Beverages in Rheumatoid Arthritis: What to Prefer or to Avoid

Abstract

Background: The role of nutrition in the pathogenesis of rheumatic diseases, including rheumatoid arthritis (RA), has gained increasing attention in recent years. A growing number of studies have focussed on the diverse nutritional contents of beverages, and their possible role in the development and progression of RA. Main body: We aimed to summarise the current knowledge on the role of a range of beverages in the context of RA. Beverages have a key role within the mosaic of autoimmunity in RA and potential to alter the microbiome, leading to downstream effects on inflammatory pathways. The molecular contents of beverages, including coffee, tea, and wine, have similarly been found to interfere with immune signalling pathways, some beneficial for disease progression and others less so. Finally, we consider beverages in the context of wider dietary patterns, and how this growing body of evidence may be harnessed by the multidisciplinary team in patient management. Conclusions: While there is increasing work focussing on the role of beverages in RA, integration of discussions around diet and lifestyle in our management of patients remains sparse. Nutrition in RA remains a controversial topic, but future studies, especially on the role of beverages, are likely to shed further light on this in coming years.

A Posteriori Dietary Patterns and Rheumatoid Arthritis Disease Activity: A Beneficial Role of Vegetable and Animal Unsaturated Fatty Acids

“…The remaining part of the sample likely experienced a statistically significant protective effect of dairy products and meat, which was attenuated by the subgroup of patients showing allergies. Analyses on the consumption of milk and dairy products as risk factors for RA development yielded inconclusive results too (see [ 63 ] for recent null results based on the Swedish Mammography Cohort Study and [ 64 ] for a recent summary of the evidence on the effects of milk).…”

“…Soluble carbohydrates derived from fresh and processed fruit are likely to have a detrimental effect on RA disease activity. Likewise, De Christopher [ 65 ] discussed the role of ingested fructose leading to the formation of advanced glycation end products that travel beyond the intestinal boundaries to other tissues and may play a role in the etiology of auto-immune arthritis [ 64 , 66 ]. To integrate our results, higher intakes of fruit were also found to decrease the OR of remission in the TOMORROW study (OR = 0.49, 95% CI: 0.47–0.92), thus suggesting a trend similar to our study in their main analysis [ 25 ].…”

The Association between Dietary Inflammation Index and Rheumatoid Arthritis in Americans: a cross-sectional study

“…Although a large number of studies support the impact of a single diet on RA [25][26][27][28] , the complexity of the human diet, genetic differences, and the variability of the external environment determines that a single nutrient may not play an important role in the onset and development of RA. Therefore, in this study, DII was used to quantify the in ammatory potential of individual dietary intake, logistic regression was used to study whether there was an association between DII and RA risk, and the degree of association.…”

The Role of Nutritional Factors and Intestinal Microbiota in Rheumatoid Arthritis Development

“…An appealing hypothesis would be that these dietary factors are effective by modifying the gut microbiota and modulating the intestinal barrier integrity, thus changing the antigenic load and subsequent immune dysregulation. While the evidence suggesting a role of nutritional factors in RA disease progression and outcomes is increasing, randomized trials with “anti-inflammatory” diets in established RA have only shown modest effects [ 147 , 148 , 149 ]. Bustamante et al are attempting an approach that would optimize the nutritional strategy based on evidence [ 150 ].…”