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
. 2021 Nov 24;13(12):4221.
doi: 10.3390/nu13124221.

Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Katja A Schönenberger  1   2 , Anne-Catherine Schüpfer  1 , Viktoria L Gloy  3 , Paul Hasler  4 , Zeno Stanga  1 , Nina Kaegi-Braun  5 , Emilie Reber  1
Affiliations
Meta-Analysis

Effect of Anti-Inflammatory Diets on Pain in Rheumatoid Arthritis: A Systematic Review and Meta-Analysis

Katja A Schönenberger et al. Nutrients. .

Abstract

Various nutritional therapies have been proposed in rheumatoid arthritis, particularly diets rich in ω-3 fatty acids, which may lead to eicosanoid reduction. Our aim was to investigate the effect of potentially anti-inflammatory diets (Mediterranean, vegetarian, vegan, ketogenic) on pain. The primary outcome was pain on a 10 cm visual analogue scale. Secondary outcomes were C-reactive protein levels, erythrocyte sedimentation rate, health assessment questionnaire, disease activity score 28, tender/swollen joint counts, weight, and body mass index. We searched MEDLINE (OVID), Embase (Elsevier), and CINAHL for studies published from database inception to 12 November 2021. Two authors independently assessed studies for inclusion, extracted study data, and assessed the risk of bias. We performed a meta-analysis with all eligible randomized controlled trials using RevMan 5. We used mean differences or standardized mean differences and the inverse variance method of pooling using a random-effects model. The search retrieved 564 unique publications, of which we included 12 in the systematic review and 7 in the meta-analysis. All studies had a high risk of bias and the evidence was very low. The main conclusion is that anti-inflammatory diets resulted in significantly lower pain than ordinary diets (-9.22 mm; 95% CI -14.15 to -4.29; p = 0.0002; 7 RCTs, 326 participants).

Keywords: Mediterranean diet; anti-inflammatory diet; arthralgia; ketogenic diet; pain; rheumatoid arthritis; vegan diet; vegetarian diet.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram (according to [16]).
Figure 2
Figure 2
Forest plot summarizing the effect of anti-inflammatory diets on pain.
Figure 3
Figure 3
Forest plot summarizing the effect of anti-inflammatory diets on C-reactive protein levels.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Smolen J.S., Aletaha D., Barton A., Burmester G.R., Emery P., Firestein G.S., Kavanaugh A., McInnes I.B., Solomon D.H., Strand V., et al. Rheumatoid arthritis. Nat. Rev. Dis. Primers. 2018;4:18001. doi: 10.1038/nrdp.2018.1. - 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;396:1204–1222. doi: 10.1016/S0140-6736(20)30925-9. - DOI - PMC - PubMed
    1. Genel F., Kale M., Pavlovic N., Flood V.M., Naylor J.M., Adie S. Health effects of a low-inflammatory diet in adults with arthritis: A systematic review and meta-analysis. J. Nutr. Sci. 2020;9:e37. doi: 10.1017/jns.2020.31. - DOI - PMC - PubMed
    1. Calder P.C. n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am. J. Clin. Nutr. 2006;83:1505S–1519S. doi: 10.1093/ajcn/83.6.1505S. - DOI - PubMed
    1. Forsyth S., Gautier S., Salem N., Jr. Global Estimates of Dietary Intake of Docosahexaenoic Acid and Arachidonic Acid in Developing and Developed Countries. Ann. Nutr. Metab. 2016;68:258–267. doi: 10.1159/000446855. - DOI - PubMed

Substances