Ernährung bei Rheumatoider Arthritis: Ihr Einfluss auf Erkrankungsrisiko und Krankheitsverlauf

Zusammenfassung

Die Art der Ernährung trägt nach den Daten großer Kohortenstudien als ätiologischer Faktor zur Entstehung einer rheumatoiden Arthritis (RA) bei. Die Bedeutung einzelner Nahrungskomponenten ist am besten belegt für den protektiven Effekt von geringen Alkoholmengen und die risikosteigernde Wirkung eines hohen Konsums an rotem Fleisch. Relativ gut untersucht ist die Rolle einer Adipositas, die Schweregrad-abhängig das Erkrankungsrisiko für die RA erhöht. Zusätzlich wird diskutiert, ob vor allem eine abdominelle Adipositas die Entstehung entzündlicher Gelenkerkrankungen begünstigt. Interventionsstudien, welche den Nutzen einzelner Kostformen bei etablierter RA untersuchen sollten, sind in ihrer Qualität und Aussagekraft beschränkt. 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. Es existieren nur wenige valide Daten zum sinnvollen Einsatz von Nahrungsergänzungsmitteln bei etablierter RA. Einige positive Effekte lassen sich 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

According to large cohort studies, nutritional factors contribute to the aetiology of rheumatoid arthritis (RA). The contribution of single components of our daily diet to the risk of RA has been most clearly demonstrated with respect to the protective effects of low-to moderate alcohol consumption and the increased RA risk in persons consuming large quantities of red meat. There is now solid evidence for the association of obesity with an increased risk for RA. In addition, the prominent role of abdominal adiposity as aetiological factor for inflammatory joint diseases is still under discussion. Interventional studies on the impact of definite dietary regimens on the course of RA are of limited quality and validity. A Mediterranean diet is probably helpful for RA patients, especially regarding the reduction of the cardiovascular risk. Valid data on the reasonable application of nutritional supplements are scant. Fish oil capsules with a high content of omega-3-fatty acids may have a mild therapeutic effect. Iron and Vitamin D should be prescribed if indicated according to objective criteria and current guidelines.

Schlüsselwörter

Ernährung - Rheumatoide Arthritis - Mediterrane Ernährung - Nahrungsergänzungsmittel

Key words

nutrition - rheumatoid arthritis - Mediterranean diet - nutritional supplements

Publication History

Article published online:
22 August 2023

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