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A pilot study of a Mediterranean-type diet intervention in female patients with rheumatoid arthritis living in areas of social deprivation in Glasgow
  1. G McKellar1,
  2. E Morrison2,
  3. A McEntegart3,
  4. R Hampson1,
  5. A Tierney1,
  6. G Mackle3,
  7. J Scoular4,
  8. J A Scott5,
  9. H A Capell1
  1. 1Centre for Rheumatic Diseases, Glasgow Royal Infirmary, Glasgow, UK
  2. 2Rheumatology Department, Southern General Hospital, Glasgow, UK
  3. 3Rheumatology Department, Stobhill Hospital, Glasgow, UK
  4. 4Health Promotion Department, Greater Glasgow & Clyde Health Board, Glasgow, UK
  5. 5Human Nutrition Department, University of Glasgow, Glasgow, UK
  1. Correspondence to:
    Dr G McKellar
    Glasgow Royal Infirmary Castle Street, G4 0SF Glasgow, UK; gayle_mckellar{at}hotmail.com

Abstract

Background: A Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats has been associated with health benefits, including improved cardiovascular profile and benefit in RA.

Objective: To overcome obstacles to healthy eating by a community-based intervention promoting a Mediterranean-type diet in patients with RA living in socially deprived areas of Glasgow.

Methods: 130 female patients with RA aged 30–70 years (median 55), disease duration 8 years were recruited from three hospital sites. The intervention group (n = 75) attended weekly 2-hour sessions for 6 weeks in the local community, including hands-on cooking classes backed up with written information. The control group (n = 55) were given dietary written information only. Both groups completed food frequency questionnaires (FFQs), and clinical and laboratory measures were assessed at baseline, 3 and 6 months.

Results: Significant benefit was shown in the intervention group compared with controls for patient global assessment at 6 months (p = 0.002), pain score at 3 and 6 months (p = 0.011 and 0.049), early morning stiffness at 6 months (p = 0.041) and Health Assessment Questionnaire score at 3 months (p = 0.03). Analysis of the FFQs showed significant increases in weekly total fruit, vegetable and legume consumption and improvement in the ratio of monounsaturated:saturated fat intake and systolic BP in the intervention group only. The cooking classes were positively received by patients and tutors; cost/patient for the 6 week course was £84 (€124).

Conclusions: Results demonstrate that a 6 week intervention can improve consumption of healthier foods. If implemented more widely it may prove a popular, inexpensive and useful adjunct to other RA treatment.

  • DAS28, 28 joint count Disease Activity Score
  • DMARD, disease modifying antirheumatic drug
  • EMS, early morning stiffness
  • FFQ, food frequency questionnaire
  • GGHBHPD, Greater Glasgow Health Board’s Health Promotion Department
  • HAQ, Health Assessment Questionnaire
  • IL6, interleukin 6
  • rheumatoid arthritis
  • diet
  • cardiovascular risk

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Footnotes

  • Published Online First 5 July 2007