are noted. A way to overcome that is by using concentrated, phospholipid-bound omega-3s from a single cold-water fish source. In the best case, these supplements can also provide peptides along with the benefits of phospholipids, which are not available in oil forms.

Abstract:

Gioxari A, Kaliora AC, Marantidou F, Panagiotakos DP. Intake of ω-3 polyunsaturated fatty acids in patients with rheumatoid arthritis: A systematic review and meta-analysis. Nutrition. 2018 Jan;45:114-124.e4.

Objectives: Rheumatoid arthritis (RA) is a chronic, autoimmune inflammatory disease of multiple joints that puts the patient at high risk for developing cardiovascular diseases (CVDs). The aim of the present study was to conduct an up-to-date systematic review and meta-analysis of published randomized controlled trials (RCTs) to assess potential changes in RA disease activity, inflammation, and CVD risk after oral intake of ω-3 polyunsaturated fatty acids.

Methods: Publications up to July 31, 2016 were examined using the PubMed, SCOPUS, and EMBASE databases.

Inclusion criteria: English language; human subjects; both sexes; RCTs; oral intake of ω-3 fatty acids; minimum duration of 3 mo; and no medication change throughout intervention. The Cochrane Risk of Bias tool was used to assess quality of trials. We included 20 RCTs, involving 717 patients with RA in the intervention group and 535 RA patients in the control group.

Results: Despite the evidence of overall low quality of trials, consumption of ω-3 fatty acids was found to significantly improve eight disease-activity-related markers. Regarding inflammation, only leukotriene B4 was reduced (five trials, standardized mean difference [SMD], -0.440; 95% confidence interval [CI], -0.676 to -0.205; I2 = 46.5%; P < 0.001). A significant amelioration was found for blood triacylglycerol levels (three trials, SMD, -0.316; 95% CI, -0.561 to -0.070; I2 = 0.0%; P = 0.012).

Conclusion: The beneficial properties of ω-3 polyunsaturated fatty acids on RA disease activity confirm the results of previous meta-analyses. Among five proinflammatory markers evaluated, only leukotriene B4 was found to be reduced. However, a positive effect on blood lipid profile of patients with RA was evident, perhaps for the first time.

 

 

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