Effects on health-related quality of life in the randomized, controlled crossover trial ADIRA (Anti-inflammatory Diet In Rheumatoid Arthritis)

• Published in: PloS one 2021-10, Vol.16 (10), p.e0258716-e0258716
• Main Authors: Turesson Wadell, Anna, Bärebring, Linnea, Hulander, Erik, Gjertsson, Inger, Hagberg, Lars, Lindqvist, Helen M, Winkvist, Anna
• Format: Article
• Language: English
• Subjects: administration & dosage; Aged; Anti-Inflammatory Agents; Anti-inflammatory diet; Arthritis; Biology and Life Sciences; Cooking; Cross-Over Studies; Diet; Diet therapy; Dietary supplements; Disease; Drug therapy; Evaluation; Fatigue; Fatty acids; Female; Food; Fruits; Grain; Health aspects; Health Surveys; Humans; Inflammation; Internal medicine; Male; Meals; Medicine; Medicine and Health Sciences; Middle Aged; Nutrition and Dietetics; Nutrition research; Näringslära; Pain; Pain Measurement; Patient Reported Outcome Measures; Patients; pharmacology; Physical Sciences; Physiological aspects; Prebiotics; Probiotics; Proteins; Quality of Life; Questionnaires; Remission (Medicine); Reumatologi och inflammation; Rheumatoid; Rheumatoid arthritis; Rheumatology; Rheumatology and Autoimmunity; Seafood; Stiffness; Sweden; Treatment Outcome
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0258716

To investigate if a proposed anti-inflammatory diet improves HrQoL in patients with RA. In this controlled crossover trial, 50 patients were randomized to start with either an intervention diet (anti-inflammatory) or a control diet (usual Swedish intake) for ten weeks followed by a wash out period before switching to the other diet. Participants received food equivalent to ~1100 kcal/day, five days/week, and instructions to consume similarly for the remaining meals. HrQoL was evaluated using Health Assessment Questionnaire (HAQ), 36-item Short Form Survey (SF-36), Visual Analogue Scales (VAS) for pain, fatigue and morning stiffness, and a time scale for morning stiffness. Forty-seven participants completed [greater than or equal to]1 diet period and were included in the main analyses. No significant difference between intervention and control diet at end of diet periods was observed for any outcome. However, significant improvements were obtained for SF-36 Physical Functioning (mean:5.79, SE: 2.12, 95% CI: 1.58, 10.01) during the intervention diet period. When excluding participants with anti-rheumatic medication changes, the differences between diet periods increased for most outcomes, favoring the intervention diet period, and the difference for SF-36 Physical Functioning became significant (n = 25, mean:7.90, 95% CI:0.56, 15.24, p = 0.036). In main analyses, the proposed anti-inflammatory diet did not significantly improve HrQoL for patients with RA compared to control diet. In sub-analyses, significant improvements in physical functioning were detected. Larger studies with consistent medication use and in populations more affected by the disease may be needed to obtain conclusive evidence.