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Objective: Healthy Eating Index-2015 (HEI-2015) is a multidimensional criterion of diet quality utilized to evaluate how well people’s dietary behaviors align with major recommendations of the 2015–2020 Dietary Guidelines for Americans. We aim to investigate the association between the diet quality and Rheumatoid arthritis (RA) activity.Design: Cross-sectional studySetting: This study was done on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall quality diet was extracted from a validated 168-item food frequency questioner (FFQ) to calculate the HEI-2015 score. RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. One-way ANOVA and ANCOVA were done to find the associations.Participants: RA patientsResults: Individuals in the highest HEI-2015 quartile had a lower mean Erythrocyte Sedimentation Rate (ESR) than those in the lowest quartiles of the HEI scores (P-value: 0.014). A linear trend towards decreasing waist circumference in patients was observed with increasing quartiles of the HEI-2015 scores (P-value= 0.005). After controlling for all potential confounders, patients in the highest HEI-2015 quartile had the lowest DAS28 scores than those in the lowest quartile of the HEI-2015 scores (Q1= 3.65; 95% CI= 3.29 – 4.02 vs. Q4= 2.35; 95% CI= 1.94 - 2.67; P-value<0.001).Conclusion: Our results indicated that following a high diet quality might be one of the therapeutic strategies to control or reduce the disease activity in RA patients.

Background: Diet plays an important role in regulating inflammation, which is a hallmark of rheumatoid arthritis (RA). Our aim was to investigate the association between the inflammatory potential of diet and RA activity.Methods: This cross-sectional study was conducted on 184 patients with RA in rheumatology clinic in Kermanshah city, Iran, in 2020. RA was diagnosed according to the criteria of the 2010 American College of Rheumatology/ European League against Rheumatism. The overall inflammatory potential of the diet was extracted from a validated 168-item food frequency questioner (FFQ) using the Dietary Inflammatory Index (DII). RA disease activity was assessed using Disease Activity Score 28 (DAS28) scores. Logistic regression and one-way ANOVA/ ANCOVA were conducted. Results: Individuals in the highest DII quartile had the significantly higher odds of positive C-reactive protein (CRP) than those in the lowest quartile of the DII scores (OR: 4.5; 95% CI: 1.16 – 17.41; P-value: 0.029). A statistically significant downward linear trend in fat-free mass and weight were observed with increasing the DII quartiles (P-value=0.003, P-value=0.019, respectively). Patients in the highest DII quartile had higher DAS 28 scores than those in the first quartile (Mean difference: 1.16; 95% CI: 0.51 – 1.81; P-value <0.001) and second quartile of the DII scores (Mean difference: 1.0; 95% CI: 0.34 – 1.65; P-value <0.001).Conclusion: Our results indicated that reducing inflammation through diet might be one of the therapeutic strategies to control and reduce the disease activity in RA patients.