Background:The Mediterranean diet (MD) has proven beneficial in a large number of chronic diseases. The relationship between the MD and rheumatic diseases is complex and there are few studies that have studied this relationship. These show that there could be a positive association between adherence to the Mediterranean diet (MD-A) and a lower prevalence of OA. In the case of RA, it has been proposed that the MD could reduce pain and improve functionality.Objectives:To determine the MD-A diet of patients with RA and OA, and compare it with that of healthy subjects.Methods:Multicenter, cross-sectional, observational study. Patients who attend the rheumatology outpatient and meet the ACR / EULAR 2010 criteria for RA and ACR for OA of hands, knees or hips are included in the study. The healthy are recruited among health personnel and companions of patients who do not live in the same address as the patient. The study is being carried out in the rheumatology consultations of two Hospitals and an outpatient center with specialized care. All participants have answered a survey of 14 questions (MEDAS-14), based on the Predimed study, which assesses MD-A. Fisher’s exact test and the Mann-Whitney U test have been used to assess statistical significance. The study was approved by the Clinical Ethics and Research Committee of the centers.Results:There have been 279 surveys (132 RA, 82 OA and 65 healthy). The MD-A in patients with RA is lower than in healthy (6.26 vs. 7.15, p <0.05). Patients with OA also have less adherence to the MD than healthy ones but this difference is not statistically significant (6.85 vs. 7.15, p> 0.05). The proportion of patients with RA and OA who consume 2 or more servings of vegetables daily is lower than that of healthy subjects (RA 20%; OA 13% and healthy 34%, p <0.05). The proportion of RA and OA that eats more than 3 weekly servings of nuts compared to healthy is also lower (RA 21%, OA 17%, healthy 35% p <0.05). The proportion of RA and OA that consume less than 1 serving of butter is lower than that of healthy (RA 86%; OA 82% and 98%, p <0.05). The proportion of RA that consumes 3 or more servings of legumes per week is lower than healthy (23% vs 40%, p <0.05). These differences between the OA group and healthy are not appreciated. The consumption of more than three pieces of fruit daily is more frequent in OA than in healthy ones (45% vs 26%, p <0.05).Conclusion:The MD-A diet quantified by MEDAS-14 in subjects with RA and OA is lower than in healthy subjects, being significant in RA. Patients with RA and OA eat less vegetables and nuts but the intake of butter is higher. The RA group consumes less legumes than healthy ones. Patients with OA eat more fruit than healthy ones, this is the only food in the MD valued by MEDAS-14 that is consumed in a lower proportion in healthy ones. Longitudinal intervention studies are necessary to assess whether the differences observed in this study have any causal relationship.References:[1]Estruch R, Ros E, Salas-Salvadó J, Covas M-I, Corella D, Arós F, et al. Primary prevention of cardiovascular disease with a Mediterranean diet. N Engl J Med. 2013;368(14):1279-90.[2]Trichopoulou A, Martínez-González MA, Tong TY, Forouhi NG, Khandelwal S, Prabhakaran D, et al. Definitions and potential health benefits of the Mediterranean diet: views from experts around the world. BMC Med. 2014;12:112.[3]Morales-Ivorra I, Romera-Baures M, Roman-Viñas B, Serra-Majem L. Osteoarthritis and the Mediterranean Diet: A Systematic Review. Nutrients. 2018;10(8) pii: E1030. doi: 10.3390/nu10081030.[4]Forsyth C, Kouvari M, D’Cunha NM, Georgousopoulou EN, Panagiotakos DB, Mellor DD, et al. The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatol Int. 2018 May;38(5):737–47.Disclosure of Interests:None declared
Osteoarthritis and the Mediterranean Diet: A Systematic Review