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  1. D. Fedkov1,
  2. C. Peine2,
  3. F. Lang3
  1. 1Bogomolets National Medical University, Internal Medicine #3, Kyiv, Ukraine
  2. 2Midaia GmbH, Research and Development, Heidelberg, Germany
  3. 3Midaia GmbH, Product Development, Heidelberg, Germany


Background Recently, diet and nutrients have received considerable attention as potential precipitating factors and exacerbation triggers of inflammatory arthritis.

Objectives To evaluate the associations of diet with disease activity and fatigue in patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA, including psoriatic arthritis [PsA]).

Methods Data of German patients with RA, SpA/ PsA were prospectively collected by the Mida Rheuma App (CE-certified mobile application, Midaia GmbH, Germany) from Jan 2022 to Dec 2022. Anonymized data of patients were extracted for retrospective analysis.

We assessed demographic parameters, major dietary patterns, and food groups by each patient’s consumption intensity. Consumption of dairy products, fruits, vegetables, sausages, meat, oily fish, white fish, sugar, and alcohol was collected. For each group, participants were asked how often, on average, they had consumed the foods and beverages, with four or five responses ranging from “never” to ‘4–5 times per day/per week or every day’. The presence of lactose, gluten, and fructose intolerance was also assessed. Disease activity was measured by Patient’s Global Assessment of Disease Activity (PtGADA, scored from 0 to 100 mm) and Patient’s Global Assessment of Pain Intensity (PPAIN, scored from 0 to 100 mm). Fatigue was assessed by The Brief Fatigue Inventory (BFI, scored from 0 to 10 points). Patients were divided into subgroups to evaluate associations depending on the food group, and the high-consumption group (HCG) was compared with the low-consumption group (LCG). Patients on a specific diet were compared with the ‘eat all group’ (EAG). The differences in the data sets were examined for their significance using t-test, p-value ≤ 0.05 was considered statistically significant.

Results Of 1564 extracted patients, 774 completed diet questionnaires. These were included in the analysis (480 RA, SpA: 180 axSpA, 61 PsA, 53 - combination of two arthritis). 79.8% of patients were female, 19.5% - male, and 0.7% - another gender; the mean age was 42.8±12.6 years. The mean PtGADA, PPAIN, and BFI were 55.7±26.7, 52.6 ±26.5, and 5,17±1,98.

According to dietary patterns, 432 (55.8%) patients were included in EAG, 21.6% were on a vegan/vegetarian diet (4.8%/16.8%), 15,5% - Mediterranean, and 7.1% - low-carb diet; 8.4% had lactose, gluten, fructose intolerance or their combinations.

The Mediterranean diet group had statistically significant lower PtGADA and PPAIN (by 8.98%, p=00.4 and 14.3%, p=0.007 respectively), compared with EAG. Vegan/vegetarian and low-carb diet groups demonstrated only positive trends for PtGADA, PPAIN, and BFI vs. EAG. At the same time, fruit and vegetable HCGs showed negative trends for all outcomes compared with LCGs. Negative trends were also found for dairy products, meat, and sugar, with the most substantial difference for sugar (10.1%, 7.92% and 8.67% for PtGADA, PPAIN and BFI, respectively). Statistically significant higher PtGADA, PPAIN and BFI were in sausage HCG vs. LCG: 16.4%, p=0.01, 15.6%, p=0.02, and 11.8%, p=0.03 for PtGADA, PPAIN and BFI respectively. Statistically significant lower PtGADA and PPAIN were in oily fish HCG vs. LCG (18.1%, p=0.01, and 17.1%, p=0.03, respectively). However, for white fish, this difference was not demonstrated.

Conclusion According to the presented data high processed meat consumption is potentially associated with higher disease activity and fatigue, while the Mediterranean diet and high oily fish consumption – with low disease activity. These findings highlight the importance of future research and the potential of dietary interventions in patients with inflammatory arthritis.


Acknowledgements: NIL.

Disclosure of Interests Dmytro Fedkov Shareholder of: Midaia GmbH, Speakers bureau: MSD, Pfizer, Novartis, Janssen, Pro-pharma, Employee of: Midaia GmbH, Christine Peine Shareholder of: Midaia GmbH, Employee of: Midaia GmbH, Felix Lang Shareholder of: Midaia GmbH, Employee of: Midaia GmbH.

  • Inflammatory arthritides
  • Diet and nutrition

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