ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1213

Prospective Study of Dietary Patterns and Risk of Rheumatoid Arthritis in Women

Bing Lu1, Yang Hu2, Jeffrey A. Sparks3, Karen H. Costenbader4, Frank Hu5 and Elizabeth W. Karlson1, 1Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 2Nutrition, Harvard School of Public Health, Boston, MA, 3Division of Rheumatology, Immunology, and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 4Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, 5Harvard School of Public Health, Boston, MA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Monday, November 9, 2015

Session Title: Epidemiology and Public Health Poster II: Pathogenesis and Treatment of Systemic Inflammatory Diseases

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose: Although some individual dietary factors have been identified to be associated with the development of rheumatoid arthritis (RA), few studies have examined the effects of overall eating patterns on RA. We examined overall dietary patterns in relation to the risk of RA in a large prospective cohort, the Nurses’ Health Study II (NHSII).

Methods:   We prospectively followed 93,859 women free of RA at baseline who provided dietary data from 1991 to 2011 in the NHS II. Dietary data were obtained from validated food frequency questionnaires in 1991 and every 4 years during follow-up. Two dietary patterns were identified using principal component analysis: the Prudent dietary pattern characterized by high intakes of fruit, vegetables, legumes, whole grains, poultry, and fish; the Western pattern characterized by high intakes of red meats, processed meats, refined grains, French fries, desserts and sweets, and high-fat dairy products. The cumulative average pattern scores over time were categorized into quartiles. Incident RA cases were validated by medical record review. Time-varying Cox proportional hazards models were used to calculate hazard ratios (HR) after adjusting for age, census-track income, smoking, body mass index (BMI), total calories, alcohol use and physical activity. 

Results : During 1,509,033 person-years of follow-up, 626 incident cases of RA developed with the mean diagnosis age of 49. In the multivariable adjusted model, the Prudent pattern was associated with a reduced risk of RA, while the Western pattern was associated with an increased risk of RA (Table). The HRs (95% CI) across increasing quartiles of the Prudent pattern score were 1.00, 0.81(0.60,1.09),0.69(0.51,0.95), and 0.71(0.52,0.98) (p trend 0.04), and for the Western pattern, HRs ((95% CI) were 1.00, 1.41(1.01,1.98), 1.61(1.14,2.27),  and 1.57(1.09,2.67) (p trend 0.03). After additional adjustment for BMI, the associations were attenuated.

Conclusion: In this female cohort study, dietary patterns were association with RA risk. A negative association was found between a Prudent diet rich in fruit, vegetables, and fish, and the risk of RA, whereas a positive association was found between a Western diet rich in refined grains, processed and red meats, desserts, and French fries, and the risk of RA. Further analysis of BMI as a potential confounder or mediator of these associations is warranted.

Table.  Hazard ratios (95% CIs) of rheumatoid arthritis according to dietary pattern scores in the Nurses’ Health Study II (1991-2011)1

Dietary pattern scores (quartiles)

p for trend2

Q1

Q2

Q3

Q4

Prudent Pattern

  Cases/ Person-years

93 / 368,986

84 / 379,428

77 / 382,024

87 / 378,595

  Age-adjusted HR (95% CI)

1.00

0.81(0.60,1.09)

0.72(0.53,0.97)

0.78(0.58,1.05)

0.11

  Multivariable HR (95% CI)3

1.00

0.81(0.60,1.09)

0.69(0.51,0.95)

0.71(0.52,0.98)

0.04

  Multivariable HR (95% CI)4

1.00

0.82(0.60,1.10)

0.72(0.52,0.98)

0.74(0.54,1.02)

0.08

Western Pattern

  Cases/ Person-years

60/371125

85/378,206

97/381,583

99/378,119

  Age-adjusted HR (95% CI)

1.00

1.40(1.00,1.94)

1.60(1.16,2.21)

1.70(1.23,2.34)

<0.01

  Multivariable HR (95% CI)3

1.00

1.41(1.01,1.98)

1.61(1.14,2.27)

1.57(1.09,2.67)

0.03

  Multivariable HR (95% CI)4

1.00

1.35(0.96,1.90)

1.49(1.06,2.11)

1.40(0.96,2.03)

0.13

1Hazard ratios were calculated by using time-varying Cox proportional hazards models.

2p for trend was derived from tests of linear trend across categories of dietary pattern scores by treating the median value of each category as a continuous variable.

3 Adjusted for age, smoking (pack-years), total calories intake. Additional adjustment for census tract median family income, alcohol use and physical activity did not change the statistical significance.

4Additional adjustment for BMI (kg/m2; <25, 25–29.9, or ≥30).

Disclosure: B. Lu, None; Y. Hu, None; J. A. Sparks, None; K. H. Costenbader, None; F. Hu, None; E. W. Karlson, None.

To cite this abstract in AMA style:

Lu B, Hu Y, Sparks JA, Costenbader KH, Hu F, Karlson EW. Prospective Study of Dietary Patterns and Risk of Rheumatoid Arthritis in Women [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/prospective-study-of-dietary-patterns-and-risk-of-rheumatoid-arthritis-in-women/. Accessed June 25, 2022.

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