Dinas Petros C, Moe Rikke Helene, Boström Carina, Kosti Rena I, Kitas George D, Metsios George S
Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42130 Trikala, Greece.
FAME Laboratory, School of Physical Education, Sport Science and Dietetics, University of Thessaly, 42131 Trikala, Greece.
Healthcare (Basel). 2023 May 15;11(10):1427. doi: 10.3390/healthcare11101427.
Research evidence suggests that, individually, diet and physical activity are effective interventions for reducing levels of inflammation in inflammatory joint diseases (IJD), however little is known about their combined use. This systematic review and meta-analysis aimed to examine the effects and/or associations of combined diet and physical activity interventions in IJD, specifically rheumatoid arthritis (RA) and the spondyloarthropathies (SpA) (PROSPERO registration number: CRD42022370993). Ten out of 11 eligible studies examined RA patients. We found that a combination of diet/nutrition and physical activity/exercise improved Health Assessment Questionnaire score (standardized mean difference = -1.36, confidence interval (CI) = (-2.43)-(-0.30), I = 90%, Z = 2.5, = 0.01), while surprisingly they increased erythrocyte sedimentation rate (mean difference = 0.20, CI = 0.09-0.31, I = 0%, Z = 3.45, < 0.01). No effects were found on C-reactive protein or weight ( > 0.05) of RA patients. We did not find studies in other IJDs that provided sufficient data for a meta-analysis. The narrative data synthesis provided limited evidence to address our research question. No firm conclusions can be made as to whether the combination of diet/nutrition and physical activity/exercise affects inflammatory load in IJDs. The results of this study can only be used as a means of highlighting the low-quality evidence in this field of investigation and the need for further and better-quality research.
研究证据表明,就个体而言,饮食和体育活动是减轻炎性关节疾病(IJD)炎症水平的有效干预措施,然而对于它们的联合使用却知之甚少。本系统评价和荟萃分析旨在研究饮食与体育活动联合干预对IJD,特别是类风湿关节炎(RA)和脊柱关节炎(SpA)的影响和/或关联(国际前瞻性注册系统登记号:CRD42022370993)。11项符合条件的研究中有10项研究了RA患者。我们发现,饮食/营养与体育活动/锻炼相结合可改善健康评估问卷评分(标准化均数差=-1.36,置信区间(CI)=(-2.43)-(-0.30),I²=90%,Z=2.5,P=0.01),而令人惊讶的是,它们会提高红细胞沉降率(均数差=0.20,CI=0.09-0.31,I²=0%,Z=3.45,P<0.01)。未发现对RA患者的C反应蛋白或体重有影响(P>0.05)。我们未找到其他IJD中能提供足够数据进行荟萃分析的研究。叙述性数据综合提供了有限的证据来回答我们的研究问题。关于饮食/营养与体育活动/锻炼的组合是否会影响IJD的炎症负荷,无法得出确凿结论。本研究结果仅可作为一种方式,用以凸显该研究领域证据质量较低的情况以及开展进一步高质量研究的必要性。