Plants for joints
. The objective of this thesis was to examine the impact of lifestyle interventions, with an emphasis on plant-based diets, on clinical outcomes in major rheumatic conditions and to investigate whether these lifestyle interventions provide benefits in reducing inflammation, addressing metabolic risk factors, and improving body composition. The first part of the thesis introduces nutritional interventions for rheumatic diseases. It reviews healthy diets for rheumatoid arthritis (RA) and osteoarthritis (OA), concluding that general dietary guidelines provide valuable references. Specific approaches for RA include fasting, plant-based diets, and the Mediterranean diet, while low-calorie diets may be suggested for OA. Evidence supporting these recommendations is however limited. The systematic review of diets for gout, reveals that fasting increases serum uric acid (SUA) levels, while low-calorie, purine-low, and Mediterranean-style diets show promise in reducing SUA and addressing cardiovascular risk factors. The second part of this thesis shows that the 16-week ‘Plants for Joints’ multidisciplinary lifestyle program based on a whole food plant-based diet (WFPD), physical activity, and stress management is effective for RA with significant improvements in disease activity, body weight, fat mass, waist circumference, HbA1c, and LDL. The results for OA patients demonstrate significant improvements in pain, stiffness, and physical function, as well as body weight, fat mass, waist circumference, and metabolic markers. The changes in body composition for both RA and MSOA participants are overall favorable, although adequate protein intake and strength training should be emphasized. Overall, this thesis shows that a WFPD-based lifestyle program is beneficial for people with rheumatic diseases. .
