Background: Patients with musculoskeletal conditions such as rheumatoid arthritis often think food plays a role in their symptoms, yet dietary treatment of these conditions remains a topic of controversy. Objective: This case study sought to determine whether close adherence to an elimination diet produced relief of chronic symptoms in patients with musculoskeletal conditions. In addition, the ability of the challenge phase of the elimination diet to identify potential allergens was examined. Methods: Two patients diagnosed with a musculoskeletal condition were assigned to an elimination diet (including both elimination and challenge phases) for a minimum of 11 weeks. Patients received diet instruction from a registered dietitian and were seen by the same dietitian at two follow-up visits. Dietary recalls were conducted by phone to measure adherence. Subjects were analyzed at baseline, post-elimination phase, and post challenge phase of the elimination diet using a medical symptoms questionnaire (MSQ), which was also used to assess reactions to potential allergens and intolerances when challenging culprit foods. Results: Two participants completed the study; both were female, one diagnosed with fibromyalgia and spondyloarthritis and the other diagnosed with osteoarthritis. They began with baseline MSQ scores of 40 and 70. Upon completion of the 3-week elimination phase of the diet, the scores dropped to 24 and 14 respectively indicating an improvement in symptoms. The challenge phase revealed an association between higher MSQ scores and reactive foods. Upon completion of the diet, the MSQ score either stayed the same or continued to decline. Dietary adherence, measured by analysis of 24- hour diet recalls, revealed both participants consumed prohibited foods. One had a lower MSQ score but consumed a greater number of prohibited portions while the other had a higher MSQ score and consumed fewer prohibited foods. Conclusion: This study demonstrated that an elimination diet free of all common allergens had a substantial impact on the relief of chronic symptoms associated with musculoskeletal conditions. Dietary manipulation such as a strict elimination diet used to identify food intolerances and allergens may be a promising treatment for this population. Future studies of a larger scale need to confirm these preliminary results.
|Commitee:||Harris, Cristen, Kirk, Elizabeth, Morrow, Kelly, Turner, Heidi|
|Department:||Department of Nutrition|
|School Location:||United States -- Washington|
|Source:||MAI 51/05M(E), Masters Abstracts International|
|Keywords:||Elimination diet, Musculoskeletal disorders, Symptom relief|
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