Background/Purpose: Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease affecting the joints that typically affects women more than men. An exact cause has yet to be identified, but the disease is thought to manifest due to both genetic and environmental factors. The predominant theory is that RA is an autoimmune disease with environmental triggers. Recently, diet as a risk factor for RA has become of interest. The objective of this literature review is to determine which dietary factors have an influence on developing RA by examining existing literature on this topic.

Methods: PubMed was searched for relevant articles. Articles that contained a sample size of >10, were published in the last 30 years, and were in English were included. A search was built using the following MeSH terms: “rheumatoid arthritis,” “risk factors,” “diet,” “nutritional status,” “nutrition therapy,” “nutrition assessment,” “nutrition disorders,” “diet, food, and nutrition,” and “nutritional requirements.” Each MeSH search included “rheumatoid arthritis” AND “risk factors” AND one of the aforementioned terms. The abstracts were first screened for suitability, and suitable articles were reviewed. Additional relevant articles were found from the references of reviewed articles. A total of 121 articles were reviewed and 53 were included.

Results: Because categorization of each dietary item varied across studies, ensuring consistency among categorization was necessary for data analysis. For example, alcohol intake may refer to only wine, only beer, both wine and beer, depending on the study. Variations in phrasing (e.g. “fruits” sometimes included citrus, other times it was not defined at all), methods of data collection, and cohort chosen were found. Some studies also reported results on RA risk based on RA serostatus. Thus, variation in results across studies is likely multifactorial, including number of cases and region of cohort chosen.

When the variations were considered, moderate alcohol consumption and increased β-cryptoxanthin (a carotenoid) consumption most notably reduced risk of developing RA. Increased coffee consumption may also be a risk factor for developing RA, but more studies are needed to draw conclusions. Fish, protein, red meat, vegetables, fruits, fats, dairy, other vitamins, tea, carbohydrates, legumes, flavonoids, sugary drinks, and sodium intake had variable significance or no significant association with RA risk. 

Conclusion: Moderate alcohol consumption and increased β-cryptoxanthin are protective against developing RA. Overall, specific dietary elements and their influence on RA risk is a promising topic, and significant findings may be helpful in preventing the development of RA.

« Back to 2019 ACR/ARP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/diet-as-a-risk-factor-for-rheumatoid-arthritis/