Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Meta-Analysis
. 2022 Jun;8(2):e002167.
doi: 10.1136/rmdopen-2021-002167.

Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

James M Gwinnutt  1 , Maud Wieczorek  2   3 , Javier Rodríguez-Carrio  4   5 , Andra Balanescu  6 , Heike A Bischoff-Ferrari  3   7   8 , Annelies Boonen  9   10 , Giulio Cavalli  11 , Savia de Souza  12 , Annette de Thurah  13   14 , Thomas E Dorner  15   16   17 , Rikke Helene Moe  18 , Polina Putrik  9   10 , Lucía Silva-Fernández  19 , Tanja Stamm  20   21 , Karen Walker-Bone  22 , Joep Welling  23 , Mirjana Zlatković-Švenda  24   25 , Francis Guillemin  2   26 , Suzanne M M Verstappen  27   22   28
Affiliations
Meta-Analysis

Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs

James M Gwinnutt et al. RMD Open. 2022 Jun.

Abstract

Background: A EULAR taskforce was convened to develop recommendations for lifestyle behaviours in rheumatic and musculoskeletal diseases (RMDs). In this paper, the literature on the effect of diet on the progression of RMDs is reviewed.

Methods: Systematic reviews and meta-analyses were performed of studies related to diet and disease outcomes in seven RMDs: osteoarthritis (OA), rheumatoid arthritis (RA), systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout. In the first phase, existing relevant systematic reviews and meta-analyses, published from 2013 to 2018, were identified. In the second phase, the review was expanded to include published original studies on diet in RMDs, with no restriction on publication date. Systematic reviews or original studies were included if they assessed a dietary exposure in one of the above RMDs, and reported results regarding progression of disease (eg, pain, function, joint damage).

Results: In total, 24 systematic reviews and 150 original articles were included. Many dietary exposures have been studied (n=83), although the majority of studies addressed people with OA and RA. Most dietary exposures were assessed by relatively few studies. Exposures that have been assessed by multiple, well conducted studies (eg, OA: vitamin D, chondroitin, glucosamine; RA: omega-3) were classified as moderate evidence of small effects on disease progression.

Conclusion: The current literature suggests that there is moderate evidence for a small benefit for certain dietary components. High-level evidence of clinically meaningful effect sizes from individual dietary exposures on outcomes in RMDs is missing.

Keywords: arthritis; epidemiology; patient reported outcome measures.

PubMed Disclaimer

Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Flowchart of search strategy to identify published systematic reviews and meta-analyses. *Embase search excluded journals included in Medline.
Figure 2
Figure 2
PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) flowchart for review of individual studies of diet. *Embase search excluded journals included in Medline.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Smolen JS, Aletaha D, Barton A, et al. . Rheumatoid arthritis. Nat Rev Dis Primers 2018;4:18001. 10.1038/nrdp.2018.1 - DOI - PubMed
    1. Martel-Pelletier J, Barr AJ, Cicuttini FM, et al. . Osteoarthritis. Nat Rev Dis Primers 2016;2:16072. 10.1038/nrdp.2016.72 - DOI - PubMed
    1. Kaul A, Gordon C, Crow MK, et al. . Systemic lupus erythematosus. Nat Rev Dis Primers 2016;2:16039. 10.1038/nrdp.2016.39 - DOI - PubMed
    1. March L, Smith EUR, Hoy DG, et al. . Burden of disability due to musculoskeletal (MSK) disorders. Best Pract Res Clin Rheumatol 2014;28:353–66. 10.1016/j.berh.2014.08.002 - DOI - PubMed
    1. GBD 2019 Diseases and Injuries Collaborators . Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet 2020;396:1204–22. 10.1016/S0140-6736(20)30925-9 - DOI - PMC - PubMed

Publication types

Supplementary concepts