Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

James M Gwinnutt, Maud Wieczorek, Javier Rodríguez-Carrio, Andra Balanescu, Heike A Bischoff-Ferrari, Annelies Boonen, Giulio Cavalli, Savia de Souza, Annette de Thurah, Thomas E Dorner, Rikke Helene Moe, Polina Putrik, Lucía Silva-Fernández, Tanja Stamm, Karen Walker-Bone, Joep Welling, Mirjana Zlatković-Švenda, Francis Guillemin, Suzanne M M Verstappen

Research output: Contribution to journalReview articlepeer-review

Abstract

BACKGROUND: A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed.

METHODS: Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage).

RESULTS: In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression.

CONCLUSION: The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.

Original languageEnglish
Article numbere002167
Number of pages17
JournalRMD Open
Volume8
Issue number2
DOIs
Publication statusPublished - Jun 2022

Keywords

  • Arthritis, Rheumatoid
  • Diet
  • Humans
  • Life Style
  • Muscular Diseases
  • Musculoskeletal Diseases/epidemiology
  • Osteoarthritis/epidemiology
  • Rheumatic Diseases/epidemiology
  • VITAMIN-D SUPPLEMENTATION
  • LUPUS-ERYTHEMATOSUS
  • RANDOMIZED DOUBLE-BLIND
  • epidemiology
  • MEDITERRANEAN-TYPE DIET
  • arthritis
  • FISH OIL SUPPLEMENTATION
  • KNEE OSTEOARTHRITIS DATA
  • ARTHRITIS PATIENTS
  • patient reported outcome measures
  • POLYUNSATURATED FATTY-ACIDS
  • PLACEBO-CONTROLLED TRIAL
  • QUALITY-OF-LIFE

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