Boaz Palterer, Gianfranco Vitiello, Bernardo D'onofrio, Emanuele Vivarelli, Daniele Cammelli, Maria Grazia Giudizi, Laura Martinez-Prat, Silvia Casas, Chelsea Bentow, Michael Mahler, Paola Parronchi
2019 Poster Presentations   unpublished
The Mediterranean diet (MD), widespread in Southern European countries, mainly consists of olive oil, cereal products, fresh or dried fruit and vegetables, nuts, a moderate amount of dairy and meat, and many condiments and spices. It has been associated with significant reduction of overall mortality, cardiovascular diseases, and neoplastic diseases. It has been suggested to have a beneficial effect on rheumatoid arthritis (RA) activity due to its richness in antioxidants and unsaturated fatty
more » ... cids. However, data on MD as a prevention of RA are limited. Objectives: To assess the association between adherence to MD and risk of RA in a general population cohort. Methods: The E3N cohort study (Etude Epidémiologique auprès des femmes de la Mutuelle générale de l'Education Nationale) is a French prospective cohort of 98,995 healthy women included in 1990-91 and followed since then (median follow-up of 28 years). Among women who completed a food-frequency questionnaire, we calculated the modified MD score (from 0 to 9) according to the consumption status of nine food components. Incident RA cases were detected using a validation process using a specific validation questionnaire and a drug reimbursement database. Hazard ratios (HRs) and 95% confidence intervals (CIs) for incident RA were estimated using Cox proportional hazards regression models with age as the time scale, and adjusting for known risk factors of RA and potential confounders. Because of the known importance of smoking on RA risk, we performed analyses adjusted and stratified on the smoking status. Results: Among 62,630 women, 480 validated incident RA cases were diagnosed after a mean (± standard deviation) of 11.7 (± 5.9) years after the food-frequency questionnaire. In the whole population, high adherence to MD was not associated with a decreased risk of RA (HR for a 6-9 vs. 0-3 score = 0.86, 95% CI: 0.68À1.09, P linear trend = 0.11). However, among ever-smoking women (current or past smokers), high adherence to MD was associated with a decreased risk of RA (HR for a 6-9 vs. 0-3 score = 0.77, 95% CI: 0.53À1.05; P linear trend = 0.025), while there was no association in non-smokers (HR for a 6-9 vs. 0-3 score = 0.98, 95% CI: 0.70À1.38, P linear trend = 0.90). HR (95% IC) for RA according to the MD score MD score [0-3] [4-5] [6-9] P for trend All population (N = 62,630) Cases no./person-years, no. 152/372,306 211/575,893 118/325,196 Age adjusted 1 0.89 (0.72-1.10) 0.86 (0.68-1.09) 0,11 Multivariate* 1 0.89 (0.72-1.10) 0.86 (0.67-1.10) 0,1098 Ever smokers (N = 29,072) Cases no./person-years, no. 73/165,745 101/270,722 57/154,709 Age adjusted 1 0.78 (0.58-1.04) 0.74 (0.53-1.05) 0,0247 Multivariate* 1 0.79 (0.58-1.06) 0.77 (0.54-1.09) 0,0444 Non smokers (N = 33,558) Cases no./person-years, no. 73/206,562 110/305,171 61/170,488 Age adjusted 1 1.01 (0.75-1.36) 0.98 (0.70-1.38) 0,9011 Multivariate* 1 0.99 (0.74-1.34) 0.96 (0.68-1.35) 0,7725 * HRs were adjusted for age, educational level, body mass index, smoking status, passive smoking during childhood, energy intake, physical activity, gastrointestinal transit. Conclusion: High adherence to a MD could reduce RA risk in eversmoking women. Further studies are needed to confirm our findings. Acknowledgement: We would like to thank the Foundation for Research in Rheumatology (FOREUM) and the French Rheumatology Society (SFR) for their financial support.
doi:10.1136/annrheumdis-2019-eular.4781 fatcat:5mzl7rbavfbhtbffjzxsxsbrdy