Intake frequency of vegetables or seafoods negatively correlates with disease activity of rheumatoid arthritis

PLoS One. 2020 Feb 13;15(2):e0228852. doi: 10.1371/journal.pone.0228852. eCollection 2020.

Abstract

Objective: To clarify the relationship between dietary habit and disease activity of rheumatoid arthritis (RA).

Methods: This study enrolled RA patients who met the ACR/EULAR 2010 classification criteria from Kyoto University Rheumatoid Arthritis Management Alliance (KURAMA) cohort in 2015. 22-item food frequency questionnaire (FFQ) was taken for the measurement of dietary habit in a single-institution cohort of RA (Kyoto University Rheumatoid Arthritis Management Alliance: KURAMA) in 2015. The disease activities of RA using the Disease Activity Score calculated based on the erythrocyte sedimentation rate (DAS28-ESR), Simplified Disease Activity Index (SDAI), Health Assessment Questionnaire (HAQ), and serum matrix metalloproteinase-3 (MMP-3) level, the use of disease-modifying anti-rheumatic drugs (DMARDs), disease duration, rheumatoid factor, anti-cyclic citrullinated antibody, and body mass index were also examined. All of them were combined and statistically analyzed.

Results: 441 RA patients (81% women; mean age 65 years; mean disease duration 15 years) were enrolled from the KURAMA cohort. Average Disease Activity Score-28 using the erythrocyte sedimentation rate (DAS28-ESR) was 2.7. Univariate analysis showed that intake frequency of vegetables had a statistically significant negative correlation with disease activity markers, such as DAS28-ESR (ρ = -0.11, p<0.01), Simplified Disease Activity Index (SDAI) (ρ = -0.16, p<0.001), matrix metalloproteinase-3 (MMP-3) (ρ = -0.21, p<0.0001), and Health Assessment Questionnaire (HAQ) (ρ = -0.13, p<0.01). Factor analysis with varimax rotation was done to simplify the relevance of disease activity to various food items. 22 foods were categorized into five dietary patterns: "seafoods", "vegetables/fruits", "meats/fried foods", "snacks", and "processed foods". The multivariate analysis adjusted for clinically significant confounders showed that "seafoods" had statistically significant negative correlations with DAS28-ESR (β = -0.15, p<0.01), SDAI (β = -0.18, p<0.001), MMP-3 (β = -0.15, p<0.01), and HAQ (β = -0.24, p<0.0001). "Vegetables/fruits" had statistically significant negative correlations with SDAI (β = -0.11 p<0.05), MMP-3 (β = -0.12, p<0.01), and HAQ (β = -0.11, p<0.05).

Conclusions: These results suggest that high intake frequency of vegetables/fruits and/or seafoods might correlate with low disease activity.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / metabolism*
  • Blood Sedimentation / drug effects
  • Cohort Studies
  • Feeding Behavior / physiology
  • Female
  • Humans
  • Male
  • Matrix Metalloproteinase 3 / analysis
  • Matrix Metalloproteinase 3 / blood
  • Middle Aged
  • Nutrients / therapeutic use*
  • Seafood / analysis
  • Severity of Illness Index
  • Vegetables / metabolism

Substances

  • Matrix Metalloproteinase 3

Grants and funding

Source of funding in this study was obtained from Grants-in-Aid for Scientific Research (KAKENHI) Research (C), 2017-2019 (17K10000, Kosaku Murakami). The Department of Advanced Medicine for Rheumatic Diseases is supported by Nagahama City, Shiga, Japan and four pharmaceutical companies (Mitsubishi Tanabe Pharma Co., Chugai Pharmaceutical Co. Ltd, UCB Japan Co. Ltd, and AYUMI Pharmaceutical Co.). KURAMA cohort study is supported by grant from Daiichi Sankyo Co. Ltd. These companies had no role in the design of the study, the collection or analysis of the data, the writing of the manuscript or decision to submit the manuscript for the publication.