DIET AND ARTHRITIS

This is an issue for which doctors (and in particular rheumatologists) must be prepared in order to enter into productive discussions with their patients, The matter is often introduced by the patient rather than the doctor. The starting point for discussion is frequently a request for an opinion on a dietary treatment for arthritis which has been promoted in the lay media. An optimally effective professional response demands an up-to-date knowledge of the the place of diet in the management of various forms of arthritis, Familiarity with the principles underlying current recommendations for a prudent diet that lowers risk for thrombotic vascular disease is also desirable as a basis for conveying positive health messages that foster self-responsibility. Discussion centred on scientific standards of proof provides an opportunity to inform patients of the status of medicine (and rheumatology as one of its specialties) as science and art: the science providing a knowledge base grounded on testable theories and reproducible observations; the art involving the sensible extrapolation of the science to the myriad contingencies that form the tapestry of every day life and medical practice.