Romatoid Artritli Hastalarda Beslenme Durumunun Değerlendirilmesi

Abstract

This study aims to determine the food consumption states and nutritional element deficiency in patients with RA, evaluate the conformability of some anthropometric measurements to standards, and examine the relation of these patients’ nutrition states and physical activity levels to biochemical parameters. The patients (n:71) who were accessed were females between the ages 51.8±7.4. These patients had been having their routine checkups in the related polyclinic and were appropriate for the research criteria. A questionnaire form was used to gather general information about these patients’, their feeding habits and physical activity states. The “individual food consumption” for three consecutive days including one weekend day and the “individual physical activity” for one day were recorded. The patients’ functional states were identified using the “Health Assessment Questionnaire (HAQ)”. Some anthropometric measurements (i.e. body weight, stature, waist circumference, hip circumference and mid upper arm circumference) were made and bioelectric impedance analysis values and handgrip strength measurements were recorded. The biochemical findings were obtained from the patients’ files. It was identified that the patients were diagnosed 10.8±7.9 years ago and had been treated for 9.9±7.7 years. Folic acid (39.4 %) and calcium-vitamin complex were used most as supporting items. The average score of the HAQ was 1.3±0.7. 59.2 % of the patients receive support for their daily chores, and 57.7 % need assistive equipment. The individuals who suffer from heat increase in joints, morning stiffness and nodules had higher HAQ scores compared to those who do not have those problems. The patients skip lunch most (40.8 %). 9.9 % of the patients have normal body weight while 46.5 % are slightly fat, 36.6 % are first degree obese and 7 % are second degree obese. The patients’ waist circumferences were under 80 cm (2.8 %), between 80-88 cm (8.5%) and over 88 cm (88.7 %). 84.5 % of the patients’ waist/hip rate is 0.8 and while 15.5% is below 0.8. The handgrip strength of the patients with normal body weight was found to be higher than those who are fat or obese. The handgrip strength of the patients who have heat increase in joints was found to be higher than those who do not (p:0.009). 50. 5% of the daily energy is obtained from carbohydrates, 32.6 % from fats and 16.8 from proteins. People who run a fever frequently were found to consume less folic acid with food than those who do not (p:0.040). It was observed that the patients who have rashes over joints (p:0.018) and symptoms of tiredness (p:0.016) take more zinc than those who do not. The individuals’ antioxidant intake with diet showed a positive relationship between Vitamin C and hemoglobin (p:0.014), albumin (p:0.007) levels, between β-carotene and liver function tests(p:0.001;0.022), and between total cholesterol (0.043) and CRP (p:0). A negative relationship was found between zinc intake and hemoglobin (p:0.011) as well as hematocrit (p:0.007) levels and between polyunsaturated fatty acid intake and ALP values (p:0.038). The results showed that the individuals who takes polyunsaturated fatty acid a lot run a fever less frequently (p:0.050); and the individuals who have anemia take less oleic acid than those who do not (p:0.050). It was concluded that in the rheumatoid arthritis treatment, the patients should be directed to a dietician in order to reduce the symptoms and increase quality of life, and that the handgrip strength and body analysis methods should be implemented as well as the Body Mass Index, waist and hip circumference measurements.