Dietary n-3 fats and outcomes in early-onset rheumatoid arthritis

有相当多的证据表明，增加omega-3多不饱和脂肪的饮食摄入对健康有积极的好处。对类风湿关节炎、其他炎症性疾病和心脏病都有好处。先前对类风湿关节炎和饮食中omega-3脂肪的研究有一个共同的设计，这可能降低了有益饮食效果的程度。因此，需要“第二代”研究来解决这些常见的设计问题，以便为使用膳食-3脂肪治疗类风湿性关节炎建立最佳条件。目前的建议将通过改变背景饮食、测量功能残疾和关节损伤以及症状、在关节损伤发生之前就开始治疗以及通过调节同时使用药物来解决以前的设计缺陷。这项研究还将评估一项新的血液测试，该测试表明增加饮食中omega-3脂肪对omega-3营养状况的影响。如果这一营养指数与更有利的结果相关，将为在常规临床情况下指导omega-3脂肪治疗奠定基础。这项研究很重要，因为类风湿关节炎的饮食治疗：(a)为类风湿关节炎患者在其疾病的终身管理中提供了更积极的作用。(b)对政府卫生预算没有持续成本，实际上有可能大幅降低类风湿性关节炎的治疗费用(c)具有更广泛的适用性，例如用于预防和治疗其他炎症和心脏病(d)需要用现代治疗方案进行测试，其中涉及在类风湿性关节炎病程早期开始的多种治疗方法；在发生不可逆转的损害和残疾之前(e)需要营养指数来指导治疗(f)必须以证据为基础。

There is considerable evidence that positive health benefits flow from increasing the dietary intake of omega-3 polyunsaturated fats. Benefits are seen in rheumatoid arthritis, other inflammatory disorders and heart disease. Previous studies of rheumatoid arthritis and dietary omega-3 fats had a common design which probably reduced the magnitude of the beneficial dietary effects. Therefore, a 'second generation' study is needed which addresses these common design issues in order to establish optimal conditions for the use of dietary omega-3 fats in therapy for rheumatoid arthritis. The current proposal will address the previous design shortcomings by changing the background diet, measuring functional disability and joint damage as well as symptoms, starting treatment in early disease before joint damage has occurred, and by regulating concurrent drug use. The study will also evaluate a novel blood test that indicates the effect of advice to increase dietary omega-3 fats upon omega-3 nutritional status. If this nutritional index correlates with more favourable outcomes, a base will have been established for guiding treatment with omega-3 fats in routine clinical situations. This study is important because dietary treatment in rheumatoid arthritis: (a) offers sufferers with rheumatoid arthritis a more active role in the life long management of their disease. (b) has no on-going cost to the government health budget, and in fact, has the potential to decrease treatment costs in rheumatoid arthritis considerably (c) has wider applicability, e.g. for prevention and treatment of other inflammatory conditions and heart disease (d) needs to be tested with modern treatment protocols that involve multiple therapies started early in the course of rheumatoid arthritis, before irreversible impairment and disability has occurred (e) requires a nutritional index to guide treatment (f) must be evidence based.