Nutritional and Environmental Factors and Rheumatic Diseases

Abstract

RA and many other systemic rheumatic diseases remain illnesses of unknown causes for which current therapy is often inadequate. This leads patients to seek questionable remedies, prominent among which are dietary manipulations. The possibility that food antigens induce or perpetuate symptoms in at least some patients is reasonable and of potential interest. Studies that link diet with atthritis offer the possibility of identifying new therapeutic approaches for selected patients and of developing new insights into disease pathogenesis. The avai !able evidence suggests that allergic reaction to foods may occur in some patients who have rheumatic disease. This seems to be a small subset of patients, and continued investigation of this issue is merited. Diets of certain nutritional factors can modulate experimental and, is some circumstances, clinical inflammation. More information in needed to define which patients benefit from which diets, under which circumstances, and by how much. Dietary therapy for arthritis should still be considered investigational (Pnnush, 1992).

Reflecting on diet and other questionable remedies in arthritis reminds us that occasionally it is salutary to critically re-examine prevailing notions. We need to balance healthy skepticism with a willingness to consider non mainstream concepts. With respect to diet and arthritis, as well as other questionable or non mainstream remedies, this has not yet