Abstract

Background: The role of nutrition in the pathogenesis of rheumatic diseases, including rheumatoid arthritis (RA), has gained increasing attention in recent years. A growing number of studies have focussed on the diverse nutritional contents of beverages, and their possible role in the development and progression of RA. Main body: We aimed to summarise the current knowledge on the role of a range of beverages in the context of RA. Beverages have a key role within the mosaic of autoimmunity in RA and potential to alter the microbiome, leading to downstream effects on inflammatory pathways. The molecular contents of beverages, including coffee, tea, and wine, have similarly been found to interfere with immune signalling pathways, some beneficial for disease progression and others less so. Finally, we consider beverages in the context of wider dietary patterns, and how this growing body of evidence may be harnessed by the multidisciplinary team in patient management. Conclusions: While there is increasing work focussing on the role of beverages in RA, integration of discussions around diet and lifestyle in our management of patients remains sparse. Nutrition in RA remains a controversial topic, but future studies, especially on the role of beverages, are likely to shed further light on this in coming years.

Highlights

  • Rheumatoid arthritis (RA) is a chronic, systemic, immune-inflammatory disease, with a complex aetiology, including genetic, environmental, and endogenous triggers [1,2]

  • Not all catechins in green tea appear to be equal, as demonstrated by epicatechin (EC), which, in this same study, was shown to hinder the marked downstream inflammatory signalling inhibition exerted by EGCG

  • Beverages are integral to our lives, whether for rehydration, socialising, or as one

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Summary

Introduction

Rheumatoid arthritis (RA) is a chronic, systemic, immune-inflammatory disease, with a complex aetiology, including genetic, environmental, and endogenous triggers [1,2]. There has been increasing evidence for the role of nutrition in RA disease onset and activity, this has failed to filter down to clinical awareness and practice as an adjunct to pharmacological treatments [7,8] This includes the important role played by beverages and their rich nutritional content [2]. We continue to move towards an era of personalised medicine, which includes the consideration of dietary and nutritional needs, and their impact on the individual patient This narrative review aims to provide an overview of the evidence on the possible role of beverages in the aetiology and progression of RA, and how this may be of help in the care of our patients. Key references were identified by all authors, and were crosschecked in recent reviews of nutrition in RA

The Mosaic of Autoimmunity in RA and the Role of Nutrition
Diet and the Microbiome
Western
Mediterranean Diet
Vegetarian and Vegan Diets
The Impact of Fasting on RA Disease Outcomes
An Evolving Multidisciplinary Team
The Role of Water and Fresh Fruit Juices
Tea and Coffee
Effect
Sugar-Sweetened Soft Drinks
Alcohol Intake
The Role of Beverages during Treatment of RA
Findings
10. Conclusions
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