Skip to main content
Top
Published in: Trials 1/2024

Open Access 01-12-2024 | Rheumatoid Arthritis | Study protocol

The effects of intermittent fasting diet on quality of life, clinical symptoms, inflammation, and oxidative stress in overweight and obese postmenopausal women with rheumatoid arthritis: study protocol of a randomized controlled trial

Authors: Mahsa Ranjbar, Sakineh Shab-Bidar, Abdolrahman Rostamian, Hamed Mohammadi, Kurosh Djafarian

Published in: Trials | Issue 1/2024

Login to get access

Abstract

Background

Rheumatoid arthritis (RA) is known as a chronic systemic autoimmune disorder that primarily targets synovial joints, and may cause pain and functional limitations. Studies show diet can have beneficial effects on symptoms and oxidative stress of this disease. Intermittent fasting (IF) is a dietary approach with cycles of fasting and intake. The current study aims to investigate the effect of IF on quality of life, clinical symptoms, inflammation, and oxidative stress in overweight and obese postmenopausal women with RA.

Methods

The current study is a randomized clinical trial, in which 44 patients with mild to moderate severity of RA will be randomly allocated to receive either IF (n = 22) or the usual diet (n = 22) for 8 weeks. Anthropometric measures and biochemical indicators including serum concentrations of erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and total oxidant and antioxidant capacity (TOC and TAC) will be assessed at the baseline and end of the study. Also, disease severity will be assessed by Disease Activity Score-28 (DAS-28) and clinical disease activity index (CDAI), and disability index will be assessed by Health Assessment Questionnaire-Disability Index (HAQ-DI) questionnaire.

Discussion

Studies show fasting has beneficial effects on inflammatory markers and results in an improvement in the health of different populations. Literature review shows it seems there is no study in this field to evaluate the effects of IF on RA patients, and they are limited to other types of fasting. However, studies show IF can have many positive effects on chronic and autoimmune diseases. Therefore, IF may have positive effects on these patients.

Trial registration

IRCT20230217057441N1. Registered on 14 February 2023. https://​en.​irct.​ir/​user/​trial/​68669.
Appendix
Available only for authorised users
Literature
1.
go back to reference Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1316–22.PubMedCrossRef Cross M, Smith E, Hoy D, Carmona L, Wolfe F, Vos T, et al. The global burden of rheumatoid arthritis: estimates from the global burden of disease 2010 study. Ann Rheum Dis. 2014;73(7):1316–22.PubMedCrossRef
2.
go back to reference Littlejohn EA, Monrad SU. Early diagnosis and treatment of rheumatoid arthritis. Prim Care. 2018;45(2):237–55.PubMedCrossRef Littlejohn EA, Monrad SU. Early diagnosis and treatment of rheumatoid arthritis. Prim Care. 2018;45(2):237–55.PubMedCrossRef
3.
go back to reference Rezaee M, Lotfi F, Gholami A, Azizpoor J, Aflaki E, Vazin A, et al. Economic bBurden of rRheumatoid aArthritis in Iran: aA sSocietal pPerspective eEconomic Bburden of RA. 2022. Rezaee M, Lotfi F, Gholami A, Azizpoor J, Aflaki E, Vazin A, et al. Economic bBurden of rRheumatoid aArthritis in Iran: aA sSocietal pPerspective eEconomic Bburden of RA. 2022.
4.
go back to reference Philippou E, Petersson SD, Rodomar C, Nikiphorou E. Rheumatoid arthritis and dietary interventions: systematic review of clinical trials. Nutr Rev. 2021;79(4):410–28.PubMedCrossRef Philippou E, Petersson SD, Rodomar C, Nikiphorou E. Rheumatoid arthritis and dietary interventions: systematic review of clinical trials. Nutr Rev. 2021;79(4):410–28.PubMedCrossRef
5.
6.
go back to reference Davatchi F, Sandoughi M, Moghimi N, Jamshidi AR, Tehrani Banihashemi A, Zakeri Z, et al. Epidemiology of rheumatic diseases in Iran from analysis of four COPCORD studies. Int J Rheum Dis. 2016;19(11):1056–62.PubMedCrossRef Davatchi F, Sandoughi M, Moghimi N, Jamshidi AR, Tehrani Banihashemi A, Zakeri Z, et al. Epidemiology of rheumatic diseases in Iran from analysis of four COPCORD studies. Int J Rheum Dis. 2016;19(11):1056–62.PubMedCrossRef
7.
go back to reference Radu AF, Bungau SG. Management of rRheumatoid aArthritis: aAn oOverview. Cells. 2021;10(11). Radu AF, Bungau SG. Management of rRheumatoid aArthritis: aAn oOverview. Cells. 2021;10(11).
8.
go back to reference Gioia C, Lucchino B, Tarsitano MG, Iannuccelli C, Di Franco M. Dietary habits and nutrition in rheumatoid arthritis: can diet influence disease development and clinical manifestations? Nutrients. 2020;12(5):1456.PubMedPubMedCentralCrossRef Gioia C, Lucchino B, Tarsitano MG, Iannuccelli C, Di Franco M. Dietary habits and nutrition in rheumatoid arthritis: can diet influence disease development and clinical manifestations? Nutrients. 2020;12(5):1456.PubMedPubMedCentralCrossRef
9.
go back to reference Philippou E, Nikiphorou E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018;17(11):1074–7.PubMedCrossRef Philippou E, Nikiphorou E. Are we really what we eat? Nutrition and its role in the onset of rheumatoid arthritis. Autoimmun Rev. 2018;17(11):1074–7.PubMedCrossRef
10.
go back to reference de Oliveira DV, da Silva TPS, Scherer FC, do Nascimento Júnior JRA, Antunes MD. O tipo de exercício físico interfere na frequência da prática de atividade física, comportamento sedentário, composição corporal e estado nutricional do idoso? RBNE-Revista Brasileira de Nutrição Esportiva. 2019;13(77):3–16. de Oliveira DV, da Silva TPS, Scherer FC, do Nascimento Júnior JRA, Antunes MD. O tipo de exercício físico interfere na frequência da prática de atividade física, comportamento sedentário, composição corporal e estado nutricional do idoso? RBNE-Revista Brasileira de Nutrição Esportiva. 2019;13(77):3–16.
11.
go back to reference Alexandrino EG, Marçal DFS, Antunes MD, Oliveira LP, Massuda EM, Bertolini SMMG. Physical activity level and lifestyle perception in prebariatric surgery patients. Einstein (São Paulo). 2019;17. Alexandrino EG, Marçal DFS, Antunes MD, Oliveira LP, Massuda EM, Bertolini SMMG. Physical activity level and lifestyle perception in prebariatric surgery patients. Einstein (São Paulo). 2019;17.
12.
go back to reference Shlisky J, Bloom DE, Beaudreault AR, Tucker KL, Keller HH, Freund-Levi Y, et al. Nutritional considerations for healthy aging and reduction in age-related chronic disease. Adv Nutr. 2017;8(1):17–26.PubMedPubMedCentralCrossRef Shlisky J, Bloom DE, Beaudreault AR, Tucker KL, Keller HH, Freund-Levi Y, et al. Nutritional considerations for healthy aging and reduction in age-related chronic disease. Adv Nutr. 2017;8(1):17–26.PubMedPubMedCentralCrossRef
13.
go back to reference Nikiphorou E, Philippou E. Nutrition and its role in prevention and management of rheumatoid arthritis. Autoimmun Rev. 2023;103333. Nikiphorou E, Philippou E. Nutrition and its role in prevention and management of rheumatoid arthritis. Autoimmun Rev. 2023;103333.
14.
go back to reference Oliviero F, Spinella P, Fiocco U, Ramonda R, Sfriso P, Punzi L. How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis. Swiss Med Wkly. 2015;45. Oliviero F, Spinella P, Fiocco U, Ramonda R, Sfriso P, Punzi L. How the Mediterranean diet and some of its components modulate inflammatory pathways in arthritis. Swiss Med Wkly. 2015;45.
15.
go back to reference Kerndt PR, Naughton JL, Driscoll CE, Loxterkamp DA. Fasting: the history, pathophysiology and complications. West J Med. 1982;137(5):379.PubMedPubMedCentral Kerndt PR, Naughton JL, Driscoll CE, Loxterkamp DA. Fasting: the history, pathophysiology and complications. West J Med. 1982;137(5):379.PubMedPubMedCentral
17.
go back to reference Stamp LK, James MJ, Cleland LG, Diet and rheumatoid arthritis: a review of the literature. Seminars in arthritis and rheumatism; 2005: Elsevier. Stamp LK, James MJ, Cleland LG, Diet and rheumatoid arthritis: a review of the literature. Seminars in arthritis and rheumatism; 2005: Elsevier.
18.
go back to reference Skoczyńska M, Świerkot J. The role of diet in rheumatoid arthritis. Reumatologia/Rheumatology. 2018;56(4):259–67.PubMedCrossRef Skoczyńska M, Świerkot J. The role of diet in rheumatoid arthritis. Reumatologia/Rheumatology. 2018;56(4):259–67.PubMedCrossRef
19.
go back to reference Schönenberger KA, Schüpfer A-C, Gloy VL, Hasler P, Stanga Z, Kaegi-Braun N, et al. Effect of anti-inflammatory diets on pain in rheumatoid arthritis: a systematic review and meta-analysis. Nutrients. 2021;13(12):4221.PubMedPubMedCentralCrossRef Schönenberger KA, Schüpfer A-C, Gloy VL, Hasler P, Stanga Z, Kaegi-Braun N, et al. Effect of anti-inflammatory diets on pain in rheumatoid arthritis: a systematic review and meta-analysis. Nutrients. 2021;13(12):4221.PubMedPubMedCentralCrossRef
20.
go back to reference Müller H, de Toledo FW, Resch K-L. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2001;30(1):1–10.PubMedCrossRef Müller H, de Toledo FW, Resch K-L. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2001;30(1):1–10.PubMedCrossRef
21.
go back to reference Tagde P, Tagde S, Bhattacharya T, Tagde P, Akter R, Rahman MH. Multifaceted Eeffects of iIntermittent fFasting on the tTreatment and pPrevention of dDiabetes, cCancer, oObesity or oOther cChronic dDiseases. Curr Diabetes Rev. 2022;18(9):33–49.CrossRef Tagde P, Tagde S, Bhattacharya T, Tagde P, Akter R, Rahman MH. Multifaceted Eeffects of iIntermittent fFasting on the tTreatment and pPrevention of dDiabetes, cCancer, oObesity or oOther cChronic dDiseases. Curr Diabetes Rev. 2022;18(9):33–49.CrossRef
22.
23.
go back to reference de Cabo R, Mattson MP. Effects of iIntermittent fFasting on Hhealth, aAging, and dDisease. N Engl J Med. 2019;381(26):2541–51.PubMedCrossRef de Cabo R, Mattson MP. Effects of iIntermittent fFasting on Hhealth, aAging, and dDisease. N Engl J Med. 2019;381(26):2541–51.PubMedCrossRef
24.
go back to reference Hamilos J. The effects of fasting on immune function and autoimmunityHE EFFECTS OF FASTING ON IMMUNE FUNCTION AND AUTOIMMUNITY. Undergraduate Academic Journal.49. Hamilos J. The effects of fasting on immune function and autoimmunityHE EFFECTS OF FASTING ON IMMUNE FUNCTION AND AUTOIMMUNITY. Undergraduate Academic Journal.49.
25.
go back to reference Morales-Suarez-Varela M, Collado Sanchez E, Peraita-Costa I, Llopis-Morales A, Soriano JM. Intermittent fasting and the possible benefits in obesity, diabetes, and multiple sclerosis: a systematic review of randomized clinical trials. Nutrients. 2021;13(9):3179.PubMedPubMedCentralCrossRef Morales-Suarez-Varela M, Collado Sanchez E, Peraita-Costa I, Llopis-Morales A, Soriano JM. Intermittent fasting and the possible benefits in obesity, diabetes, and multiple sclerosis: a systematic review of randomized clinical trials. Nutrients. 2021;13(9):3179.PubMedPubMedCentralCrossRef
26.
go back to reference He Z, Xu H, Li C, Yang H, Mao Y. Intermittent fasting and immunomodulatory effects: aA systematic review. Frontiers in Nutrition. 2023;10:269.CrossRef He Z, Xu H, Li C, Yang H, Mao Y. Intermittent fasting and immunomodulatory effects: aA systematic review. Frontiers in Nutrition. 2023;10:269.CrossRef
27.
go back to reference Sundqvist T, Lindström F, Magnusson K-E, Sköldstam L, Stjernström I, Tagesson C. Influence of fasting on intestinal permeability and disease activity in patients with rheumatoid arthritis. Scand J Rheumatol. 1982;11(1):33–8.PubMedCrossRef Sundqvist T, Lindström F, Magnusson K-E, Sköldstam L, Stjernström I, Tagesson C. Influence of fasting on intestinal permeability and disease activity in patients with rheumatoid arthritis. Scand J Rheumatol. 1982;11(1):33–8.PubMedCrossRef
28.
go back to reference Wallentin L, Sköldstam L. Lipoproteins and cholesterol esterification rate in plasma during a 10-day modified fast in man. Am J Clin Nutr. 1980;33(9):1925–31.PubMedCrossRef Wallentin L, Sköldstam L. Lipoproteins and cholesterol esterification rate in plasma during a 10-day modified fast in man. Am J Clin Nutr. 1980;33(9):1925–31.PubMedCrossRef
29.
go back to reference Fraser D, Thoen J, Dioseland O, Forre O, Kjeldsen-Kragh J. Serum levels of interleukin-6 and dehydroepiandrosterone sulphate in response to either fasting or a ketogenic diet in rheumatoid arthritis patients. Clin Exp Rheumatol. 2000;18(3):357–62.PubMed Fraser D, Thoen J, Dioseland O, Forre O, Kjeldsen-Kragh J. Serum levels of interleukin-6 and dehydroepiandrosterone sulphate in response to either fasting or a ketogenic diet in rheumatoid arthritis patients. Clin Exp Rheumatol. 2000;18(3):357–62.PubMed
30.
go back to reference Trang LE, Lövgren O, Horn R, Walaas O, Mjös O. Cyclic nucleotides in rheumatoid arthritis. Agents Actions. 1980;10(6):566–9.PubMedCrossRef Trang LE, Lövgren O, Horn R, Walaas O, Mjös O. Cyclic nucleotides in rheumatoid arthritis. Agents Actions. 1980;10(6):566–9.PubMedCrossRef
31.
go back to reference Iwashige K, Kouda K, Kouda M, Horiuchi K, Takahashi M, Nagano A, et al. Calorie restricted diet and urinary pentosidine in patients with rheumatoid arthritis. J Physiol Anthropol Appl Hum Sci. 2004;23(1):19–24.CrossRef Iwashige K, Kouda K, Kouda M, Horiuchi K, Takahashi M, Nagano A, et al. Calorie restricted diet and urinary pentosidine in patients with rheumatoid arthritis. J Physiol Anthropol Appl Hum Sci. 2004;23(1):19–24.CrossRef
32.
go back to reference Saleh LA, Sebaie MA, El Shishtawy HF, Ahmed SF. Effect of Mediterranean diet versus low caloric diet on rheumatoid arthritis disease activity. QJM: An International Journal of Medicine. 2021;114(Supplement_1):hcab116. 004CrossRef Saleh LA, Sebaie MA, El Shishtawy HF, Ahmed SF. Effect of Mediterranean diet versus low caloric diet on rheumatoid arthritis disease activity. QJM: An International Journal of Medicine. 2021;114(Supplement_1):hcab116. 004CrossRef
33.
go back to reference Zuo L, He F, Tinsley GM, Pannell BK, Ward E, Arciero PJ. Comparison of high-protein, intermittent fasting low-calorie diet and heart healthy diet for vascular health of the obese. Front Physiol. 2016;350. Zuo L, He F, Tinsley GM, Pannell BK, Ward E, Arciero PJ. Comparison of high-protein, intermittent fasting low-calorie diet and heart healthy diet for vascular health of the obese. Front Physiol. 2016;350.
34.
go back to reference Simons G, Mason A, Falahee M, Kumar K, Mallen CD, Raza K, et al. Qualitative exploration of illness perceptions of rheumatoid arthritis in the general public. Musculoskeletal Care. 2017;15(1):13–22.PubMedCrossRef Simons G, Mason A, Falahee M, Kumar K, Mallen CD, Raza K, et al. Qualitative exploration of illness perceptions of rheumatoid arthritis in the general public. Musculoskeletal Care. 2017;15(1):13–22.PubMedCrossRef
35.
go back to reference Arnett FC, Edworthy SM, Bloch DA, Mcshane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1988;31(3):315–24.CrossRef Arnett FC, Edworthy SM, Bloch DA, Mcshane DJ, Fries JF, Cooper NS, et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology. 1988;31(3):315–24.CrossRef
36.
go back to reference Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO III, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569–81.PubMedCrossRef Aletaha D, Neogi T, Silman AJ, Funovits J, Felson DT, Bingham CO III, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569–81.PubMedCrossRef
37.
go back to reference Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the Stages of Reproductive Aging Workshop+ 10: addressing the unfinished agenda of staging reproductive aging. Climacteric. 2012;15(2):105–14.PubMedPubMedCentralCrossRef Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, et al. Executive summary of the Stages of Reproductive Aging Workshop+ 10: addressing the unfinished agenda of staging reproductive aging. Climacteric. 2012;15(2):105–14.PubMedPubMedCentralCrossRef
38.
go back to reference Fraenkel L, Bathon JM, England BR, St. Clair EW, Arayssi T, Carandang K, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2021;73(7):1108–23.PubMedCrossRef Fraenkel L, Bathon JM, England BR, St. Clair EW, Arayssi T, Carandang K, et al. 2021 American College of Rheumatology guideline for the treatment of rheumatoid arthritis. Arthritis Rheumatol. 2021;73(7):1108–23.PubMedCrossRef
40.
go back to reference Maska L, Anderson J, Michaud K. Measures of functional status and quality of life in rheumatoid arthritis: health assessment questionnaire disability index (HAQ), modified health assessment questionnaire (MHAQ), multidimensional health assessment questionnaire (MDHAQ), health assessment questionnaire II (HAQ-II), improved health assessment questionnaire (improved HAQ), and rheumatoid arthritis quality of life (RAQoL). Arthritis Care Res. 2011;63(S11):S4–S13.CrossRef Maska L, Anderson J, Michaud K. Measures of functional status and quality of life in rheumatoid arthritis: health assessment questionnaire disability index (HAQ), modified health assessment questionnaire (MHAQ), multidimensional health assessment questionnaire (MDHAQ), health assessment questionnaire II (HAQ-II), improved health assessment questionnaire (improved HAQ), and rheumatoid arthritis quality of life (RAQoL). Arthritis Care Res. 2011;63(S11):S4–S13.CrossRef
41.
go back to reference Wolfe F. The determination and measurement of functional disability in rheumatoid arthritis. Arthritis Research & Therapy. 2002;4(2):1–5. Wolfe F. The determination and measurement of functional disability in rheumatoid arthritis. Arthritis Research & Therapy. 2002;4(2):1–5.
42.
go back to reference زهرا ت, خديجه ش, زهرا س. روانسنجي مقياس 8 سوالي ناتواني پرسشنامه سنجش سلامت استانفورد (HAQ 8-item DI) در سالمندان. زهرا ت, خديجه ش, زهرا س. روانسنجي مقياس 8 سوالي ناتواني پرسشنامه سنجش سلامت استانفورد (HAQ 8-item DI) در سالمندان.
43.
go back to reference Fries JF. The dimension of health outcomes: the Health Assessment Questionnaire. j. Rheumatol. 1982;9:789–93. Fries JF. The dimension of health outcomes: the Health Assessment Questionnaire. j. Rheumatol. 1982;9:789–93.
44.
go back to reference Bruce B, Fries JF. The Stanford health assessment questionnaire: dimensions and practical applications. Health Qual Life Outcomes. 2003;1:1–6.CrossRef Bruce B, Fries JF. The Stanford health assessment questionnaire: dimensions and practical applications. Health Qual Life Outcomes. 2003;1:1–6.CrossRef
45.
go back to reference Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2016;13(1):67–75.PubMedCrossRef Heller GZ, Manuguerra M, Chow R. How to analyze the Visual Analogue Scale: Myths, truths and clinical relevance. Scand J Pain. 2016;13(1):67–75.PubMedCrossRef
46.
go back to reference Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Prim. 2018;4(1):18001.PubMedCrossRef Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS, et al. Rheumatoid arthritis. Nat Rev Dis Prim. 2018;4(1):18001.PubMedCrossRef
48.
go back to reference England BR, Tiong BK, Bergman MJ, Curtis JR, Kazi S, Mikuls TR, et al. 2019 update of the American College of Rheumatology recommended rheumatoid arthritis disease activity measures. Arthritis Care Res. 2019;71(12):1540–55.CrossRef England BR, Tiong BK, Bergman MJ, Curtis JR, Kazi S, Mikuls TR, et al. 2019 update of the American College of Rheumatology recommended rheumatoid arthritis disease activity measures. Arthritis Care Res. 2019;71(12):1540–55.CrossRef
49.
go back to reference Khan NA, Yazici Y, Calvo-Alen J, Dadoniene J, Gossec L, Hansen TM, et al. Reevaluation of the role of duration of morning stiffness in the assessment of rheumatoid arthritis activity. J Rheumatol. 2009;36(11):2435–42.PubMedCrossRef Khan NA, Yazici Y, Calvo-Alen J, Dadoniene J, Gossec L, Hansen TM, et al. Reevaluation of the role of duration of morning stiffness in the assessment of rheumatoid arthritis activity. J Rheumatol. 2009;36(11):2435–42.PubMedCrossRef
50.
go back to reference Ayazi P, Mahyar A, Daneshi MM, Hashemi HJ, Pirouzi M, Esmailzadehha N. Diagnostic accuracy of the quantitative C-reactive protein, erythrocyte sedimentation rate and white blood cell count in urinary tract infections among infants and children. The Malaysian journal of medical sciences: MJMS. 2013;20(5):40.PubMedPubMedCentral Ayazi P, Mahyar A, Daneshi MM, Hashemi HJ, Pirouzi M, Esmailzadehha N. Diagnostic accuracy of the quantitative C-reactive protein, erythrocyte sedimentation rate and white blood cell count in urinary tract infections among infants and children. The Malaysian journal of medical sciences: MJMS. 2013;20(5):40.PubMedPubMedCentral
51.
go back to reference Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem. 1996;239(1):70–6.PubMedCrossRef Benzie IF, Strain JJ. The ferric reducing ability of plasma (FRAP) as a measure of “antioxidant power”: the FRAP assay. Anal Biochem. 1996;239(1):70–6.PubMedCrossRef
52.
go back to reference Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38(12):1103–11.PubMedCrossRef Erel O. A new automated colorimetric method for measuring total oxidant status. Clin Biochem. 2005;38(12):1103–11.PubMedCrossRef
53.
go back to reference Aslan R, Kutlu R, Civi S, Tasyurek E. The correlation of the total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase activity (PON1) with smoking. Clin Biochem. 2014;47(6):393–7.PubMedCrossRef Aslan R, Kutlu R, Civi S, Tasyurek E. The correlation of the total antioxidant status (TAS), total oxidant status (TOS) and paraoxonase activity (PON1) with smoking. Clin Biochem. 2014;47(6):393–7.PubMedCrossRef
54.
go back to reference Behrens F, Koehm M, Schwaneck EC, Schmalzing M, Gnann H, Greger G, et al. Use of a “critical difference” statistical criterion improves the predictive utility of the Health Assessment Questionnaire-Disability Index score in patients with rheumatoid arthritis. BMC rheumatology. 2019;3:1–9.CrossRef Behrens F, Koehm M, Schwaneck EC, Schmalzing M, Gnann H, Greger G, et al. Use of a “critical difference” statistical criterion improves the predictive utility of the Health Assessment Questionnaire-Disability Index score in patients with rheumatoid arthritis. BMC rheumatology. 2019;3:1–9.CrossRef
56.
go back to reference Frech TM, Khanna D, Maranian P, Frech EJ, Sawitzke AD, Murtaugh MA. Probiotics for the treatment of systemic sclerosis-associated gastrointestinal bloating/distention. Clinical and Experimental Rheumatology-Incl Supplements. 2011;29(2):S22. Frech TM, Khanna D, Maranian P, Frech EJ, Sawitzke AD, Murtaugh MA. Probiotics for the treatment of systemic sclerosis-associated gastrointestinal bloating/distention. Clinical and Experimental Rheumatology-Incl Supplements. 2011;29(2):S22.
58.
go back to reference Uden A, Trang L, Venizelos N, Palmblad J. Neutrophil functions and clinical performance after total fasting in patients with rheumatoid arthritis. Ann Rheum Dis. 1983;42(1):45–51.PubMedPubMedCentralCrossRef Uden A, Trang L, Venizelos N, Palmblad J. Neutrophil functions and clinical performance after total fasting in patients with rheumatoid arthritis. Ann Rheum Dis. 1983;42(1):45–51.PubMedPubMedCentralCrossRef
59.
go back to reference Abendroth A, Michalsen A, Lüdtke R, Rüffer A, Musial F, Dobos GJ, et al. Changes of intestinal microflora in patients with rheumatoid arthritis during fasting or a Mediterranean diet. Complementary Medicine Research. 2010;17(6):307–13.CrossRef Abendroth A, Michalsen A, Lüdtke R, Rüffer A, Musial F, Dobos GJ, et al. Changes of intestinal microflora in patients with rheumatoid arthritis during fasting or a Mediterranean diet. Complementary Medicine Research. 2010;17(6):307–13.CrossRef
60.
go back to reference Patikorn C, Roubal K, Veettil SK, Chandran V, Pham T, Lee YY, et al. Intermittent fasting and obesity-related health outcomes: an umbrella review of meta-analyses of randomized clinical trials. JAMA Netw Open. 2021;4(12):e2139558-e.CrossRef Patikorn C, Roubal K, Veettil SK, Chandran V, Pham T, Lee YY, et al. Intermittent fasting and obesity-related health outcomes: an umbrella review of meta-analyses of randomized clinical trials. JAMA Netw Open. 2021;4(12):e2139558-e.CrossRef
Metadata
Title
The effects of intermittent fasting diet on quality of life, clinical symptoms, inflammation, and oxidative stress in overweight and obese postmenopausal women with rheumatoid arthritis: study protocol of a randomized controlled trial
Authors
Mahsa Ranjbar
Sakineh Shab-Bidar
Abdolrahman Rostamian
Hamed Mohammadi
Kurosh Djafarian
Publication date
01-12-2024
Publisher
BioMed Central
Published in
Trials / Issue 1/2024
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-024-07977-2

Other articles of this Issue 1/2024

Trials 1/2024 Go to the issue