1. FAQ in Clinical Practice อาหารเสริมกับโรคข้อ แคลเซี่ยมกับกระดูกงอก Gout กับการกินอาหาร ไข่ลวกกับโอวัลตินเป็นอาหารบำรุงหรือไม่ ชาเขียวมีประโยชน์จริงหรือ (separate file) น้ำลูกยอมีประโยชน์จริงหรือ (separate file)

2. Suggestion diet in RA reduce red meat Balance, healthy diet for ideal weight eat more fish (eg. mackerel, sardines) three or four times a week. Suggestion diet in Gout reduce purine rich diet especially from animal protein avoid alcohol consumption particularly beer drink more water consume low fat daily product eg. skim milk, yogurt evidence support กลับเมนูหลัก

3. Scientific Backgroud Diet for RA Scientific Backgroud Diet for RA Next

4. Diet and arthritis Pattison DJ, Symmons DPM, Lunt M et al. Dietary risk factors for the development of inflammatory polyarthritis. Evidence for a role of high level of red meat consumption. Arthritis Rheum 2004; 50: 3804-3812. Consumption of large amounts of red meat  linked to development of RA Possible explanations: Little scientific evidence confirming the benefits of modified diets for patients with arthritis, and mostly focus on diet and RA proinflammatory property of meat fats from iron accumulated in syn tissue collagen sensitization from a high level of protein intake the role of nitrite and nitric oxide infectious mechanisms such as alterations in intestinal flora Next

5. Intake of fruit and coffee was not associated with risk of RA increase in intake of 30 g fat fish per day  49% reduction in the risk of RA Whereas medium fat fish (3-7 g fat/100 g fish)  significantly increased risk no associations were found between risk of RA and other dietary factors: (long chain FA, olive oil, vitamins A, E, C, D, zinc, selenium, iron, and meat. J Rheumatol. 2005 Jul;32(7):1249-52 Diet and arthritis Next

6. Fish oil could help ? essential fatty acids (EFAs) Prostaglandins, leukotrienes inflammation in RA the right balance of EFAs is important to control inflammation. Next

7. fish liver oil (cod or halibut) also contains these EFAs & vit D,  helps the body to absorb calcium There are two groups of EFAs: omega-3  found naturally in oily fish (mackerel, sardines, pilchards, salmon) main omega-3 = EPA & DHA omega-6  the best known source is evening primrose oil, also in sunflower oil. main omega-6 = GLA Back

8. Scientific Backgroud Diet for RA Scientific Backgroud Diet for RA Next

9. Diet and Gout association of purine-rich foods with gout had long been suspected but never proven Health Professionals Follow-up Study 47,150 men with no history of gout at baseline 12-year FU (1986-1998) 730 men developed gout N Engl J Med. 2004;350:1071-1073, 1093-1103 Next

10. Incidence of gout = 1.0-1.8 / 1,000 high intake of meat & seafood consumption   risk of gout (RR 1.4-1.5) high intake of low-fat dairy products (skim milk,yogurt)   risk. (RR 0.5) for seafood intake  risk of gout was stronger for men with BMI < 25 beef, pork, and lamb were the worst offenders in the meat group Diet and Gout Next

11. for this population purine-rich vegetables (peas, beans, mushrooms, cauliflower, and spinach) over all protein intake, alcohol, and BMI did not associated with an increased risk of gout. there was a potential protective effect from vegetable and dairy proteins Diet and Gout Next

12. June 1995 issue of the European Journal of Epidemiology, four weeks of a dairy-free diet  associated with a significant increase in uric acid levels Milk proteins (casein and lactalbumin) reduce serum uric acid levels in healthy subjects ( uricosuric effect ) Diet and Gout Next

13. "Dietary manipulation and behavioral modification to reduce risk of gout may have a much more substantial impact than currently believed “ Individual who have family history of gout are at high risk "Reducing red meat consumption may be recommended because it also has been associated with such problems as colon cancer and diabetes” healthy foods such as vegetables do not need to be restricted Diet and Gout Next

14. Gout and alcohol consumption The risk of gout is significantly raised with alcohol intake as low as 10.0 to 14.9 g / day with a dose-response relationship. Beer and liquor consumption carry the greatest risk, while moderate wine consumption does not increase risk of incident gout. Risk is 2.5 times higher in men who consume 50 g or more / day independent of BMI and other dietary factors Next

15. Gout and alcohol consumption For alcohol consumption of 5.0 to 9.9 g per day, the RR of gout was 1.3 For daily consumption of 50 g or more per day, the RR was 3.02 for every 10 g increase in daily alcohol consumption increase in RR = 1.17 Next

16. Both increased urate production and decreased urate excretion Beer having predominantly guanosine as its high purine content Mechanism of ethanol in inducing hyperuricemia กลับเมนูหลัก

17. Calcium and Osteophytes in OA In OA patients, no data supports the relationship between osteophyte formation and calcium supplement evidence support กลับเมนูหลัก

18. However, osteophyte may also develop as an isolated feature associated with age and precede rather than follow cartilage loss in animal studies. Mechanism of osteophyte formation in OA Although osteophyte is viewed as a remodelling and reparative feature of OA, the factors that determine osteophyte formation and growth are unknown. Growth factors (TGF-b, IGF-1) influence both chondrocyte synthesis and osteophyte formation in experimental joint damage. Evidence from animal and human studies shows that cartilage damage initiates "secondary" osteophyte growth. Next

19. Chondrocalcinosis due to calcium pyrophosphate crystals has also been suggested to be associated with a tendency to osteophyte formation and a "hypertrophic" form of OA. Possibly, multiple factors may influence osteophyte formation and contribute to the marked heterogeneity of OA. Joint instability has been emphasised as a biomechanical trigger to osteophyte formation, with osteophyte and bone remodelling being viewed as an attempt to stabilise and broaden the compromised joint to better withstand loading forces. Mechanism of osteophyte formation in OA กลับเมนูหลัก

20. ไข่ลวก กับ โอวัลติน Raw egg  incomplete protein digestion Ovaltin : nutritional fact Mainly carbohydrate Sugar added Small amount of protein  high calories High calorie diet with lower protein กลับเมนูหลัก