Abstract
To our knowledge, no studies have investigated the relationship between a posteriori dietary patterns (DPs)—representing current dietary behavior—and disease activity in patients with rheumatoid arthritis (RA). We analyzed data from a recent Italian cross-sectional study including 365 RA patients (median age: 58.46 years, 78.63% females). Prevalent DPs were identified through principal component factor analysis on 33 nutrients. RA activity was measured according to the Disease Activity Score on 28 joints (DAS28) and the Simplified Disease Activity Index (SDAI). Single DPs were related to disease activity through linear and logistic regression models, adjusted for the remaining DPs and confounders. We identified five DPs (~80% variance explained). Among them, Vegetable unsaturated fatty acids (VUFA) and Animal unsaturated fatty acids (AUFA) DPs were inversely related to DAS28 in the overall analysis, and in the more severe or long-standing RA subgroups; the highest score reductions (VUFA: 0.81, AUFA: 0.71) were reached for the long-standing RA. The SDAI was inversely related with these DPs in subgroups only. This Italian study shows that scoring high on DPs based on unsaturated fats from either source provides independent beneficial effects of clinical relevance on RA disease activity, thus strengthening evidence on the topic.
Highlights
Rheumatoid arthritis (RA) is a chronic immune-mediated disease, primarily characterized by synovial inflammation, which leads to a progressive joint damage; the disease activity impairs physical function, activities of daily living, and quality of life [1,2].Despite the increasing therapeutic armamentarium, a significant proportion of RA patients have an inadequate response to the available disease modifying anti-rheumatic drugs (DMARDs) [2].In an attempt to relieve their symptoms, these patients make enquires to their rheumatologists about dietary modifications that might help them with symptoms
A higher consumption of the dominant nutrients for the Vegetable unsaturated fatty acids (VUFA) and Animal unsaturated fatty acids (AUFA) dietary patterns (DPs) was still associated with a lower risk of Simplified Disease Activity Index (SDAI)-based disease activity, but the effect was more pronounced in the stratified analyses: the rheumatoid factor (RF) and/or anti-citrullinated protein antibodies (ACPA) positive subjects showed an Odds Ratios (ORs) equal to 0.36 for the VUFA DP and subjects with longer disease durations showed an OR of borderline significance for the AUFA DP (OR = 0.27, 95% confidence Intervals (CIs): 0.07–1.02), in the absence of heterogeneity across strata
This paper is the first attempt to provide a comprehensive description of actual dietary habits in RA subjects with the identification of a posteriori DPs
Summary
Rheumatoid arthritis (RA) is a chronic immune-mediated disease, primarily characterized by synovial inflammation, which leads to a progressive joint damage; the disease activity impairs physical function, activities of daily living, and quality of life [1,2].Despite the increasing therapeutic armamentarium, a significant proportion of RA patients have an inadequate response to the available disease modifying anti-rheumatic drugs (DMARDs) [2].In an attempt to relieve their symptoms, these patients make enquires to their rheumatologists about dietary modifications that might help them with symptoms. Rheumatoid arthritis (RA) is a chronic immune-mediated disease, primarily characterized by synovial inflammation, which leads to a progressive joint damage; the disease activity impairs physical function, activities of daily living, and quality of life [1,2]. Despite the increasing therapeutic armamentarium, a significant proportion of RA patients have an inadequate response to the available disease modifying anti-rheumatic drugs (DMARDs) [2]. In an attempt to relieve their symptoms, these patients make enquires to their rheumatologists about dietary modifications that might help them with symptoms. A recent survey capturing RA patients’ perspectives suggests nutritional advice being among relevant topics for future research [3]. Websites and leaf letters from patients’ associations often suggest foods, nutrients, or dietary patterns (DPs) to relieve symptoms [4,5]. The increasing recognition of this unmet need and of “unorthodox”
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