Abstract

Objective: A Mediterranean-type diet rich in fish, fruit and vegetables and low in saturated fats has been associated with health benefits including improved cardiovascular profile and benefit in RA. This pilot study of a community-based intervention promoting a Mediterranean-type diet in RA patients living in socially deprived areas in Glasgow, aimed to overcome obstacles to healthy eating.

Methods: 130 female RA patients aged 30-70 years were recruited from 3 hospital sites. Intervention group (n=75) attended weekly 2-hour sessions for 6 weeks in the local community, including hands-on cooking classes backed up with written information. Control group (n=55) were given dietary written information only. Both groups completed food frequency questionnaires (FFQ), and clinical and laboratory parameters were assessed at baseline, 3 and 6 months.

Results: Median age 55 years, disease duration 8 years. Significant benefit was shown in the intervention group compared with control for patient global at 6 months (p=0.002), pain score at 3 and 6 months (p=0.011 and 0.049), early morning stiffness (EMS) at 6 months (p=0.041) and health assessment questionnaire score (HAQ) at 3 months (p=0.03). Analysis of FFQ revealed significant increases in weekly total fruit, vegetable and legume consumption and improvement in ratio of monounsaturated: saturated fat intake and systolic BP in the intervention group only. The cooking classes were positively received by patients and tutors and cost per patient for the 6 week course was £84 (€124).

Conclusions: Results of this pilot study are encouraging and demonstrate that a 6 week intervention can make a difference to consumption of healthier foods. It is difficult to ascribe the observed benefits to any one feature from our study. If implemented more widely it may prove a popular inexpensive and useful adjunct to other RA therapy.