Association between nutritional status and disease activity in Tunisian patients with rheumatoid arthritis

Abstract

Background: Rheumatoid arthritis (RA) is influenced by nutritional factors: a healthy diet rich in anti-inflammatory  foods may help reduce inflammation and improve disease outcomes.

Objectives: To compare the anthropometric, nutritional, and psychological profiles of two groups: patients with mildly  active RA and patients with highly active RA.

Methods: This was a comparative cross-sectional study involving 52 patients: 35 patients with mildly active RA and 17  patients with highly active RA, all consulting the Rheumatology Department of La Rabta Hospital.

Results: the main  factors associated with the highly active RA group were significantly higher CRP levels (p=0.004), number of painful  joints (p=0.0001), number of swollen joints ( p=0.0001), number of night-time awakenings (p=0.009), duration of  morning stiffness ( p=0.003), visual analog scale for pain (EVA, p=0.004), higher global assessment of disease activity  (EGP, p=0.0001), and increased functional disability (p=0.001). We also found that the diet of our population, particularly  in the highly active RA group, was imbalanced, hypercaloric, rich in lipids, polyunsaturated fatty acids (PUFA), and  sodium, and low in fiber. Additionally, it was deficient in calcium, magnesium, iron, vitamin D, vitamin E, vitamin A,  vitamin C, folic acid, docosahexaenoic acid (DHA), and eicosapentaenoic acid (EPA). Adherence to the Mediterranean diet was also low in this group. The main factor associated with the mildly active RA group was excessive sodium intake  (p=0.01).

Conclusion: Our study revealed imbalanced diets in both the highly active and mildly active RA groups.