Is There More to the Mediterranean Diet than Fish Oil When It Comes To Quelling Rheumatoid Arthritis Symptoms?

Author: Zack Yates

Mentor: Sharon Doetsch-Kidder, Honors College



Rheumatoid arthritis is an autoimmune disease that was defined in 2010 by the American College of Rheumatism and the European League against Rheumatism as chronic inflammation resulting in joint swelling, joint tenderness, and destruction of synovial joints leading to severe disability and premature mortality. This disease has long plagued people from many different walks of life both young and old. The current methods of treating the symptoms associated with the disease are called disease-modifying antirheumatic drugs (DMARDs). This class of medicine is very effective; however, it comes with dire side effects one of which being the suppression of the immune system. This has caused researchers to begin observing natural and holistic treatments for this disease which include both the Mediterranean diet and the omega-3 fatty acids involved in the diet. The problem behind the Mediterranean diet lies in the ability of patients to adhere to the diet’s strict structure. If omega-3 fatty acids are in fact the reason behind the diet’s success in quelling rheumatoid arthritis symptoms, then there is a possibility that patient’s may be able to reap similar benefits with simple omega-3 supplementation. This project looks to compare the effects of both the Mediterranean diet and omega-3 fatty acid supplementation side-by-side in an effort to discover any discrepancies between the two. This information will continue the research pool into holistic remedies for rheumatoid arthritis. The COVID-19 pandemic has been eye-opening for just how dangerous immunosuppression can be and this particular research could provide patients with an alternative treatment that does not leave them vulnerable to a disease. My firsthand experience with this disease has shown the freedom that comes with rheumatoid arthritis treatment, but also the helplessness that comes from having a compromised immune system.

Video Transcript


What’s going on guys my name is Zack and the research question I am talking about today is if there is more to the Mediterranean diet than fish oil when it comes to quelling rheumatoid arthritis symptoms.

 First, I wanted to start off by defining rheumatoid arthritis. Rheumatoid arthritis or RA is an autoimmune disease that is defined by chronic inflammation resulting in joint swelling, joint tenderness, and destruction of synovial joints leading to severe disability and premature mortality. This definition was created by the American College of Rheumatology and the European League Against Rheumatism in 2010 and it is actually an update of a 1987 definition that was criticized for missing key early indications of the disease. 

Treatments for this disease must obviously address the symptoms by reducing pain and swelling, slowing damage to joints, and maintaining the patient’s range of motion and mobility, The current way to address these symptoms is the use of disease modifying anti-rheumatic drugs or DMARDs, but unfortunately these medications do have side effects that generally include immunosuppression. Research into this disease is still new so currently studies have been leading into natural treatments such as diet changes, exercise implementations, and even mindfulness habits.

Now the exigence of this research lies in the patient’s need for treatment that minimizes side effects and can be maintained over the long term. Eliminating the immunosuppression side effects is huge especially in the current pandemic that we are in. While the Mediterranean diet does address this issue, it can be difficult for somebody to maintain this long term. If omega-3 fatty acids are the driving factor behind the diet’s effectiveness, then taking a simple supplement should be just as beneficial as the diet itself. Studies have shown that both effectiveness in isolation, but few have actually looked at them together.

First, I wanted to take a look at the omega-3 fatty acids fish oils contain the fatty acids EPA and DHA. Omega-3 supplementation has led to benefits such as a decrease in number of tender joints, duration of morning stiffness, and others. Now the way this is accomplished is omega-3 fatty acids actually alter the cell membranes of inflammatory cells. This can unfortunately also be done by pro-inflammatory omega-6 acids that are characteristics of foods such as vegetable oils that are typical of the traditional Western diet. In fact a systemic review by A.P Simopoulos uncovered that omega-6 omega-3 fatty acid ratio has increased over 15 times that of what it was in early humans.

Now looking at the Mediterranean diet, this is a diet characteristic of those living in the area proximate to the Mediterranean Sea and is characterized by a frequent consumption of olive oil, unrefined cereals, freshly dried fruit and vegetables, a moderate amount of fish, dairy, and meat, and many condiments and spices all accompanied by wine or its infusions. Geographical studies in areas where the diet is most prevalent have actually displayed lower RA prevalence. Now throughout the research I’ve conducted I’ve begun to see the monounsaturated fatty acids emerge as a large part of this diet’s success.

In regard to combination therapy, a 2018 observational study conducted by Yoshinari Matsumoto interestingly enough showed that the intake of monounsaturated fatty acids actually had a higher effect on the disease activity than the Mediterranean diet itself. Now continuing in that direction, olive oil which is made up of the monounsaturated fatty acids was shown as an independent RA predictor in Greece where fish was much less fatty than ocean fish. In a 2005 study by A.A. Berbert a combinational therapy of omega-3 fatty acids and these monosaturated fatty acids actually outperformed simple omega-3 fatty acid supplementation.

In conclusion, my lines of inquiry come from omega-3 fatty acids to the Mediterranean diet to the two in comparison. Now it was the monounsaturated fatty acids characteristic of the Mediterranean diet that emerged as a major contributor to the diet’s success and must be looked into further. My study looks to compare the effects of omega-3 fatty acids and the Mediterranean diet side by side to determine the differences between the two. My study is not a completely novel idea but will be a continuing contributor to the growing field of research. I’m open to new ideas regarding the topic and continuing to check out this pool of research possibly diving into the realm of monounsaturated fatty acids.

Now here’s my work cited. I appreciate you guys watching if you have any questions feel free to ask me.

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