Exclusive: ACR Convergence 2024| Focus Rheums

An official publication of the ACR and the ARP serving rheumatologists and rheumatology professionals

Lifestyle Medicine Interventions Can Benefit Patients with Rheumatic Disease

  |  Issue: May 2024  |  

SAN DIEGO—Lifestyle interventions, such as diet, exercise and mindfulness, can benefit patients with rheumatic disease. Although the benefits of lifestyle medicine have been shown in many studies, how best to put these strategies to use for rheumatology patients is still far from being fully explored, an expert said during a session at ACR Convergence 2023.

“The application of lifestyle medicine in the rheumatic diseases is critically important to people who are living with these conditions,” said Sarah Patterson, MD, assistant professor of medicine at the University of California, San Francisco (UCSF), and integrative rheumatologist at UCSF’s Osher Center for Integrative Health.

Dr. Patterson

These interventions can make a difference for patients when conventional therapies are not completely effective or are poorly tolerated. Lifestyle medicine can help ease persistent symptoms, while offering additional benefits, such as lowering cardiovascular disease risk.

Diet

Studies dating back to the 2000s demonstrated the benefit of the Mediterranean diet in patients with active rheumatoid arthritis (RA) compared with control. The diet consists of vegetables, nuts, fish and has very limited red meat, added sugar and processed food. In the study, these patients experienced improvements from baseline in pain and function when simply taking Mediterranean-diet cooking classes. A 2022 study comparing a Mediterranean diet with a low-fat diet and a regular diet among obese and overweight patients with RA found the greatest improvements were seen in patients using the Mediterranean diet.1

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In a recent study, 20 patients with active RA who were put on an anti-inflammatory diet—known as the ITIS diet—had significant improvement in pain after the intervention compared with baseline. Also, the fecal microbiome and metabolome were different in patients with at least 50% pain improvement compared with those who had a lesser response.2

In patients with lupus, in which diet has been studied less, researchers found that most patients who made dietary changes after diagnosis perceived a benefit from that change.3 Other research has found an independent association between sugar intake and disease activity.4

Studies have also demonstrated the benefits for omega-3 supplementation in patients with RA and lupus.5,6 Dr. Patterson pointed the audience to a UCSF Web site (http://tiny.ucsf.edu/rheumnutrition) with evidence-based information on diet and people with rheumatic conditions.

Movement

Physical activity has been repeatedly found to improve with patient-reported outcomes in RA, Dr. Patterson said. In a study, a 10-week, high-intensity walking program significantly improved disease activity and immune function among previously physically inactive patients.7

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