BACKGROUND: The question of what potential benefits and harms are associated with certain dietary regimes used in @entity309 is an important one for many @entity1 and health care providers. OBJECTIVES: To assess the effectiveness and safety of dietary interventions in the treatment of @entity309 . SEARCH STRATEGY: We searched the Cochrane Central Register of Controlled Trials (CENTRAL)(The Cochrane Library, issue 1 2008), MEDLINE, EMBASE, AMED, CINAHL and reference lists of relevant articles (up to January 2008), and contacted authors of included articles. SELECTION CRITERIA: Randomised controlled trials (RCTs) or controlled clinical trials (CCTs) where the effectiveness of dietary manipulation was evaluated. Dietary supplement studies (including fish oil supplements) were not included. DATA COLLECTION AND ANALYSIS: Two authors independently selected trials for inclusion, assessed the internal validity of included trials and extracted data. Investigators were contacted to obtain missing information. MAIN RESULTS: Fourteen RCTs and one CCT, with a total of 837 @entity1 , were included. Due to heterogeneity of interventions and outcomes, baseline imbalance and inadequate data reporting, no overall effects were calculated. A single trial with a moderate risk of bias found that fasting, followed by 13 months on a vegetarian diet, may reduce @entity158 (mean difference (MD) on a 0 to 10 scale -1.89, 95% confidence interval (CI) -3.62 to -0.16), but not physical function or morning stiffness immediately after intervention. Another single trial with a moderate risk of bias found that a 12-week Cretan Mediterranean diet may reduce @entity158 (MD on a 0 to 100 scale -14.00, 95% CI -23.6 to -4.37), but not physical function or morning stiffness immediately after intervention. Two trials compared a 4-week elemental diet with an ordinary diet and reported no significant differences in @entity158 , function or stiffness. Due to inadequate data reporting, the effects of vegan and elimination diets are uncertain. When comparing any dietary manipulation with an ordinary diet we found a significantly higher total drop-out of 10% (risk difference (RD) 0.10, 95% CI 0.02 to 0.18), higher treatment-related drop-out of 5% (RD 0.05, 95% CI -0.03 to 0.14) and a significantly higher @entity353 (weighted mean difference -3.23, 95% CI -4.79 to -1.67 kg) in the diet groups compared to the control groups. AUTHORS' CONCLUSIONS: The effects of dietary manipulation, including vegetarian, Mediterranean, elemental and elimination diets, on @entity309 are still uncertain due to the included studies being small, single trials with moderate to high risk of bias. Higher drop-out rates and @entity353 in the groups with dietary manipulation indicate that potential adverse effects should not be ignored.

Dietary interventions for XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity353 :: ('MESH:D015431', 'Disease') :: ['weight loss'] @entity309 :: ('MESH:D001172', 'Disease') :: ['rheumatoid arthritis'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain']
@entity309 :: (MESH:D001172,Disease) :: ['rheumatoid arthritis']
