Dietary Quality Associated with Self-Reported Diabetes, Osteoarthritis, and Rheumatoid Arthritis among Younger and Older US Adults: A Cross-Sectional Study Using NHANES 2011–2016

Abstract

Background: To date, few studies have compared the dietary quality of US adults with diabetes mellitus (DM), osteoarthritis (OA), and rheumatoid arthritis (RA) by age groups. Methods: This study used cross-sectional data from adult participants from National Health and Nutrition Examination Survey 2011–2016 to identify dietary quality measured by Healthy Eating Index (HEI)-2015 total and component scores and self-reported disease status for DM, OA, and RA. Associations between the disease status and HEI-2015 total/component scores among younger adults aged 20–59 years (n = 7988) and older adults aged 60 years and older (n = 3780) were examined using logistic regression models. These accounted for the complex survey design and were adjusted for self-reported disease status, sex, race/ethnicity, education levels, income status, weight status, physical activity levels, and smoking status. Results: Among younger adults, 7% had DM, 7% had OA, and 3% had RA. Among older adults, 20% had DM, 32% had OA, and 6% had RA. Moderate added sugar intake was associated with diabetes in all adults. Excess sodium intake was associated with DM among younger adults. Inadequate seafood and plant protein intake was associated with RA among younger adults, while a poor overall dietary pattern was associated with RA among older adults. Conclusions: The dietary quality of US adults varied by self-reported DM, OA, and RA status, and each varied by age group.

Nutrition Patterns and Their Gender Differences among Rheumatoid Arthritis Patients: A Descriptive Study

“…Similar results were reported by other authors as well [ 38 , 39 ]. Other studies have mostly reported a different macronutrient distribution compared to our study, including higher energy, carbohydrate, fat, sugar, and arachidonic acid intakes [ 40 , 41 , 42 , 43 , 44 ]. Under-reporting of energy intake and reporting of biased dietary information has been described in individuals with RA, which may have influenced average energy and macronutrient intake [ 38 , 45 ].…”

Is The Healthy Eating Index-2015 Associated With Rheumatoid Arthritis?

“…In a cross-sectional study in Arizona, USA in 2009 with aim of assessing the dietary quality of older women (≥55 years) with RA and healthy controls using the Healthy Eating Index-2005 (HEI-2005), it was shown that patients with RA had signi cantly lower dietary quality (30). In cross-sectional study conducted in 11,768 US adult from National Health and Nutrition Examination Survey 2011-2016 to assay dietary quality measured by Healthy Eating Index (HEI)-2015 and self-reported disease status for RA, showed that a poor overall quality of dietary pattern was related with RA among older adults aged 60 years and older (17). Indeed, it seems that following a healthier dietary pattern could reduce the chance or developing RA.…”

“…In a prospective cohort of the Nurses' Health Study and the Nurses' Health Study II, with the aim of evaluating the relationship between long-term diet quality, was measured by the 2010 Alternative Healthy Eating Index and the risk of RA in women, it was shown that a healthier diet was associated with a reduced risk of RA (16). In crosssectional study conducted in US adult from National Health and Nutrition Examination Survey 2011-2016 to assay dietary quality measured by Healthy Eating Index (HEI)-2015, it was shown that adherence to a poor quality dietary pattern was related to odds of RA among older adults (17). Previous studies have examined the relationship between HEI and the odds of RA and it should be mentioned that to our knowledge there is no data on the association of the HEI-2015 and RA disease activity.…”

Combined Effects of Diet and Physical Activity on Inflammatory Joint Disease: A Systematic Review and Meta-Analysis

“…Three of the included studies in the current systematic review were RCT [23,25,28], three were CT [21,29,30], and the remaining studies were epidemiological. Ten studies referred to RA patients [21][22][23]25,28,[30][31][32][33][34], while two studies [29,31] referred to SpA. One study was an epidemiological design study that used a sample of the general population to identify associations of the combination of diet/nutrition and physical activity with selfreported RA [33].…”