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Open AccessArticle

The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study

1
Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054 Erlangen, Germany
2
Melio.Care GmbH, 91080 Marloffstein, Germany
*
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Nutrients 2019, 11(10), 2392; https://doi.org/10.3390/nu11102392
Received: 29 August 2019 / Revised: 23 September 2019 / Accepted: 2 October 2019 / Published: 7 October 2019
(This article belongs to the Special Issue Arthritis and Nutrition: Can Food Be Medicine?)
Short-chain fatty acids are microbial metabolites that have been shown to be key regulators of the gut–joint axis in animal models. In humans, microbial dysbiosis was observed in rheumatoid arthritis (RA) patients as well as in those at-risk to develop RA, and is thought to be an environmental trigger for the development of clinical disease. At the same time, diet has a proven impact on maintaining intestinal microbial homeostasis. Given this association, we performed a feasibility study in RA patients using high-fiber dietary supplementation with the objective to restore microbial homeostasis and promote the secretion of beneficial immunomodulatory microbial metabolites. RA patients (n = 36) under routine care received daily high-fiber bars or cereals for 28 days. Clinical assessments and laboratory analysis of immune parameters in blood and stool samples from RA patients were done before and after the high-fiber dietary supplementation. We observed an increase in circulating regulatory T cell numbers, favorable Th1/Th17 ratios, as well as decreased markers of bone erosion in RA patients after 28 days of dietary intervention. Furthermore, patient-related outcomes of RA improved. Based on these results, we conclude that controlled clinical studies of high-fiber dietary interventions could be a viable approach to supplement or complement current pharmacological treatment strategies. View Full-Text
Keywords: high-fiber diet (HFD); short chain fatty acids (SCFA); rheumatoid arthritis (RA); gut–joint axis; microbiota high-fiber diet (HFD); short chain fatty acids (SCFA); rheumatoid arthritis (RA); gut–joint axis; microbiota
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MDPI and ACS Style

Häger, J.; Bang, H.; Hagen, M.; Frech, M.; Träger, P.; Sokolova, M.V.; Steffen, U.; Tascilar, K.; Sarter, K.; Schett, G.; Rech, J.; Zaiss, M.M. The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study. Nutrients 2019, 11, 2392. https://doi.org/10.3390/nu11102392

AMA Style

Häger J, Bang H, Hagen M, Frech M, Träger P, Sokolova MV, Steffen U, Tascilar K, Sarter K, Schett G, Rech J, Zaiss MM. The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study. Nutrients. 2019; 11(10):2392. https://doi.org/10.3390/nu11102392

Chicago/Turabian Style

Häger, Julian; Bang, Holger; Hagen, Melanie; Frech, Michael; Träger, Pascal; Sokolova, Maria V.; Steffen, Ulrike; Tascilar, Koray; Sarter, Kerstin; Schett, Georg; Rech, Jürgen; Zaiss, Mario M. 2019. "The Role of Dietary Fiber in Rheumatoid Arthritis Patients: A Feasibility Study" Nutrients 11, no. 10: 2392. https://doi.org/10.3390/nu11102392

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