Adam O, Fasse S, Ditrich O
Ernährungsmedizin, Physiologikum, Ludwig-Maximilians-Universität München, Pettenkoferstr. 12-14, 80336, München, Deutschland.
Z Rheumatol. 2009 Sep;68(7):549-58; quiz 559. doi: 10.1007/s00393-009-0507-6.
The goals of dietary therapy in rheumatic diseases are alleviation of under- and malnutrition, inhibition of inflammation, prophylaxis of osteoporosis, as well as recognition and treatment of nutrient sensitivities or intolerances.Inflammation inhibition in these patients is improved by manipulating the omega-3/omega-6 fatty acids ratio in the diet. Reduction of dietary arachidonic acid is recommended. This polyunsaturated fatty acid is the main precursor of pro-inflammatory mediators which interact with chemokines und cytokines. Simultaneously, intake of anti-inflammatory omega-3 fatty acids is increased. Studies have shown that this dietary regimen results in an amelioration of symptoms in patients with inflammatory rheumatic diseases. Dietary therapy in rheumatic diseases is often complicated by concomitant diseases and physical handicaps necessitating interdisciplinary patient care, consisting of rheumatologists, nutritionists, physiotherapists and ergotherapists. Dietary therapy of rheumatic diseases is an adjuvant therapy that should be initiated after a patient is properly diagnosed.
风湿性疾病饮食治疗的目标包括缓解营养不足和营养不良、抑制炎症、预防骨质疏松，以及识别和治疗营养素敏感或不耐受。通过调整饮食中ω-3/ω-6脂肪酸的比例，可以改善这些患者的炎症抑制情况。建议减少膳食中花生四烯酸的摄入。这种多不饱和脂肪酸是促炎介质的主要前体，促炎介质会与趋化因子和细胞因子相互作用。同时，增加抗炎ω-3脂肪酸的摄入量。研究表明，这种饮食方案可改善炎性风湿性疾病患者的症状。风湿性疾病的饮食治疗常因合并症和身体残疾而变得复杂，这需要由风湿病学家、营养师、物理治疗师和职业治疗师组成的跨学科团队对患者进行护理。风湿性疾病的饮食治疗是一种辅助治疗，应在患者得到正确诊断后开始。
