Nutr 408 Unit 3 MNT for Rheumatic Diseases

Rheumatic Disease Characterized by

Inflammation
Loss of function of connective tissue and supporting body structure
Possible autoimmune components

Inflammation due to

osteoarthritis, rheumatoid arthritis, gout

osteoarthritis

Stress on joint

rheumatoid arthritis, gout

Autoimmune response

Omega 6 PUFAs are precursors to

pro

pro

inflammatory eicosanoids

Omega 3 PUFSa are precursors to

anti

anti

inflammatory eicosanoids

Arthritis Symptoms

Pain, stiffness, loss of function

Physical Examination for Arthritis

Redness, swelling

Biochemical assessment for Arthritis

Rheumatoid factor
CRP
Homocysteine

Inflammatory markers

C

Treatment for Arthritis

Analgesics, DMARDs, Anti

Analgesics examples

Tylenol, opioids

DMARDs

Disease modifying anti rheumatic drugs

Disease modifying anti rheumatic drugs

Associated with autoimmune component
Suppress immune system to reduce inflammationn

DMARDs Examples

Methotrexate
Humira

Anti

inflammatories

NSAIDs

Nonsteroidal antinflammatory drugs

What do NSaids block?

Block cox 1 and cox 2 enzyme

Corticosteroids mimic

cortisol

Corticosteroids usually end in

sone

Osteoarthritis risk factors

Obesity
Aging
Female gender
Repetitive use injury

Osteoarthritis characteristics

Cartilage destruction
Asymmetric inflammation

MNT for osteoarthritis

Weight management
Anti

osteoarthritis supplements

S

Anti

inflammatory diet limit

Anti

inflammatory diet increase

Anti

inflammatory diet antioxidants

Anti

inflammatory diet phytochemicals

Rheumatoid Arthritis

Genetic related risk factors

Rheumatoid Arthritis is an

Autoimmune disease due to infection or exposure to something in the environment

Rheumatoid Arthritis risk factors

Age
Genetics
Female gender
Obesity
Smoking

Rheumatoid Arthritis characteristics

Symmetric inflammation
Bone and cartilage loss
Inflammed synovium
Swollen joint capsule

rheumatoid Arthritis nutrition assessment

Weight change, muscle wasting
Ability to perform nutrition related ADLs
CVD risk

MNT for rheumatoid Arthritis

Anti

Energy for rheumatoid Arthritis

Depends on weight and mobility
REE may be increased but PA may be reduced

Protein for rheumatoid Arthritis

RDA if well nourished
1.5 to 2 g/day if malnourished or in catabolic phase

Supplements for rheumatoid Arthritis

Limited evidence for ginger, cinnamon, saffron, curcumin
Fish oil
Calcium and Vitamin D if on steroids
Folic Acid if on MTX
Probiotics

Gout

Disorder of purine metabolism, resulting in hyperuricemia

In gout, sodium urate crystals

form and deposit in joints

Gout results in

Sudden and acute onset of pain

Gout risk factors

Obesity
Genetics
Age, gender
HTN, CKD
Sleep Apnea
Lead exposure
Consumption of alcohol and HFCS

for Gout, limit

Seafood, red meat
Alcohol
Fructose

What type of foods should you avoid for gout

High

With gout, you should have a high intake of

fluids

What are the foods and nutrients with protective effects for gout?

Low

Steroids often used to treat rheumatic diseases, increase the risk of

Osteoporosis

An important aspect of medical nutrition therapy for osteoarthritis is

Achieving and maintaining healthy weight

In patients with rheumatoid arthritis, inflammation may cause

A loss of lean body mass