International Research Journal of Applied and Basic Sciences
© 2015 Available online at www.irjabs.com
ISSN 2251-838X / Vol, 9 (3): 367-370
Science Explorer Publications
Consumption of some spices in patients with
rheumatoid arthritis: a case-control study
Sara Moradi1, Ahmad-Reza Dorosty-Motlagh1*, Milad Daneshi-Maskooni1, Keramat Nouri-Jelyani2
1. Department of Community Nutrition, School of Nutritional Sciences and Dietetics,Tehran University of Medical
Sciences, Tehran, Iran
2. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences,
Tehran, Iran.
Corresponding Author email: dorostim@sina.tums.ac.ir
ABSTRACT:The consumption of spicy foods has received more attention in relation to Rheumatoid
arthritis in recent years. The traditional Iranian diet contains large amounts of spicy foods, including
turmeric, and ginger, sesame, allium, chili pepper, providing an opportunity to assess consumption of
spicy foods in relation to health. In addition, few data exist about the association between diet and
Rheumatoid arthritis. Here, we present the study that aimed to explore the association between
consumption of spicy foods among Iranian Rheumatoid arthritispatients. This case - control study was
conducted on 60 patients with Rheumatoid arthritis and 60 healthy adults aged 20- 60 years. Dietary
intakes of peoples obtained using questionnaire. Diagnosis of Rheumatoid arthritis was evaluated by
aRheumatologist. Statistical analysis was performed with the software SPSS IBM 20. This study
showed a significant positive relationship between intake of Ginger (p< 0.001) and Sesame (p< 0.05) in
case and control groups.
Keywords:Rheumatoid arthritis, Turmeric, Ginger, Sesame, Allium, Chili pepper.
INTRODUCTION
Rheumatoid arthritis is an autoimmune disease that results in a chronic, systemicinflammatory disorder that
may affect many tissues and organs, but principally attacks joints. It can be a disabling and painful condition, which
can lead to substantial loss of functioning and mobility if not adequately treated. The process involves an
inflammatory response of the capsule around the joints secondary to swelling of synovial cells, excess synovial
fluid, and the development of fibrous tissue in the synovium. RA can also produce diffuse inflammation in the lungs,
heart,and subcutaneous tissue. Although the cause of RA is unknown, autoimmunity plays a big part. Treatments
are pharmacological and non-pharmacological. Non-pharmacological treatment includes physical therapy,
occupational therapy and nutritional therapy but these don't stop the progression of joint destruction. Analgesics
and anti-inflammatory drugs, including steroids, suppress symptoms, but don't stop the progression of joint
destruction either. Disease-modifying antirheumatic drugs (DMARDs) slow or halt the progress of the disease. The
newer biologics are DMARDs (MajithiaV,et al. 2007 ). The evidence for complementary and alternative medicine
(CAM) treatments for RA related pain is weak, with the lack of high quality evidence leading to the conclusions that
their use is currently not supported by the evidence ( Macfarlane GJ,et al. 2011 ).About 0.6% of the United States
adult population has RA, women two to three times as often as men (Helmick, CG, etal. 2009). Onset is most
frequent during middle age, but people of any age can be affected (National Institute of Arthritis and
Musculoskeletal and Skin Diseases, 2009). Herbal supplements and spices can often have significant side effects,
and can interact with prescription medications being taken at the same time. These risks are often exacerbated by
the false general belief by patients that herbal supplements are always safe and the hesitancy by patients in
reporting the use of herbal supplements to physicians (Efthimiou, P, Kukar, M 2010).
Turmeric is plant of the ginger family (Chan, E.W.C. et al. 2009). It is native to India.Curcumin has been a
centre of attraction for potential treatment of an array of diseases, including cancer, alzheimer's disease, diabetes,
allergies, arthritis and other chronic illnesses (Nagpal M, Sood S. 2013; Shehzad A, 2013). It is a significant
ingredient in most commercial curry powders. Most turmeric that is used is in the form of rhizome powder.Although
typically used in its dried, powdered form, turmeric is also used fresh, like ginger. It has numerous uses in Far
Intl. Res. J. Appl. Basic. Sci. Vol., 9 (3), 367-370, 2015
Eastern recipes. Turmeric is widely used as a spice in South Asian and Middle Eastern cooking. Many Persian
dishes use turmeric as a starter ingredient. Almost all Iranian fried dishes consist of oil, onions, and turmeric
followed by any other ingredients that are to be included (Aggarwal BB, et al. 2007). The active compound of
Turmeric,curcumin is believed to have a wide range of biological effects including anti-inflammatory, antioxidant,
antitumour, antibacterial, and antiviral activities, which indicate potential in clinical medicine (NCCAM,2012; NIH,
2013). According to the National Center for Complementary and Alternative Medicine, "there is little reliable
evidence to support the use of turmeric for any health condition because few clinical trials have been
conducted."(Yang C, et al. 2013). Curcumin is well-tolerated; the most common side effects are nausea and
diarrhea (Asher GN, Spelman K. 2013). Allium sativum, commonly known as garlic, is a species in the onion genus,
Allium.With a history of human use of over 7,000 years, garlic is native to central Asia(Ensminger, AH, 1994). It
was known to Ancient Egyptians, and has been used for both culinary and medicinal purposes(Simonetti G. 1990).
Such as PMS and rheumatism (Zohary D, Hopf M. 2000). Ginger is the rhizome of the plant, consumed as a
delicacy, medicine, or spice. Ginger cultivation began in South Asia and has since spread to East Africa and the
Caribbean (Spices, 2007).Preliminary studies showed that ginger may affect arthritis pain or have blood thinning
and cholesterol lowering properties, but these effects remain unconfirmed. Ginger has also been historically used to
treat inflammation (Ginger, 2007). Sesame is a flowering plant in the genus sesamum. Numerous wild relatives
occur in Africa and a smaller number in India.With a rich nutty flavor, it is a common ingredient in cuisines across
the world (TenWolde S, 1997). Like other nuts and foods, it can trigger allergic reactions in some people.[19]These
results do not suggest an anti-inflammatory effect of sesame oil as present in injectable gold preparations which are
used in the treatment of rheumatoid arthritis( Ray Hansen R, et al. 2011).
The chili pepper is the fruit of plant.The substances that give chili peppers their intensity when ingested or
applied topically are capsaicin and several related chemicals, collectively called capsaicinoids.Chili peppers
originated in the Americas (Thenibble, 2013). Capsaicin is a safe and effective topicalanalgesic agent in the
management of arthritis pain, herpes zoster-related pain, diabetic neuropathy, mastectomy pain, and headaches
(Cancer nursing , 2005 ) Besides its use as a food additive in various spicy cuisines, capsaicin is currently utilized
for therapeutic purposes to treat various peripheral painful conditions such as rheumatoid arthritis and diabetic
neuropathy(Surh Y, 1996 ).
Food spices used in canned beverages and baked products, dairy products, ice cream, yogurt, yellow cakes,
orange juice, biscuits, popcorn color, sweets, cake icings, cereals, sauces, gelatins, etc.The traditional Iranian diet
contains large amounts of spicy foods, including turmeric, ginger,sesame, allium, chili pepper, providing an
opportunity to assess consumption of spicy foods in relation to health. In addition, few data exist about the
association between diet and Rheumatoid arthritis. Here, we present the study that aimed to explore the
association between consumption of spicy foods among Iranian Rheumatoid arthritis patients.
METHODS AND SUBJECTS
Thisstudywas designedas case–control .Sample sizewasdeterminedbased onthepilot study. Spices are
eatenby Rheumatoid arthritis patients(ascases)and healthyadults(ascontrols) assessed, in level of error probability
α=0.05and1–β=0.95.The sample size ineach groupwas60.Study was conducted on60 Rheumatoid arthritis
patientsreferred toRheumatologyclinicsof Tehran hospitals and60healthy adults (whoreferredto the other parts
ofhospitalswithpatients).Theinclusioncriteriaincludethe diagnosis of Rheumatoid arthritisalmost in 9 months
ago).The researcherafter of explanation about study and completion of informed consent,to assess spice
intakeused semi-quantitative food frequency questionnaire. After that, questions about spices assessed. SemiquantitativeFFQincluded list of147 foodswithastandard sizeand have been validated in glucose and lipid study of
Tehran in 2004. The subjects were asked to report their frequency of consumption of each food according to its
value in the past year. Thefrequency offood and spicesconsumptionwasbyday, week ormonthinquestion and
analyzed by general consumption or not. Afterdata collection, thestatisticalsoftwareSPSS IBM 20 were
usedforentryand analysisof them.P-valuesless than 0.05 weresignificant.
RESULTS
The mean age of case and controls are 41. 65percent ofcases and 91 percent of controls were married. The
difference of educationlevelincases and controls was significant, so that 38 percent of cases were lower
thandiploma and 28 percent of controls were higher than diploma. Diploma in bout groups is the same (P<0.001).
Other of differences have presented in below table.
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Intl. Res. J. Appl. Basic. Sci. Vol., 9 (3), 367-370, 2015
P-Value
<0.001
=0.50
< .05
=0.54
Table 1. Frequenyof spices in cases and controls
Count (%)
Factors
controls
Cases
5( 8.3% )
35 ( 58.3% )
Ginger
49( 81.7% )
46( 76.7% )
Allium
60( 100.0%
60( 100.0% )
Tturmeric
)
9( 15.0% )
20( 33.3% )
Sesame
18( 30.0% )
15( 25.0% )
Chili pepper
DISCUSSION
This studyshowed a significant positiverelationship betweenintakeof ginger and sesame in case and control
groups. Ginger and sesame consumption in rheumatoid arthritis patients were seven times more than healthy
adults. Ginger-turmeric rhizomes mixture may be effective against RA severity and complications as shown in an
AIA rat model (Ramadan G, 2013).Ginger extract was as effective an anti-inflammatory agent as betamethasone in
this in vitro model (Ribel-Madsen S,et al, 2012).Seven patients suffering from such disorders reported relief in pain
and associated symptoms on ginger administration. (Srivastava KC, Mustafa T, 1989).Themethodologyof this
studyisdifferent fromother studiesandthis studyhas beenperformedfor the firsttime inIran. The traditional Iranian diet
contains large amounts of spicy foods, including turmeric and use of turmeric is routine in Iran and almost every
food thus in this study 100% of cases and controls use turmeric. In must studies effect of the active component of
spices, especially in animal models or gene expressionstudies evaluated, but in this study, consumption of spices
between rheumatoid arthritis patients and healthy adults were evaluated. In this study, allium (p=0.50) and chili
pepper (p=0.54) showed no significant relationship with rheumatoid arthritis.
CONCLUSION
Ginger and Sesame consumption in rheumatoid arthritis patients were seven times more than healthy adults.
ACKNOWLEDGMENT
This study was a research program proposed by the school of nutritional science and dietetics of Tehran
University of Medical Sciences that they had no role in the design, analysis or writing of this article. Writers
designed the study, collected and analyzed the data, and wrote the manuscript, performed thestatistical analysis.
We thank participants in this research for their enthusiastic support and President and Staff of Imam Khomeini and
Shariati hospitals for their valuable help in the conduct of this study. Ethical approval was not required.
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