Fish Consumption and Risk of Rheumatoid Arthritis: Findings from the E3N Cohort Study.

Yann Nguyen,Xavier Mariette,Carine Salliot,Raphaèle Seror,Marie-Christine Boutron-Ruault

doi:10.3390/nu14040861

Abstract

Fish consumption has been thought to reduce the risk of rheumatoid arthritis (RA), but the reported data are conflicting. We aimed to assess the association between fish consumption (overall, lean fish, and oily fish) and the risk of RA. The E3N Study is a French prospective cohort study including 98,995 women since 1990. Dietary data were collected via a validated food frequency questionnaire in 1993. Cox proportional hazards models were used to calculate HRs and 95% CIs for incident RA. Models were adjusted for age and for the main potential confounders including cigarette smoking. Among 62,629 women, 480 incident cases of RA were identified. In the overall population, we did not find a linear association between overall fish consumption and RA risk (p for trend 0.65), but a moderate consumption of fish was associated with a decreased risk of RA (HR 0.74; 95% CI 0.59–0.94 for tertile 2 compared with tertile 1), especially among current or former smokers (HR 0.61; 95% CI 0.44–0.85). Although not statistically significant, a trend towards an inverse association was only found with oily fish consumption (HR 0.81; 95% CI 0.65–1.02), but not with lean fish. Our results suggest that moderate fish consumption could reduce the risk or RA and potentially counterbalance the increased risk of RA induced by smoking. This inverse association might be explained by the omega-3 fatty acid content of oily fish.

Highlights

Rheumatoid arthritis (RA) is an inflammatory rheumatoid disease, in which an interaction between genetic factors and environment could trigger autoimmunity and play a role in its pathogenesis [1]
In our large population-based cohort study of French women, there was a U-shaped relationship between overall fish consumption and the risk of RA, with a reduced RA
When separately considering oily and lean fish, the second tertile of oily fish consumption was inversely associated with the risk of RA only in non-smoking women, while there was no association whatsoever with lean fish

Summary

Introduction

Rheumatoid arthritis (RA) is an inflammatory rheumatoid disease, in which an interaction between genetic factors and environment could trigger autoimmunity and play a role in its pathogenesis [1]. Special attention has been given to fish consumption, as fish is rich in omega-3 fatty acids. Moderate fish consumption has been thought to be associated with lower risk of cardiovascular diseases and mortality in some populations [4]. Regarding the risk of RA, increased intake of omega fatty acids has been suggested to decrease the risk of developing ACPAs and to prevent the onset of RA once ACPAs have been detected [3]. In a case-control study, Shapiro et al found that a high consumption of broiled or baked fish was associated with a lower risk of incident RA (odds ratio 0.57; 95% CI [0.35; 0.93]) [10]

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