Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity.
Study Goal
The researchers aimed to investigate whether an anti-inflammatory diet reduces disease activity in patients with rheumatoid arthritis (RA).
Results Summary
The study found no significant difference in disease activity between the intervention and control diets in the main analysis, but unadjusted analyses showed a significant decrease in disease activity during the intervention period compared to the control period. No significant differences were observed in the individual components of disease activity.
Population
50 patients with rheumatoid arthritis (RA).
Effective Dosage
Food equivalent to ∼50% of energy requirements was delivered weekly.
Duration
10 weeks per diet period, with a 4-month washout between periods.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
an anti-inflammatory diet | no change | Disease Activity Score in 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR) | patients with RA | P = 0.116 | no significant difference | #1 |
an anti-inflammatory diet | decrease | Disease Activity Score in 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR) | patients with RA | median: 3.05; IQR: 2.41, 3.79 compared with median: 3.27; IQR: 2.69, 4.28; P = 0.04 | significantly decreased | #2 |
an anti-inflammatory diet | no change | the components of DAS28-ESR (tender and swollen joints, ESR, and visual analog scale for general health) | patients with RA | - | No significant differences | #3 |
an anti-inflammatory diet | no change | DAS28-C-reactive protein | patients with RA | - | No significant differences | #4 |
BACKGROUND: Many patients with rheumatoid arthritis (RA) report symptom relief from certain foods. Earlier research indicates positive effects of food and food components on clinical outcomes in RA, but insufficient evidence exists to provide specific dietary advice. Food components may interact but studies evaluating combined effects are lacking. OBJECTIVES: We aimed to investigate if an anti-inflammatory diet reduces disease activity in patients with RA. METHODS: In this single-blinded crossover trial, 50 patients with RA were randomly assigned to an intervention diet containing a portfolio of suggested anti-inflammatory foods, or a control diet similar to the general dietary intake in Sweden, for 10 wk. After a 4-mo washout period the participants switched diet. Food equivalent to ∼50% of energy requirements was delivered weekly to their homes. For the remaining meals, they were encouraged to consume the same type of foods as the ones provided during each diet. Primary outcome was change in Disease Activity Score in 28 joints-Erythrocyte Sedimentation Rate (DAS28-ESR). Secondary outcomes were changes in the components of DAS28-ESR (tender and swollen joints, ESR, and visual analog scale for general health) and DAS28-C-reactive protein. RESULTS: In the main analysis, a linear mixed ANCOVA model including the 47 participants completing ≥1 diet period, there was no significant difference in DAS28-ESR between the intervention and control periods (P = 0.116). However, in unadjusted analyses, DAS28-ESR significantly decreased during the intervention period and was significantly lower after the intervention than after the control period in the participants who completed both periods (n = 44; median: 3.05; IQR: 2.41, 3.79 compared with median: 3.27; IQR: 2.69, 4.28; P = 0.04, Wilcoxon's Signed Rank test). No significant differences in the components were observed. CONCLUSIONS: This trial indicates positive effects of a proposed anti-inflammatory diet on disease activity in patients with RA. Additional studies are required to determine if this diet can cause clinically relevant improvements.This trial was registered at clinicaltrials.gov as NCT02941055.