Diet and Rheumatoid Arthritis Symptoms: Survey Results From a Rheumatoid Arthritis Registry

Abstract

Objective Patients with RA often ask if specific foods, popularized as “inflammatory” or “anti-inflammatory,” can improve or worsen their RA. We surveyed patients regarding diet and RA symptoms. Methods We mailed a diet survey to 300 subjects in a single-center RA registry at a large academic center. Subjects were asked whether they consume each of 20 foods and whether these foods make their RA symptoms better, worse, or unchanged. Semi-annual registry data include demographics, medications, comorbidities, and disease activity scores. Fisher's exact and Wilcoxon rank-sum tests evaluated associations between subject characteristics from the most recent registry assessment and change in RA symptoms from specific foods. Results Among 217 subjects (72% response rate), 83% were female, median RA duration was 17 years (IQR 9-27), and 58% were using a biologic DMARD. Twenty-four percent of subjects reported that foods affect their RA, with 15% reporting improvement and 19% worsening. Blueberries and spinach were the foods most often reported to improve RA symptoms, while soda with sugar and desserts were most often reported to worsen RA symptoms. Younger age and noting that sleep, warm room temperature, and vitamin/mineral supplements improve RA were each associated with reporting that foods affect RA symptoms. Medication use, sex, body mass index, smoking, disease duration, disease activity scores, and self-reported RA flares were not associated with reporting that foods affect RA. Conclusion Nearly one-quarter of RA subjects with longstanding disease reported an effect of diet on their RA symptoms.

Poor Dietary Quality Is Associated with Increased Inflammation in Swedish Patients with Rheumatoid Arthritis

“…The patients with RA also reported a lower intake of discretionary foods compared to the general population. This was in line with previous data, indicating that patients with RA report that these foods worsen their symptoms [ 28 ] and they therefore might avoid them. Additionally, the patients with RA had all volunteered to participate in a dietary intervention trial, and might therefore have been more interested in diet than the general population.…”

“…Possibly, a higher intake of dietary fiber (plant-based foods such as fruit and vegetables and whole grain) and a high-quality fat intake (lower intake of saturated fats and a higher intake of unsaturated and long-chain polyunsaturated fatty acids) could contribute to decreased inflammation and disease activity. However, despite indications from patients with RA that dietary intake impacts the disease [ 28 ], there is a great lack of research in this area.…”

Characteristics and risk factors of rheumatoid arthritis in the United States: an NHANES analysis

“…A small cross-sectional case series of 53 women with RA indicated that the patients overall had a low dietary consumption of vitamins A and C, and zinc, and in the elderly in particular there was low consumption of vitamin E and selenium ( Silva et al, 2014 ). In a survey study of a single-center RA registry, 24% of subjects reported that foods affect their RA, with 15% reporting improvement and 19% worsening ( Tedeschi et al, 2017 ). Blueberries and spinach were the foods most often reported to improve RA symptoms, while soda with sugar and desserts were most often reported to worsen RA symptoms.…”

The role of diet in rheumatoid arthritis

“…In a survey, 24% of patients reported perceived effects of their diet on RA symptoms; 19% observed negative effects of sugary drinks and sweets, while 15% reported beneficial effects of some foods’ consumption, most often berries or spinach [ 23 ]. It might be worthwhile to try to provide some insight through clinical studies of whether perceptions match reality.…”