Intake frequency of vegetables or seafoods negatively correlates with disease activity of rheumatoid arthritis.

Isao Murakami,Motomu Hashimoto,Hajime Yoshifuji,Akiko Kuwabara,Kaori Ikeda,Hiromu Ito,Kosaku Murakami,Koichiro Ohmura,Masao Tanaka,Takao Fujii,Mie Torii,Takashi Usui,Tsuneyo Mimori,Satoshi Morita,Ran Nakashima,Kiyoshi Tanaka,Shuji Akizuki,Akiko Yoshida,Jose M Moran

doi:10.1371/journal.pone.0228852

Abstract

ObjectiveTo clarify the relationship between dietary habit and disease activity of rheumatoid arthritis (RA).MethodsThis study enrolled RA patients who met the ACR/EULAR 2010 classification criteria from Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort in 2015. 22-item food frequency questionnaire (FFQ) was taken for the measurement of dietary habit in a single-institution cohort of RA (Kyoto University Rheumatoid Arthritis Management Alliance: KURAMA) in 2015. The disease activities of RA using the Disease Activity Score calculated based on the erythrocyte sedimentation rate (DAS28-ESR), Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire (HAQ), and serum matrix metalloproteinase-3 (MMP-3) level, the use of disease-modifying anti-rheumatic drugs (DMARDs), disease duration, rheumatoid factor, anti-cyclic citrullinated antibody, and body mass index were also examined. All of them were combined and statistically analyzed.Results441 RA patients (81% women; mean age 65 years; mean disease duration 15 years) were enrolled from the KURAMA cohort. Average Disease Activity Score-28 using the erythrocyte sedimentation rate (DAS28-ESR) was 2.7. Univariate analysis showed that intake frequency of vegetables had a statistically significant negative correlation with disease activity markers, such as DAS28-ESR (ρ = −0.11, p<0.01), Simplified Disease Activity Index (SDAI) (ρ = −0.16, p<0.001), matrix metalloproteinase-3 (MMP-3) (ρ = −0.21, p<0.0001), and Health Assessment Questionnaire (HAQ) (ρ = −0.13, p<0.01). Factor analysis with varimax rotation was done to simplify the relevance of disease activity to various food items. 22 foods were categorized into five dietary patterns: “seafoods”, “vegetables/fruits”, “meats/fried foods”, “snacks”, and “processed foods”. The multivariate analysis adjusted for clinically significant confounders showed that “seafoods” had statistically significant negative correlations with DAS28-ESR (β = −0.15, p<0.01), SDAI (β = −0.18, p<0.001), MMP-3 (β = −0.15, p<0.01), and HAQ (β = −0.24, p<0.0001). “Vegetables/fruits” had statistically significant negative correlations with SDAI (β = −0.11 p<0.05), MMP-3 (β = −0.12, p<0.01), and HAQ (β = −0.11, p<0.05)ConclusionsThese results suggest that high intake frequency of vegetables/fruits and/or seafoods might correlate with low disease activity.

Highlights

Rheumatoid arthritis (RA) is an autoimmune disease that mainly affects systemic joints [1]
The disease activities of RA using the Disease Activity Score calculated based on the erythrocyte sedimentation rate (DAS28-ESR), Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire (HAQ), and serum matrix metalloproteinase-3 (MMP-3) level, the use of disease-modifying anti-rheumatic drugs (DMARDs), disease duration, rheumatoid factor, anti-cyclic citrullinated antibody, and body mass index were examined
Univariate analysis showed that intake frequency of vegetables had a statistically significant negative correlation with disease activity

Summary

Introduction

Rheumatoid arthritis (RA) is an autoimmune disease that mainly affects systemic joints [1]. The precise etio-pathogenesis of RA is unclear, but the contribution of both genetic and environmental factors has been suggested. Various environmental factors, such as periodontal bacteria and smoking, are reported to be associated with RA in several epidemiological or basic medical studies [2], [3]. Dietary habits are important environmental factors which are associated with many diseases. In previous reports from Western countries, fish intake improves RA disease activity, whereas high consumption of fats and sugars worsens it [4]. Consumption of omega-3 polyunsaturated fatty acids improves disease activity of RA and JIA [5, 6]. The Mediterranean diet may decrease arthralgia in RA patients [8]

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Results

Conclusion