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The role of dietary modifications and nutritional supplements in the management of rheumatoid arthritis (RA) remains uncertain.
PUFAs, probiotics, total glucosides of paeony, and anti-inflammatory diets appear to have beneficial effects on rheumatoid arthritis symptoms.
The role of dietary modifications and nutritional supplements in the management of rheumatoid arthritis (RA) remains uncertain. Hence, this umbrella review of meta-analyses sought to examine the effects of nutritional supplementation and dietary interventions in RA-affected individuals.
A comprehensive literature search was carried out across Cochrane Library, PubMed, Web of Science, and Embase, covering all records up to December 2024. Eligible studies encompassed meta-analyses of randomized controlled trials (RCTs) assessing the impact of dietary supplements or interventions on RA. The methodological quality of included reviews was monitored via AMSTAR 2 tool, while the certainty of evidence was assessed with the help of GRADE approach.
In total, 14 studies were incorporated According to AMSTAR 2, 5 as critically low quality, 6 as low quality, and 3 were rated as high quality. The evidence certainty regarding intervention effects ranged from low to very low. Investigated interventions included polyunsaturated fatty acids (PUFAs), probiotics, total glucosides of paeony, anti-inflammatory diets, and others.
Among these, total glucosides of paeony was the only intervention to significantly reduce both the disease activity score and erythrocyte sedimentation rate, though the evidence was rated as low quality. Probiotics were associated with notable reductions in C-reactive protein and visual analog scale (VAS) scores, also with low-quality evidence. PUFAs led to significant improvements in tender joint count, swollen joint count, and morning stiffness, yet these findings were similarly supported by low-quality evidence.
While PUFAs, probiotics, total glucosides of paeony, and anti-inflammatory diets may offer potential benefits for RA management, the overall low quality of evidence underscores the need for more rigorous, high-quality studies and real-world data to substantiate their efficacy.
Autoimmunity Reviews
Effects of nutritional supplements and dietary interventions on rheumatoid arthritis: An umbrella review of meta-analyses of randomized controlled trials
Xue-Er Cheng et al.
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