Fish oils recommended for rheumatoid arthritis

NEWCASTLE, AUSTRALIA. At least 13 published randomized, controlled clinical trials have reported significant benefits of fish oil supplementation in rheumatoid arthritis patients. Now researchers at the University of Newcastle weight in with the additional evidence to support these earlier findings. Their 15-week study involved 50 patients who had been diagnosed with rheumatoid arthritis. The patients were all consuming a diet which contained less than 10 grams/day of omega-6 fatty acids. These fats are known to promote inflammation through their eicosanoid metabolites. Half the patients were given fish oil capsules to provide a daily intake of 40 mg/kg body weight (about 2.8 grams for a 70 kg person); the other half received placebo capsules containing 50/50 corn/olive oil. All subjects continued with their regular diet and medications. About half the patients dropped out during the experiment, mainly due to changes in their medications. Complete clinical evaluations were carried out at baseline, 4, 8 and 15 weeks.

There were no significant changes after 4 or 8 weeks, but at the 15-week evaluation major improvements were noted in the group receiving fish oil. Particularly impressive were the improvements in the duration of morning stiffness and the overall assessment of disease activity (by both patients and physicians). Significant improvements were noted in 6 of the 9 evaluation parameters in the fish oil group; no improvements were noted in the control group. Only the total number of joints affected, the erythrocyte sedimentation rate (ESR), and the C-reactive protein level were unaffected by supplementation.

In an accompanying editorial Drs. Cleland and James of the Royal Adelaide Hospital emphasize the importance of maintaining a low intake of omega-6 fatty acids in order to keep the ratio of omega-6 to omega-3 as low as possible. They conclude that “dietary fish oil supplements should now be regarded as part of standard therapy for rheumatoid arthritis”.
Volker, Dianne, et al. Efficacy of fish oil concentrate in the treatment of rheumatoid arthritis. Journal of Rheumatology, Vol. 27, October 2000, pp. 2343-46
Cleland, Leslie G. and James, Michael J. Fish oil and rheumatoid arthritis: antiinflammatory and collateral health benefits. Journal of Rheumatology, Vol. 27, October 2000, pp. 2305-06 (editorial)

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