1. Introduction
rheumatoid arthritis, RA, weight reduction, Rheumatoid arthritis, dietary behaviors, weight loss
RHEUMATOID ARTHRITIS, RHEUMATOID ARTHRITIS, DISEASE, INFLAMMATORY JOINT DISEASE
These authors contributed equally to this work and share first authorship.This study aimed at comparing the nutrient supply and dietary behaviors during a plant-based diet (PBD) combined with time-restricted eating (TRE) to standard dietary recommendations in rheumatoid arthritis patients. In this open-label, randomized, controlled clinical trial, patients were assigned to either a 7-day fast followed by an 11-week PBD including TRE (A) or a 12-week anti-inflammatory diet following official German guidelines (German Nutrition Society, DGE) (B). Dietary habits were assessed by 3-day food records at weeks -1, 4 and 9 and food frequency questionnaires. 41 out of 53 participants were included in a post-hoc per protocol analysis. Both groups had similar energy, carbohydrate, sugar, fiber and protein intake at week 4. Group A consumed significantly less total saturated fat than group B (15.9 ± 7.7 vs. 23.2 ± 10.3 g/day; Rheumatoid arthritis (RA) is an inflammatory joint disease whose etiology is still largely unknown. Accordingly, there is no causal therapy yet [In search for complementary therapeutic options, many studies have been conducted on dietary influences in patients with RA [We have previously reported on the benefits of fasting followed by a plant-based diet (PBD) on disease activity and cardiovascular (CV) risk factors in RA. The positive impact was comparable to that of an anti-inflammatory diet based on the recommendations of the German Nutrition Society (Deutsche Gesellschaft für Ernährung, DGE) [Additionally, participants assigned to the fasting and PBD group in this trial experienced greater weight loss than the DGE group within the normal BMI range. However, it remains uncertain whether, in this case, weight reduction is attributable to reduced daily energy intake, altered diet composition or medium-term sustained fasting effects. Prolonged fasting is known for its blood-pressure-lowering and weight-reducing effects via increased water excretion [Our objectives were (i) to investigate whether the delivered dietary intervention corresponded to the actual dietary behavior and (ii) to compare the influences of the two different dietary approaches on nutrient supply.