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Nutrition and Rheumatic Disease pp 89–110Cite as

Complementary and Alternative Therapies

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Part of the book series: Nutrition and Health ((NH))

Summary

• Complementary and alternative medicine encompasses a wide array of interventions, including diets, dietary supplements, and herbal products.

• Scientific evidence does not support a substantial role of special diets in the treatment of the majority of patients with rheumatic disease, but various dietary manipulations may be beneficial when combined with standard medical therapy.

• Long-term safety of dietary and herbal supplements is a legitimate concern and patients should always be cautioned about their use of these products.

• Observed benefits in disease activity owing to short-term trials may be more reflective of the natural history of rheumatic disease rather than true differences in long-term outcome.

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References

  1. Eisenberg D, Kessler R, Foster C, et al. Unconventional medicine in the United States: prevalence, costs, and patterns of use. N Engl J Med 1993;328:246–252.

    Article  PubMed  CAS  Google Scholar 

  2. Eisenberg D, Davis R, Ettner S, et al. Trends in alternative medicine use in the United States, 1990–1997: results from a national survey. JAMA 1998;280:1569–1575.

    Article  PubMed  CAS  Google Scholar 

  3. Barnes P, Powell-Griner E, McFann K, Nahin R. Complementary and alternative medicine use among adults: united states, 2002. Advance Data From Vital and Health Statistics, Centers for Disease Control and Prevention 2004;343:1–20.

    Google Scholar 

  4. National Center for Complementary and Alternative Medicine. Available at: http://nccam.nih.gov/about/almanac/organization/NCCAM.htm.

    Google Scholar 

  5. Committee on the framework for evaluating the safety of dietary supplements. Dietary Supplement, a Framework for Evaluating Safety. National Academies Press, Washington, DC, The 2005.

    Google Scholar 

  6. Rao J, Mihaliak K, Kroenke K, et al. Use of complementary therapies for arthritis among patients of rheumatologists. Ann Intern Med 1999;131:409–416.

    PubMed  CAS  Google Scholar 

  7. Ramsey S, Spencer A, Topolski T, et al. Use of alternative therapies by older adults with osteoarthritis. Arthritis Care Res 2001;45:222–227.

    Article  CAS  Google Scholar 

  8. Henderson C, Panush R. Diets, dietary supplements, and nutritional therapies in rheumatic diseases. Rheum Dis Clin North Am 1999;25:937–968.

    Article  PubMed  CAS  Google Scholar 

  9. McDougall J, Bruce B, Spiller G, et al. Effects of very low-fat, vegan diet in subjects with rheumatoid arthritis. J Altern Complement Med 2002;8:71–75.

    Article  PubMed  Google Scholar 

  10. Felson D. Osteoarthritis of the knee. N Engl J Med 2006;354:841–848.

    Article  PubMed  CAS  Google Scholar 

  11. Clegg D, Reda D, Harris C, et al. Glucosamine, chondroitin sulfate and the two in combination for painful knee osteoarthritis. N Engl J Med 2006;354:795–808.

    Article  PubMed  CAS  Google Scholar 

  12. Arthritis Foundation. Arthritis: The Basic Facts. Arthritis Foundation, Atlanta, GA, 1981.

    Google Scholar 

  13. Stamp L, James M, Cleland L. Diet and rheumatoid arthritis: a review of the literature. Semin Arthritis Rheum 2005;35:77–94.

    Article  PubMed  CAS  Google Scholar 

  14. Panush R, Stroud R, Webster E. Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk. Arthritis Rheum 1986;29:220–226.

    Article  PubMed  CAS  Google Scholar 

  15. Darlington L, Ramsey N, Mansfield J. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986;1:237–239.

    Google Scholar 

  16. Vegetarian diet: a starter’s guide to a plant based diet. Available at: http://mayoclinic.com/health/vegetarian-diet/HQ01596

    Google Scholar 

  17. Kjeldsen-Kragh J, Borchgrevink C, Mowinkel P, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 1991;338:899–902.

    Article  PubMed  CAS  Google Scholar 

  18. Rhen T, Cidlowski, J. Antiinflammatory action of glucocorticoids—new mechanisms for old drugs. Arthritis Foundation 2005;353:1711–1723.

    CAS  Google Scholar 

  19. Kronmann N, Green A. Epidemiological studies in the Upernavik district, Greenland: incidence of some chronic diseases 1950–1974. Acta Med Scand 1980;208:401–406.

    Article  Google Scholar 

  20. Gruppo Italiano per lo Studio Della Sopravvivenza nell’Infarto micocarico. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Lancet 1999;354:447–455.

    Article  Google Scholar 

  21. Kremer J. n-3 Fatty acid supplements in rheumatoid arthritis. Am J Clin Nutr 2000;71:349S-351S.

    PubMed  CAS  Google Scholar 

  22. Ariza-Ariza R, Mestanza-Peralta M, Cardiel M. Omega-3 fatty acids in rheumatoid arthritis: an overview. Semin Arthritis Rheum 1998;6:366–370.

    Article  Google Scholar 

  23. Cleland L, James M, Proudman S. The role of fish oils in the treatment of rheumatoid arthritis. Drugs 2003;63:845–853.

    Article  PubMed  CAS  Google Scholar 

  24. Kris-Etherton P, Harris W, Appel L. Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease. Circulation 2002;106:2747–2757.

    Article  PubMed  Google Scholar 

  25. Kris-Etherton P, Taylor D, Yu-Poth S, et al. Polyunsaturated fatty acids in the food chain in the United States. Am J Clin Nutr 2000;71:179S-188S.

    PubMed  CAS  Google Scholar 

  26. Fujikawa M, Yamashita N, Yamazaki K, et al. Eicosapentaenoic acid inhibits antigen-presenting cell function of murine splenocytes. Immunology 1992;75:330–335.

    PubMed  CAS  Google Scholar 

  27. Kremer J, Lawrence D, Jubiz W, et al. Effects of high-dose fish oil on rheumatoid arthritis after stopping non-steroidal anti-inflammatory drugs. Clinical and immune correlates. Arthritis Rheum 1995;38:1107–1114.

    Article  PubMed  CAS  Google Scholar 

  28. Endres S, Ghorbani R, Kelley V, et al. The effect of dietary supplementation with n-3 polyunsaturated fatty acids on the synthesis of interleukin-1 and tumor necrosis factor by mononuclear cells. N Engl J Med 1989;320:265–271.

    Article  PubMed  CAS  Google Scholar 

  29. Curtis C, Hughes C, Flannery C, et al. n-3 fatty acids specifically modulate catabolic factors involved in articular cartilage degredation. J Biol Chem 2000;275:721–724.

    Article  PubMed  CAS  Google Scholar 

  30. Curtis C, Rees S, Little C, et al. Pathological indicators of degradation and inflammation in human osteoarthritis cartilage are abrogated by exposure to n-3 fatty acids. Arthritis Rheum 2002;46: 1544–1553.

    Article  PubMed  CAS  Google Scholar 

  31. Lau C, Morley K, Belch J. Effects of fish oil supplementation on non-steroidal anti-inflammatory requirement in patiens with mild rheumatoid arthritis—a double-blind placebo-controlled trial. Br J Rheumatol 1993;32:982–989.

    Article  PubMed  CAS  Google Scholar 

  32. Geusens P, Wouters C, Nijs J, et al. Long-term effect of omega-3 fatty acid supplementation in active rheumatoid arthritis. A 12-month, double-blind, controlled study. Arthritis Rheum 1994;37:824–829.

    Article  PubMed  CAS  Google Scholar 

  33. Kremer J, Lawrence D, Jubiz W, et al. Dietary fish oil and olive oil supplementation in patients with rheumatoid arthritis. Arthritis Rheum 1990;33:810–819.

    Article  PubMed  CAS  Google Scholar 

  34. Volker D, Firtzgerald P, Major G, et al.. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. J Rheumatol 2000;27:2343–2346.

    PubMed  CAS  Google Scholar 

  35. Fortin P, Lew R, Liang M, et al. Validation of a meta-analysis: the effects of fish oil in rheumatoid arthritis. J Clin Epidemiol 1995;48:1379–1390.

    Article  PubMed  CAS  Google Scholar 

  36. Burr M, Fehily A, Gilbert J, et al. Effects of changes in fat, fish, and fibre intakes on death and myocardial reinfarction: diet and reinfarction trial (DART). Lancet 1989;2:757–761.

    Article  PubMed  CAS  Google Scholar 

  37. Leaf A, Jorgensen M, Jacobs A, et al. Do fish oils prevent restenosis after coronary angioplasty? Circulation 1994;90:2248–2257.

    PubMed  CAS  Google Scholar 

  38. Eritsland J, Arnesen H, Gronseth K, et al. Effect of dietary supplementation with n-3 fatty acids on coronary artery bypass graft patency. Am J Cardio 1996;77:31–36.

    Article  CAS  Google Scholar 

  39. Montori V, Farmer A, Wollan P, et al. Fish oil supplementation in type 2 diabetes: a quantitative systematic review. Diabetes Care 2000;23:1217–1218.

    Article  Google Scholar 

  40. Department of Health and Human Services, US Food and Drug Administration. Substances affirmed as generally recognized as safe: menhaden oil. Federal Register 1997;62:30751–30757. Available at: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=1997_register&docid= fr05jn97–5.

    Google Scholar 

  41. Office of Nutritional Products, Labeling, and Dietary Supplements, Center for Food Safety and Applied Nutrition, US Food and Drug Administration 2002. Available at: http://www.cfsan.fda.gov/~dms/ds-ltr28.html.

    Google Scholar 

  42. Harris, W, Ginsberg H, Arunakul N, et al. safety and efficacy of Omacor in severe hypertriglyceridemia. J Cardiovasc Risk 1997;4:385–391.

    Article  PubMed  CAS  Google Scholar 

  43. US Food and Drug Administration. What you need to know about mercury in fish and shellfish. FDA/CFSAN Consumer Advisory 2004. Available at: http://www.cfsan.fda.gov/~dms/admehg3.html.

    Google Scholar 

  44. Covington, M. Omega-3 fatty acids. Am Fam Physician 2004;70:133–140.

    PubMed  Google Scholar 

  45. Setty A, Sigal L. Herbal medications commonly used in the practice of rheumatology: mechanisms of action, efficacy, and side effects. Semin Arthritis Rheum 2005;34:773–784.

    Article  PubMed  Google Scholar 

  46. Belch J, Hill A. Evening primrose oil and borage oil in rheumatologic conditions. Am J Clin Nutr 2000;71:352S-356S.

    PubMed  CAS  Google Scholar 

  47. Leventhal L, Boyce E, Zurier R. Treatment of rheumatoid arthritis with gammalinolenic acid. Ann Int Med 1993;119:867–873.

    PubMed  CAS  Google Scholar 

  48. Theander E, Horrobin D, Jacobsson L, et al. Gammalinolenic acid treatment of fatigue associated with primary Sjogren’s syndrome. Scand J Rheumatol 2002;31:72–79.

    Article  PubMed  Google Scholar 

  49. McAlindon T, Felson D, Zhanf Y, et al. Relation of dietary intake and serum levels of vitamin D to progression of osteoarthritis of the knee among participants in the Framingham study. Ann Intern Med 1996;125:353–359.

    PubMed  CAS  Google Scholar 

  50. Lane N, Gore L, Cummings S, et al. Serum vitamin D levels and incident changes of radiographic hip osteoarthritis. A longitudinal study. Arthritis Rheum 1999;42:854–860.

    Article  PubMed  CAS  Google Scholar 

  51. Merlino L, Curtis J, Mikuls T, et al. Vitamin D is inversely associated with rheumatoid arthritis: results from the Iowa Women’s Health Study. Arthritis Rheum 2004;50:72–77.

    Article  PubMed  CAS  Google Scholar 

  52. Peterkosfsky B. Ascorbate requirement for hydroxylation and secretion of procollagen: relationship to inhibition of collagen synthesis in scurvy. Am J Clin Nutr 1991;54:1135S-1140S.

    Google Scholar 

  53. Schwartz E, Oh W, Leveille C. Experimentally induced osteoarthritis in guinea pigs: metabolic responses in articular cartilage to developing pathology. Arthritis Rheum 1981;24:1345–1355.

    Article  PubMed  CAS  Google Scholar 

  54. Kraus V, Huebner J, Stabler T, et al. Ascorbic acid increases the severity of spontaneous knee osteoarthritis in a guinea pig model. Arthritis Rheum 2004;50:1822–1831.

    Article  PubMed  CAS  Google Scholar 

  55. McAlindon T, Jacques P, Zhang Y, et al. Do antioxidant micronutrients protect against the development and progression of knee osteoarthritis? Arthris Rheum 1996;39:648–656.

    Article  CAS  Google Scholar 

  56. Henrotin Y, Kurz G, Aigner T. Review: oxygen and reactive oxygen species in cartilage degredation: friend or foes? Osteoarthrtitis Cartilage 2005;13:643–654.

    Article  CAS  Google Scholar 

  57. Jordan J, De Roos A, Renner J, et al. A case-control study of serum tocopherol levels and the alpha- to gamma-tocopherol ratio in radiographic knee osteoarthritis: the Johnston County Osteoarthritis Project. Am J Epidemiol 2004;159:968–977.

    Article  PubMed  Google Scholar 

  58. Newman B, Gigout L, Sudre L, et al. Coordinated expression of matrix Gla protein is required during endochondral ossification for chondrocyte survival. J Cell Biol 2001;154:659–666.

    Article  PubMed  CAS  Google Scholar 

  59. Neogi T, Booth S, Zhang Y, et al. Low vitamin K status is associated with osteoarthritis in the hand and knee. Arthritis Rheum 2006;54:1255–1261.

    Article  PubMed  CAS  Google Scholar 

  60. Kolata G. 2 Top-selling arthritis drugs are found to be ineffective. NY Times. Feb 23, 2006.

    Google Scholar 

  61. Lewis S, Crossman M, Flannelly J, et al. Chondroitin sulphation patterns in synovial fluid in osteoarthritis subset. Ann Rheum Dis 1999;58:441–445.

    PubMed  CAS  Google Scholar 

  62. Kolasinski S. Glucosamine and Chondroitin: Update 2006. Alt Med Alert 2006;9:73–84.

    Google Scholar 

  63. Biggee B, Blinn C, McAlindon T, et al. Low levels of human serum glucosamine after ingestion of glucosamine sulphate relative to capability for peripheral effectiveness. Ann Rheum Dis 2006;65: 222–226.

    Article  PubMed  CAS  Google Scholar 

  64. Bassleer C, Henrotin Y, Franchimont P. In vitro evaluation of drugs proposed as chondroprotective agents. Int J Tissue React 1992;14:231–240.

    PubMed  CAS  Google Scholar 

  65. Neil K, Orth M, Coussens P, et al. Effects of glucosamine and chondroitin sulfate on mediators of osteoarthritis in cultured equine chondrocytes stimulated by use of recombinant equine interleukin-1b. Am J Vet Res 2005;66:1861–1869.

    Article  PubMed  CAS  Google Scholar 

  66. Reginster J, Deroisy R, Rovati L, et al. Long-term effects of glucosamine sulphate on osteoarthrtitis progression: a randomized, placebo-controlled clinical trial. Lancet 2001;357:251–256.

    Article  PubMed  CAS  Google Scholar 

  67. Cibere J, Kopee J, Thorne A, et al. Randomized, double-blind, placebo-controlled glucosamine discontinuation trial in knee osteoarthritis. Arthritis Rheum 2004;51:738–745.

    Article  PubMed  CAS  Google Scholar 

  68. Towheed T, Maxwell L, Anastassiades T, et al. Glucosamine therapy for treating osteoarthritis. The Cochrane Database of Systematic Reviews 2005;2:CD002946.

    Google Scholar 

  69. Uebelhart D, Malaise M, Marcolongo R, et al. Intermittent treatment of knee osteoarthritis with oral chondroitin sulfate: a one-year, randomized, double-blind multicenter study versus placebo. Osteoarthritis Cartilage 2004;12:269–276.

    Article  PubMed  Google Scholar 

  70. Michel B, Stucki G, Frey D, et al. Chondroitins 4 and 6 sulfate in osteoarthritis of the knee: a randomized, controlled trial. Arthritis Rheum 2005;52:779–786.

    Article  PubMed  CAS  Google Scholar 

  71. Hochberg M. Nutritional supplements for knee osteoarthritis-still no resolution. N Engl J Med 2006;52:858–860.

    Article  Google Scholar 

  72. Weiger W, Smith M, Boon H, et al. Advising patients who seek complementary and alternative medical therapies for cancer. Ann Intern Med 2002;137:889–903.

    PubMed  Google Scholar 

  73. Saper R, Kales S, Paquin J, et al. Heavy metal content of ayurvedic herbal medicine products. JAMA 2004;292:2868–2873.

    Article  PubMed  CAS  Google Scholar 

  74. Bent S, Ko R. Commonly used herbal medicines in the United States: a review. Am J Med 2004;116:478–485.

    Article  PubMed  Google Scholar 

  75. Chrubasik S, Eisenberg E, Balan E, et al. Treatment of low back pain exacerbations with willow bark extract: a randomized double-blind study. Am J Med 2000;109:9–14.

    Article  PubMed  CAS  Google Scholar 

  76. Schmid B, Ludtke R, Selbmann H, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized placebo-controlled, double blind clinical trial. Phytother Res 2001;15:344–350.

    Article  PubMed  CAS  Google Scholar 

  77. Phan P, Sohrabi A, Polotsky A, et al. Ginger extract components suppress induction of chemokine expression in human synoviocytes. J Alt Complement Med 2005;11:149–154.

    Article  Google Scholar 

  78. Altman R, Marcussen K. Effects of ginger extract on knee pain in patients with osteoarthritis. Arthritis Rheum 2001;44:2531–2538.

    Article  PubMed  CAS  Google Scholar 

  79. Bliddal H, Rosetzsky A, Schlichting P, et al. A randomized, placebo-controlled, cross-over study of ginger extracts and ibuprofen in osteoarthritis. Osteoarthritis Cartilage 2000;8:9–12.

    Article  PubMed  CAS  Google Scholar 

  80. Tao X, Younger J, Fan F, et al. Benefit of an extract of Tripterygium Wilfordii Hook F in patients with rheumatoid arthritis: a double-blind, placebo-controlled study. Arthritis Rheum 2002;46: 1735–1743.

    Article  PubMed  Google Scholar 

  81. Pattrick M, Heptinstall S, Doherty M. Feverfew in rheumatoid arthritis: a double-blind, placebo controlled study. Ann Rheum Dis 1989;48:547–549.

    Article  PubMed  CAS  Google Scholar 

  82. Henrotin Y, Sanchez C, Deberg M, et al. Avocado/soybean unsaponifiables increase aggrecan synthesis and reduce catabolic and proinflammatory mediator production by human osteoarthritic chondrocytes. J Rheumatol 2003;30:1825–1834.

    PubMed  CAS  Google Scholar 

  83. Henrotin Y, Deberg M, Cielaard J, et al. Avocado/soybean unsaponifiables prevent the inhibitory effect of osteoarthritic subchondral osteoblasts on aggrecan and type II collagen synthesis by chondrocytes. J Rheumatol 2006;33:1668–1678.

    PubMed  Google Scholar 

  84. Maheu E, Mazieres B, Valat J-P, et al. Symptomatic efficacy of avocado/soybean unsaponifiables in the treatment of osteoarthritis of the knee and hip. Arthritis Rheum 1998;41:81–91.

    Article  PubMed  CAS  Google Scholar 

  85. Appelboom T, Schuermans J, Verbruggen G, et al. Symptoms modifying effect of avocado/soybean unsaponifiables (ASU) in knee osteoarthritis. Scan J Rheumatol 2001;30:242–247.

    Article  CAS  Google Scholar 

  86. Lequesne M, Maheu E, Cadet C, et al. Structural effects of avocado/soybean unsaponifiables on joint-space loss in osteoarthritis of the hip. Arthritis Rheum 2002;47:50–58.

    Article  PubMed  CAS  Google Scholar 

  87. Hong J, Bose M, Ju J, et al. Modulation of arachidonic acid metabolism by curcumin and related b-diketone derivatives: effects on cytosolic phospholipase A2, cyclooxygenases and 5-lipoxygenase. Carcinogenesis 2004;25:1671–1679.

    Article  PubMed  CAS  Google Scholar 

  88. Lev-Ari S, Strier L, Kaznov D, et al. Curcumin synergistically potentiates the growth-inhibitory and pro-apoptotic effects of celecoxib in osteoarthritis synovial adherent cells. Rheumatology 2006;45:171–177.

    Article  PubMed  CAS  Google Scholar 

  89. Cheng A, Hsu C, Lin J, et al. Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res 2001;21:2895–2900.

    PubMed  CAS  Google Scholar 

  90. Deodhar S, Sethi R, Srimal R. Preliminary study on antirheumatic activity of curcumin (diferuloyl methane). Indian J Med Res 1980;71:632–634.

    PubMed  CAS  Google Scholar 

  91. Satoskar R, Shah S, Shenoy S. Evaluation of anti-inflammatory property of curcumin (diferuloyl methane) in patients with post-operative inflammation. Int J Clin PharmacolTher Toxicol 1986;24:651–654.

    CAS  Google Scholar 

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Authors
  1. Kevin Khaw
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  2. Sharon L. Kolasinski
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Editors and Affiliations

  1. Marshfield Clinic Research Foundation, Marshfield, WI

    Laura A. Coleman PhD, RD

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© 2008 Humana Press, Totowa, NJ

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Khaw, K., Kolasinski, S.L. (2008). Complementary and Alternative Therapies. In: Coleman, L.A. (eds) Nutrition and Rheumatic Disease. Nutrition and Health. Humana Press. https://doi.org/10.1007/978-1-59745-403-2_6

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  • DOI: https://doi.org/10.1007/978-1-59745-403-2_6

  • Publisher Name: Humana Press

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