EULAR systematic review concludes that dietary interventions aren’t likely to help common rheumatoid and musculoskeletal conditions.
There’s no good evidence to suggest any diet interventions help against the progression of common rheumatic and musculoskeletal conditions, according to a major analysis of the scientific literature.
The analysis of 24 systematic reviews of randomised controlled trials and observational studies instead found that the quality of studies was poor, and any possible benefits were small and not clinically meaningful.
“Based on the current literature, health professionals can advise people with rheumatic and musculoskeletal diseases that consuming specific dietary components is unlikely to influence the progression of their [rheumatic or musculoskeletal disease], but that it is important to maintain a healthy diet and healthy weight for general health reasons,” the authors wrote.
Dietary interventions have long been sought by people with rheumatoid and musculoskeletal problems, but evidence supporting their effects has been scant.
This prompted EULAR to gather an international taskforce in 2018 to investigate the benefits of diet, exercise, weight, smoking, alcohol and paid work on disease progression, in order to provide evidence-based recommendations around the interventions.
They analysed data on physical outcomes in people with osteoarthritis, rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, psoriatic arthritis, systemic sclerosis and gout.
The analysis of 24 systematic reviews and 150 original studies published from January 2013 to September 2018 covered 83 different dietary exposures, mostly involving osteoarthritis and rheumatoid arthritis cohorts.
“Exposures that have been assessed by multiple, well-conducted studies (e.g. osteoarthritis: vitamin D, chondroitin, glucosamine; rheumatoid arthritis: omega-3) were classified as moderate evidence of small effects on disease progression,” the authors wrote.
For lupus and psoriatic arthritis, the researchers determined that the quality of evidence for fish oil was moderate, and that there was no evidence it benefited either condition.
All other research into dietary interventions for lupus, systemic sclerosis, axial spondyloarthritis and gout was rated “poor”.
“Therefore, based on the current evidence, there is no single dietary intervention which has substantial benefits on the outcomes of people with OA and RA,” they continued. “While there have been far fewer research studies published for the other included RMDs, again there is no consistent evidence that any dietary exposure significantly improves outcomes in these conditions.”
Not only were there limited studies, but the authors considered many of the studies had a moderate or high risk of bias.
The review was used to inform the 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal disease.
