Patients Respond to Nutrition Guidance Via Telehealth, Study Shows

A 2023 qual­i­ta­tive study pub­lished in Rheumatoid International explored the expe­ri­ence of patients with rheuma­toid arthri­tis who were advised to con­sume 60 to 80 mil­li­liters of extra vir­gin olive oil.

Audrey Tierney, an asso­ciate pro­fes­sor in human nutri­tion and dietet­ics at the University of Limerick’s School of Allied Health, con­firmed that dietary inter­ven­tion deliv­ered through tele­health meth­ods could pos­i­tively com­ple­ment face-to-face care in sus­tain­ing dietary and lifestyle changes.

“This study showed that, when pro­vided with sup­port, guid­ance and infor­ma­tion from a trained dieti­cian through online plat­forms, patients with rheuma­toid arthri­tis ate a bet­ter qual­ity diet and increased con­sump­tion of foods not com­mon to their coun­try, such as extra vir­gin olive oil,” she told Olive Oil Times.

“The study showed that a dietary inter­ven­tion deliv­ered through online plat­forms can be effec­tive, con­ve­nient, and empow­er­ing for peo­ple liv­ing with rheuma­toid arthri­tis,” Tierney added. ​“These online inter­ven­tions offer acces­si­bil­ity to mem­bers of the mul­ti­dis­ci­pli­nary team and pro­vide the oppor­tu­nity for peo­ple to take an active role in man­ag­ing their dis­ease.”

Previous stud­ies con­firm a pos­i­tive ben­e­fit for patients with rheuma­toid arthri­tis by fol­low­ing a Mediterranean diet. The researchers’ aim of this study was to explore the expe­ri­ence and per­cep­tion of par­tic­i­pants in mak­ing lifestyle and dietary changes via tele­ses­sions.

The study explored sev­eral over­ar­ch­ing themes, such as par­tic­i­pant moti­va­tion for join­ing the pro­gram, the pro­gram’s ben­e­fits, dietary adher­ence and the pros and cons of tele­health.

The par­tic­i­pants iden­ti­fied pos­i­tively with tele­health inter­ven­tions pro­vided by a reg­is­tered dieti­cian. The researchers con­cluded that tele­sem­i­nars may be a viable way to sup­port face-to-face care with patients with rheuma­toid arthri­tis.

“Additional efforts were required to estab­lish rap­port and build trust for a sup­port­ive and empa­thetic envi­ron­ment,” Tala Raad, a Ph.D. can­di­date at the University of Limerick focused on Mediterranean dietary pat­terns in adults liv­ing with rheuma­toid arthri­tis in Ireland, told Olive Oil Times.

“As some par­tic­i­pants had lim­ited tech­no­log­i­cal lit­er­acy and access to good inter­net con­nec­tiv­ity, these cre­ated some bar­ri­ers to engage­ment and par­tic­i­pa­tion,” she added.

Tierney said one of the sig­nif­i­cant chal­lenges asso­ci­ated with tele­health is ensur­ing patients’ com­pli­ance with dietary rec­om­men­da­tions.

“Therefore, we had to develop reli­able meth­ods to mon­i­tor the par­tic­i­pants’ intakes and track their progress effec­tively,” she said.

According to the researchers, this is the first study that demon­strated a Mediterranean diet was accepted in a non-Mediterranean, Irish pop­u­la­tion.

The data con­firmed that a dietary inter­ven­tion pro­gram deliv­ered by a reg­is­tered dieti­cian through tele­health is an accept­able com­ple­ment to face-to-face care for man­ag­ing rheuma­toid arthri­tis.

Researchers con­cluded that moti­va­tion and per­ceived ben­e­fits of dietary changes are impor­tant for par­tic­i­pa­tion. These per­cep­tions can pro­duce both phys­i­cal and psy­cho­log­i­cal ben­e­fits.

The study also con­firmed that adults with rheuma­toid arthri­tis are often inter­ested in evi­dence-based pro­grams and pro­grams with expert input.

A grow­ing body of evi­dence sup­ports dietary and lifestyle changes in improv­ing the lives of peo­ple with rheuma­toid arthri­tis. The Mediterranean diet has gen­er­ated inter­est, in par­tic­u­lar, due to its car­dio­vas­cu­lar and anti-inflam­ma­tory ben­e­fits.

According to the Arthritis Foundation, dietary inter­ven­tions offer a pos­i­tive direc­tion for patients with arthri­tis. A Mediterranean diet relies on extra vir­gin olive oil, which can lower lev­els of chem­i­cals that cause inflam­ma­tion.

“A meal plan like the Mediterranean diet can lower inflam­ma­tion and con­trol some rheuma­toid arthri­tis symp­toms,” wrote Debra Fulghum Bruce, an edi­to­r­ial con­sul­tant at WebMD. ​“While food is not promis­ing to cure the dis­ease, this method of eat­ing can keep inflam­ma­tion in check.”

The researchers envi­sion that this study may facil­i­tate research trans­la­tion to prac­tice and con­tribute toward a more holis­tic approach to rheuma­toid arthri­tis man­age­ment. Future stud­ies may also explore how to assist patients in over­com­ing bar­ri­ers and enhanc­ing enablers for adopt­ing health­ier eat­ing pat­terns.

“This study shows that by using online video ses­sions, dieti­cians can reach peo­ple and help them make health­ier choices and good deci­sions about their diet,” Tierney and Raad told Olive Oil Times. ​“We were able to show­case the impor­tance of diets such as the Mediterranean diet and foods like using extra vir­gin olive oil, which can lead to bet­ter health and well-being for every­one.”

Potential direc­tions for future stud­ies include com­par­ing and exam­in­ing par­tic­i­pants’ expe­ri­ences on var­i­ous online plat­forms, includ­ing video calls, web-based mod­ules, vir­tual sup­port groups, or mobile appli­ca­tions for deliv­er­ing lifestyle inter­ven­tions.

“Future stud­ies should also con­sider iden­ti­fy­ing bar­ri­ers and enablers to engage­ment in diet inter­ven­tions, inves­ti­gat­ing expe­ri­ences of indi­vid­u­als from diverse and socio-demo­graphic char­ac­ter­is­tics, and assess­ing poten­tial dis­par­i­ties on access and engage­ment,” Raad said.

She added that this would help iden­tify strate­gies to pro­mote equity in tele­health and improve access to online inter­ven­tions for every­one.

“Future research should also explore the expe­ri­ences and chal­lenges encoun­tered by health­care pro­fes­sion­als,” Raad con­cluded. ​“Based on find­ings of par­tic­i­pants and providers, guide­lines for design­ing and imple­ment­ing effec­tive online dietary inter­ven­tions can be devel­oped.”

• Arthritis.org