Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-25T01:20:05.942Z Has data issue: false hasContentIssue false
  • English
  • Français

Changes in plasma phospholipid fatty acids and their relationship to disease activity in rheumatoid arthritis patients treated with a vegetarian diet

Published online by Cambridge University Press:  09 March 2007

Margaretha A. Haugen ,
Jens Kjeldsen-Kragh ,
Kristian S. Bjervea ,
Arne T. Høstmark  and
Øystein Førre
Margaretha A. Haugen
Affiliation:
Oslo Sanitetsforening Rheumatism Hospital, Oslo, Norway
Jens Kjeldsen-Kragh
Affiliation:
Institute of Immunology and Rheumatology, National Hospital, Oslo, Norway
Kristian S. Bjervea
Affiliation:
Department of Chemical Chemistry, Regional Hospital, University of Trondheim, Trondheim, Norway
Arne T. Høstmark
Affiliation:
Department of Preventive Medicine, University of Oslo, Norway
Øystein Førre
Affiliation:
Oslo Sanitetsforening Rheumatism Hospital, Oslo, Norway
Rights & Permissions [Opens in a new window]

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

In a controlled clinical trial we have recently shown that patients with rheumatoid arthritis (RA) improved after fasting for 7–10 d and that the improvement could be sustained through 3.5 months with a vegan, diet and 9 months with a lactovegetarian diet. Other studies have indicated that the inflammatory process in R A can be reduced through manipulation of dietary fatty acids. A switch to a vegetarian diet significantly alters the intake of fatty acids. Therefore, we have analysed the changes in fatty acid profiles of the plasma phospholipid fraction and related these changes to disease activity. The concentrations of the fatty acids 20: 3n-6 and 20: 4n-6 were significantly reduced after 3.5 months with a vegan diet (P < 0.0001 and P < 0.01 respectively), but the concentration increased to baseline values with a lactovegetarian diet. The concentration of 20: 5n-3 was significantly reduced after the vegan diet (P < 0.0001) and the lactovegetarian diet periods (P < 0.01). There was no significant difference in fatty acid concentrations between diet responders and diet non-responders after the vegan or lactovegetarian diet periods. Our results indicate that the changes in the fatty acid profiles cannot explain the clinical improvement.

Keywords

Fatty acid profileVegetarian dietRheumatoid arthritis
Type
Vegetarian diets and plasma phospholipids in rheumatoid arthritis
Information
British Journal of Nutrition , Volume 72 , Issue 4 , October 1994 , pp. 555 - 566
Copyright
Copyright © The Nutrition Society 1994

References

REFERENCES

Abdulla, M., Andersson, I., Asp, N.-G., Berthelsen, K., Birkhed, D., DeFcker, I., Johansson, C.-G., Jagerstad, M., Kolar, K., Nair, B. M., Nilsson-Ehle, P., Norden, A, Rassner, S., Akesson, B. & Ockerman, P.-A. (1981). Nutrient intake and health status of vegans. Chemical analyses of diets usingthe duplicate portion sampling technique. American Journal of Clinical Nutrition 34, 246–247.CrossRefGoogle Scholar
Adam, O. (1992). Immediate and long range effects of the uptake of increased amounts of arachidonic acid. Clinical Investigator 70, 721–727.CrossRefGoogle ScholarPubMed
Baker, D. G., Krakauer, K. A., Tate, G., Laposata, M. & Zurier, R. B. (1989). Suppression of human synovial cell proliferation by dihomogamma-linolenic acid. Arthritis and Rheumatism 32, 1273–1281.CrossRefGoogle Scholar
Belch, J. J. F., Ansell, D., Madhok, R., ODowd, A. & Sturrock, R. D. (1988). Effects of altering dietary essential fatty acids on requirements for non4teroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. Annals of the Rheumatic Diseases 41, 96–104.CrossRefGoogle Scholar
Banaa, K. H., Bjerve, K., Straume, B., Gram, I. T. K. & Thelle, D. (1990). Effects of eicosapentaenoic and docosahexaenoic acids on blood pressure in hypertension. New England Journal of Medicine 322, 795–801.CrossRefGoogle Scholar
Bruderlein, H., Daniel, R., Boismenu, D., Julien, N. & Couture, F. (1981). Fatty acid profiles of serum phospholipids in patients suffering rheumatoid arthritis. Progress in Lipid Research 20, 625–631.CrossRefGoogle ScholarPubMed
Brzeski, M., Madhok, R. & Capell, H. A. (1991). Evening primrose oil in patients with rheumatoid arthritis and side-effects of non-steroidal antiinflammatory drugs. British Journal of Rheumatology 30, 370–372.CrossRefGoogle Scholar
Cleland, L. G., French, J. K., Betts, W. H., Murphy, G. A. & Elliott, M. J. (1988). Clinical and biochemical effects of dietary fish oil supplements in rheumatoid arthritis. Journal of Rheumatology 15, 1471–1475.Google ScholarPubMed
Endres, S., Ghorbani, R., Kelley, V. & Dinarello, C. A. (1989). The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. New England Journal of Medicine 320, 265–271.CrossRefGoogle ScholarPubMed
Fries, J. F., Spitz, P., Kraines, R. G. & Holman, H. R. (1980). Measurement of patient outcome in arthritis. Arthritis and Rheumatism 23, 137–145.CrossRefGoogle ScholarPubMed
Grernn, M., Gsrbitz, C., Christensen, E., Levorsen, A., Ose, L., Hagve, T.-A. & Christophersen, B. O. (1991). Dietary n-6 fatty acids inhibit the incorporation of dietary n-3 fatty acids in thrombocyte and serum phospholipids in humans: a controlled dietetic study. Scandinavian Journal of Clinical and Laboratory Investigation 51, 251–263.Google Scholar
Haugen, M., Heryeraal, H. M., Larsen, S., Gilboe, I.-M. & Trygg, K. (1992). Nutrient intake and nutritional status in children with juvenile chronic arthritis. Scandinavian Journal of Rheumatology 21, 165–170.CrossRefGoogle ScholarPubMed
Herstmark, A. T., Lystad, E., Vellar, O. D., Hovi, K. & Berg, J. E. (1993). Reduced plasma fibrinogen, serum peroxides, lipids, and apolipoproteins after a 3-week vegetarian diet. Plant Foods for Human Nutrition 43, 55–61.CrossRefGoogle Scholar
Jacobsson, L., Lindgiirde, R., Manthorpe, R. & Akesson, B. (1990). Correlation of fatty acid composition of adipose tissue lipids and serum phosphatidylcholine and serum concentrations of micronutrients with disease duration in rheumatoid arthritis. Annals of the Rheumatic Diseases 49, 901–905.CrossRefGoogle ScholarPubMed
Jantti, J., Isomaki, H., Laitinen, O., Nikkari, T., Sepplla, E. & Vapaatalo, H. (1985). Linoleic acid treatment in inflammatory arthritis. International Journal of Clinical Pharmacology, Therapy and Toxicity 23, 89–91.Google ScholarPubMed
Johansson, U., Portinsson, S., Akesson, A., Svantesson, H. & Akesson, B. (1986). Fatty acid composition of plasma phosphatidylcholine and erythrocyte lipids, and dietary fat intake in juvenile chronic arthritis. Progress in Lipid Research 25, 579–582.CrossRefGoogle Scholar
Kirkeby, K. & Bjerkedal, I. (1968). The fatty acid composition in serum of Norwegian vegetarians. Acto Medica Scandinavica 183, 143–148.CrossRefGoogle ScholarPubMed
Kjeldsen-Kragh, J., Haugen, M., Borchgrevink, C. F., Laerum, E., Eek, M., Mowinkel, P., Hovi, K. & Ferrre, O. (1991). Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 338, 899–902.CrossRefGoogle ScholarPubMed
Kjeldsen-Kragh, J., Lund, J. A., Riise, T., Finnanger, B., Haaland, K., Finstad, R., Mikkelsen, R. & Fsrre, O. (1992). Dietary omega-3 fatty acid supplementation and Naproxen treatment in patients with rheumatoid arthritis. Journal of Rheumatology 19, 1531–1536.Google ScholarPubMed
Kleinbaum, D. G., Kupper, L. L. & Miiller, K. E. (1988). Applied Regression Analyses and Other Multivariable Methods, pp. 96–314. Boston: PWS-KENT Publishing Company.Google Scholar
Kosugi, H., Kojima, T. & Kikugawa, K. (1989). Thiobarbituric acid-reactive substances from peroxidized lipids. Lipids 24, 873–881.CrossRefGoogle ScholarPubMed
Kowsari, B., Finnie, S. K., Carter, R. L., Love, J., Katz, P., Longley, S. & Panush, R. S. (1983). Assessment of the diet of patients with rheumatoid arthritis and osteoarthritis. Journal of the American Dietetic Association 82, 657–659.CrossRefGoogle ScholarPubMed
Kremer, J. M., Jubiz, W., Michalek, A., Rynes, R. I., Bartholomew, L. E., Bigaouette, J., Timchalk, J. M., Beeler, D. & Lininger, L. (1987). Fish oil supplementation in active rheumatoid arthritis: a double-blinded, controlled, crossover study. Annals of Internal Medicine 106, 497–503.CrossRefGoogle ScholarPubMed
Linos, A., Kaklamanis, E., Kontomerkos, A., Koumantak, Y., Gazi, G., Vaiopoulos, G., Tsokos, G. C. & Kaklamanis, P. (1991). The effect of olive oil and fish consumption on rheumatoid arthritis - a case control study. Scandinavian Journal of Rheumatology 20,419–426.CrossRefGoogle ScholarPubMed
Lunec, J., Halloran, S. P., White, A. G. & Dormandy, L. (1981). Free-radical oxidation (peroxidation) products in serum and synovial fluid in rheumatoid arthritis. Journal of Rheumatology 8, 233–245.Google ScholarPubMed
Montgomery, D. C. (1984). Design and Analysis of Experiments, pp. 117–131. New York: John Wiley.Google Scholar
Paulus, H. E., Egger, M. J., Ward, J. R., Williams, H. J. & The Cooperative Systematic Studies of Rheumatoid Diseases Group (1990). Analysis of improvement in individual rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs, based on the findings in patients treated with placebo. Arthritis and Rheumatism 33, 417–484.CrossRefGoogle ScholarPubMed
Phinney, S. D., Odin, R. S., Johnson, S. B. & Holman, R. T. (1990). Reduced arachidonatein serum phospholipids and cholesteryl esters associated with vegetarian diets in humans. American Journal of Clinical Nutrition 51, 385–392.CrossRefGoogle ScholarPubMed
Pullman-Mooar, S., Laposata, M., Lem, D., Holman, R. T., Leventhal, L. J., DeMarco, D. & Zurier, R. B. (1990). Alteration of cellular fatty acid profile and the production of eicosanoids in human monocytes by gamma-linolenic acid. Arthritis and Rheumatism 33, 1526–1533.CrossRefGoogle ScholarPubMed
Ropes, M. W., Bennet, G. A., Cobb, S., Jacox, R. & Jessar, R. A. (1958). 1958 revision of diagnostic criteria for rheumatoid arthritis. Bulletin on the Rheumatic Diseases 9, 175–176.Google ScholarPubMed
Roshanai, F. & Sanders, T. A. B. (1984). Assessment of fatty acids intake in vegans and omnivores. Human Nutrition: Applied Nutrition 38, 345–354.Google Scholar
Rowley, D., Gutteridge, J. M. C., Blake, D., Farr, M. & Halliwell, B. (1984). Lipid peroxidation in rheumatoid arthritis: thiobarbituric acid-reactive material and catalytic iron salts in synovial fluid from rheumatoid patients. Clinical Science 66, 691–695.CrossRefGoogle ScholarPubMed
Sanders, T. A. B., Ellis, F. R. & Dickerson, J. W. T. (1978). Studies of vegans: the fatty acid composition of plasma choline phosphoglycerides, erythrocytes, adipose tissue, and breast milk, and some indicators of susceptibility to ischemic heart disease in vegans and omnivore controls. American Journal of Clinical Nutrition 31, 805–813CrossRefGoogle ScholarPubMed
Sanders, T. A. B. & Roshanai, F. (1992). Platelet phospholipid fatty acid composition and function in vegans compared with age- and sex-matched omnivore controls. European Journal of Clinical Nutrition 46, 823–831.Google ScholarPubMed
Santoli, D., Phillips, P. D., Colt, T. L. & Zurier, R. B. (1990). Suppression of interleukin 2-dependent human T cell growth in vitro by prostaglandin E (PGE) and their precursor fatty acids. Journal of Clinical Investigation 85, 424–432.CrossRefGoogle Scholar
Skoldstam, L., Eriksson, A. & Berglund, U. (1988). Rheumatoid arthritis (RA) and polyunsaturated fat. Scandinavian Journal of Rheumatology Suppl. 72, 16.Google Scholar
Statens Ernzringsrid (1988). Matraretabell (The Norwegian Food Composition Tables), 5th ed. Oslo: Lands foreningen for Kosthold & Helse.Google Scholar
Tate, T., Mandell, B. F., Laposata, M., Ohliger, D., Baker, D. G., Schumacher, H. R. & Zurier, R. B. (1989). Suppression of acute and chronic inflammation by dietary gamma linolenic acid. Journal of Rheumatology 16, 729–734.Google ScholarPubMed
Tugwell, P., Boers, M. & the OMERACT Committee (1993). Developing consensus on preliminary core efficacy endpoints for rheumatoid arthritis clinical trials. Journal of Rheumatology 20, 555–556.Google ScholarPubMed
Vossen, R. C. R. M., Feijge, M. A. H., Heemskerk, J. W. M., van Dam-Mieras, M. C. E., Hornstra, G. & Zwaal, R. F. A. (1993). Long-term fatty acid modification of endothelial cells: implications for arachidonic acid distribution in phospholipid classes. Journal of Lipid Research 34, 409–420.CrossRefGoogle ScholarPubMed
Ziff, M. (1983). Diet in the treatment of rheumatoid arthritis. Arthritis and Rheumatism 26, 457–461.CrossRefGoogle ScholarPubMed