Nutrition Changes Bring Relief to Rheumatoid Arthritis Sufferers
Nov. 19, 1999 (Boston) -- The debilitating effects of chronic rheumatoid
arthritis can be softened -- if not always to a great degree -- by nutrition
and exercise, according to Ronenn Roubenoff, MD, a nutritionist at the Tufts
University School of Medicine. Roubenoff spoke to an audience of doctors here
this week at a meeting of the American College of Rheumatology.
People with rheumatoid arthritis have twice the risk of dying compared to
the general population, Roubenoff said. Reduced muscle mass contributes to that
risk. The average 70-year-old has 30% less muscle than the average 25-year-old,
said Roubenoff, and "if you lose 40%, you die."
Lack of muscle reserves, Roubenoff said, is one reason an elderly person who
lands in the ICU after getting hit by a truck is so much more likely to die
than a young person. "People who are acutely ill stop eating," said
Roubenoff. But while fasting puts a normal, healthy person into a metabolic
mode that burns fat and spares protein, under the stress of major trauma or
illness, the body burns its own protein.
People with rheumatoid arthritis need to eat more protein than normal,
healthy individuals, said Roubenoff, who recommends eating about 2.7 ounces of
protein daily. That's roughly equivalent to one 4 ounce chicken breast or two
servings of beans.
But simply eating more protein does not result in increased stores of
protein in the body, said Roubenoff.
The problem is that the body stores protein as fat, because muscle is not
being built. Resistance exercise -- which involves leg lifts and arm exercises
using weights -- helps build muscle so that protein can be stored.
Also, certain important B vitamins are often deficient in people with
rheumatoid arthritis, Roubenoff said. "The three we worry about are B6,
B12, and folate. Supplements are important, particularly for elderly people,
some of whom lose the ability to absorb B12 from food. "They can still
absorb it from pills," said Roubenoff.
Much of the damage rheumatoid arthritis inflicts upon the body is probably
the result of so-called "free radicals," said Roubenoff. Free radicals
are fast-moving, destructive atoms -- created by smoking, inhaling pollutants,
or being exposed to ultraviolet radiation from the sun. Free radicals circulate
through the body, damaging cells, and are believed to cause many chronic
diseases including rheumatoid arthritis, heart disease, cancer, Alzheimer's
disease, and Parkinson's disease.
"European studies suggest that large doses of vitamin E have a good
effect [in combating free radicals], Roubenoff said. "The rationale is that
anything that increases free radical production lowers the body's ability to
defend itself against damage. People with rheumatoid arthritis not only have
increased free radicals, but reduced vitamin E, C, and beta carotene,"
which may result from using up these antioxidants. Vitamin E in particular has
been shown to relieve pain in "a few small studies from Germany,"
Roubenoff tells WebMD. He recommends 200 mg/d.