DIET AND NUTRITION IN RHEUMATOID-ARTHRITIS AND OTHER CHRONIC INFLAMMATORY DISEASES

A greater understanding of the etiology of rheumatoid and other inflam matory diseases, their association with reactive oxygen species (ROS), and the role of environmental chemicals as antigens, has opened the w ay to new approaches in disease prevention and treatment by dietary mo dulation. Normal protection against the inflammatory effects of ROS (a ntioxidant defense) and environmental chemicals (detoxication) require s constant dietary replenishment to provide the redox buffer, glutathi one (GSH), the antioxidant vitamins, E, C, and A, and other essential components such as selenium for the GSH peroxidase enzymes. Fasting an d some environmental chemicals (haloalkanes) induce the ROS-generating enzyme cytochrome P4502E, as also does inorganic iron; and the variou s dietary lipids provide prostanoids of different inflammatory potenti als. Adequate calories (NADPH) are essential for maintaining the two d efense systems, but caloric excess may lead to changes in membrane com position, electron leakage, ROS generation, and exacerbation of the in flammatory condition.