Systematic review and meta-analyses informing the new EULAR recommendations

In 2022, EULAR – the European Alliance of Rheumatology Associations – published new recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases (RMDs). Alongside these recommendations, the society has also made public the collated evidence and supporting analyses – including looking specifically at the impact of diet.

People’s diet can influence their wellbeing, with known impacts on wide-ranging body systems such as cardiovascular and mental health. However, it has not previously been clear whether dietary factors influence RMD-specific outcomes, and what knowledge there was focused primarily on osteoarthritis and rheumatoid arthritis, rather than people across the full spectrum of RMDs.

A task force was set up to examine the evidence across six key lifestyle factors – diet, exercise, weight, alcohol, smoking, and paid work – in people with one of seven RMDs (axial spondyloarthritis, systemic lupus erythematosus, systemic sclerosis, gout, and osteo-, rheumatoid, or psoriatic arthritis). This study was performed in accordance with the EULAR standard operating procedure and is reported following PRISMA guidelines.

Although a number of dietary components were identified as having a low impact, there were none with a high impact in any of the RMDs studied. Therefore, based on the current evidence, there is no single dietary intervention which has substantial benefits, and no consistent evidence that any dietary exposure significantly improves outcomes in these conditions.

This paper from EULAR is important, as it suggests that health professionals can advise people with RMDs that consuming specific dietary components is unlikely to influence the progression of their disease. However, it is still important to maintain a well-balanced diet and healthy weight for general health reasons.

Source
Gwinnutt JM, et al. Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs. RMD Open 2022;8(2):e002167.

Further reading
Gwinnutt JM, et al. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis 2022;annrheumdis-2021-222020.

Source: European Alliance of Associations for Rheumatology, EULAR

Full bibliographic information
Gwinnutt JM, Wieczorek M, Rodríguez-Carrio J, et al
Effects of diet on the outcomes of rheumatic and musculoskeletal diseases (RMDs): systematic review and meta-analyses informing the 2021 EULAR recommendations for lifestyle improvements in people with RMDs
RMD Open 2022;8:e002167. doi: 10.1136/rmdopen-2021-002167