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Women smokers may benefit from Mediterranean diet to reduce RA risk

Publish date:: October 2, 2020

Key clinical point: The Mediterranean diet appeared to mitigate rheumatoid arthritis (RA) risk among women smokers; absolute risk was 38.3 per 100,000 person-years for smokers with high reported adherence to the Mediterranean diet and 51.5 per 100,000 person-years for smokers with low reported adherence.

Major finding: A total of 480 incident cases of RA occurred in the study population; high adherence to a Mediterranean diet was not associated with risk of RA overall (hazard ratio, 0.86; 95% confidence interval, 0.67-1.10), but was associated with significantly decreased risk among ever-smokers (HR, 0.91; 95% CI, 0.84-0.99; P = 0.03).

Study details: The data come from the E3N Study, a French prospective cohort including 98,995 women since 1990; dietary diet in this study were collected since 1993.

Disclosures: The study was supported in part by the Agence Nationale de la Recherche, FOREUM Foundation for Research in Rheumatology, and the Société Française de Rhumatologie. The researchers had no financial conflicts to disclose.

Commentary

“This prospective cohort study of more than 98,000 French women examines the number of RA cases among women reporting following a “Mediterranean diet” (MD), including fruits, nuts, legumes, fish, olive oil, and moderate alcohol consumption. Adjustments were made to the scoring of adherence to the diet due to lower amounts of olive oil consumption in non-Mediterranean populations. Incident cases of RA were not lower among women who reported more adherence to the MD. However, in an analysis of women who had ever smoked, there was a lower RA incidence rate in women adherent to the MD which was more prominent in women who reported more adherence. The significance of this finding is not clear given the HR was 0.91 [95% CI 0.84-0.91]. This study perhaps provides more support for the idea of an “anti-inflammatory diet,” but given the difference in olive oil consumption and relatively small reduction in RA incidence rates, is not yet solid evidence of the benefit of the MD in preventing RA or in reducing pain and inflammation among symptomatic RA patients.”