Adherence to a Mediterranean diet and severity of pain and gastrointestinal symptoms in people with Rheumatoid Arthritis: A cross-sectional analysis

Summary: Background: Diet quality may be an important modifiable risk factor for managing the intensity of symptoms and disease progression in people with Rheumatoid Arthritis (RA). Therefore, the objective of this study was to explore the independent associations between adherence to a Mediterranean diet (MedDiet) and severity of pain and gastrointestinal (GI) symptoms in adults with RA. Methods: This was a cross-sectional online survey of community-dwelling adults (≥18 years) with a confirmed medical diagnosis of RA. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS); the Rheumatoid Arthritis Pain Scale (RAPS) was used to assess the intensity of pain; and severity of GI symptoms was assessed using the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS). Results: A total of n = 80 participants commenced the online questionnaire (67 female; 12 males; 1 unspecified, 54.7 ± 13.8 years; BMI 29.1 ± 7.2 kg/m2), of which n = 70 completed in full and were included in the final analyses. Participants reported a low-moderate MedDiet adherence (4.9 ± 2.3; range: 1–11) and reported moderate levels of pain (RAPS: 81.4 ± 3.8; range: 0–144) and a low severity of GI symptoms (SAGIS: 10 (19); range 0–51). After adjusting for age, gender, BMI, physical activity duration, years active with disease and use of antirheumatic prescription medication, we found that MedDiet adherence was not related to pain (β: -0.10; 95 % CI: -0.02, 0.01; P = 0.44) or severity of GI symptoms (β: -0.09; 95 % CI: 0.06, 0.03; P = 0.49). Conclusion: Adherence to a MedDiet was not related to severity of pain or GI disturbances in this sample of RA participants. Nevertheless, further exploration of how diet and nutrition can attenuate RA progression and symptom management is important for the development of evidence-based guidelines and dietary recommendations for patients with RA.