Food for Thought: On Eating & Inflammation in Rheumatic Disease

Think Beyond the Prescription Pad

Neha Shah, MD

Nearly one-third of patients with RA in a recent survey were dissatisfied with their treatment plan, and in another survey of adults with self-reported, doctor-diagnosed arthritis, almost 40% said they had sought out a complementary or alternative therapy for their symptoms.^17,18 “So our patients are seeking care outside of the rheumatologist’s office. We can move in the direction of more patient-centered care by using complementary medicine,” said rheumatologist Neha S. Shah, MD, assistant professor of medicine at Stanford University in California.

Rheumatologists may help patients build self-efficacy (i.e., the perception that they can do something to cope with their disease) by talking with them about lifestyle habits, such as nutrition, exercise, tobacco use, sleep or stress, and help them set goals to improve these habits.

“This lifestyle-medicine approach is one way we can empower our patients and allow them to put some control back into their lives,” said Dr. Shah. “To be an integrative rheumatologist, one need not do an 800-hour acupuncture course or get a master’s in nutrition or become a certified yoga instructor. What it really takes is asking the right questions” and carefully listening to patients’ answers, she said.

For patients who ask about herbal treatments, Dr. Shah discussed the potentially positive effects of two Ayurvedic herbs (turmeric and ginger) on rheumatic disease patients, who may easily incorporate these spices into their daily diet or take them as supplements. Turmeric, also called curcumin, improved knee osteoarthritis pain in a 2019 double-blind, randomized, placebo-controlled trial.¹⁹ Ginger supplementation improved some immunity and inflammation gene expression in patients with active RA in a 2019 trial.²⁰

Rheumatologists may feel they have little time to cover these topics during busy clinic hours, so Dr. Shah suggests virtual meetings with groups of patients interested in complementary medicine.

“This ideal of perfect health may not be attainable for our patients who are in advanced stages of autoimmune disease, but helping them get one step closer to their optimal state of well-being is certainly within our power,” she said.

Susan Bernstein is a freelance journalist based in Atlanta.

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