Dietary Pattern or Weight Loss: Which One Is More Important to Reduce Disease Activity Score in Patients with Rheumatoid Arthritis? A Randomized Feeding Trial
Alireza Sadeghi, Mojtaba Tabatabaiee, Mir Ali Mousavi, Seyedeh Neda Mousavi, Somayae Abdollahi Sabet, Nooshin Jalili
Abstract
Objectives . Herein, disease activity score 28 (DAS 28) was compared between patients with rheumatoid arthritis (RA) receiving the Mediterranean dietary pattern (MD) and low‐fat diet. Subjects/Methods . Overweight and obese RA patients aged 15–75 y participated in this randomized feeding trial. Participants were randomized to MD ( n = 51) and low‐fat high‐carbohydrate diet ( n = 53) for 12 weeks. The control group followed their regular diet ( n = 50). Participants completed the form of tender and swollen joint counts before the study enrollment and after 12 weeks to compute DAS 28. Results . Weight loss was not statistically significant between the MD and LF‐HC groups. DAS 28 significantly decreased in MD compared to the LF‐HC group ( p = 0.02) and controls ( p = 0.001). Adjusting for the baseline variables, MD reduced DAS 28 by 76% (95% CI = −0.45, −0.2; p = 0.03) after 12 weeks of intervention. The baseline serum ESR level showed 99.8% effect on DAS 28 score at the end (95% CI = 0.014, 0.035; p < 0.001). Conclusions . The MD showed beneficial effects on DAS 28 compared to the LF‐HC diet in patients with RA, regardless of weight loss. It is a better dietary choice for pain reduction in patients with RA. The trial is registered at Iranian Registry of Clinical Trials ( IRCT20200929048876N2 ).