Smoking is linked to the onset of rheumatoid arthritis, especially in people who have smoked for decades. However, the health benefits of a particular diet may help lower the risk in people who have ever smoked.
In a new French study published in the journal Arthritis & Rheumatology, researchers evaluated the data of more than 60,000 women for particular environmental factors and prevalence of chronic disease. While following a Mediterranean diet was not associated with a lower risk of rheumatoid arthritis overall, high adherence to the diet did lower the risk for those who had ever smoked.
Most of the women involved in the study were born between 1925 and 1950, and recruited in 1990. They answered questionnaires every other year about health and lifestyle concerns, plus disease diagnoses such as rheumatoid arthritis.
Of the participants, 13.2 percent reported current smoking and 33.2 percent reported formerly smoking. Adherence to a Mediterranean-style diet was low in 29.2 percent of participants, medium in 45.2 percent of participants, and high in 25.5 percent of participants.
The only specific food that was linked to a lower risk of rheumatoid arthritis was fish: A moderate consumption of 9 to 25 grams per day resulted in lower RA risk than eating less than 9 grams per day. The researchers didn’t find a difference in risk for the high consumption of any food group.
“The Mediterranean diet has been reported to be associated with significant reduction of non-communicable diseases,” note the researchers. “Our results suggest that adherence to the Mediterranean diet could reduce the high risk of rheumatoid arthritis among ever-smoking women.”
You’re likely familiar with the mainstays of the Mediterranean diet: This plant-heavy eating pattern, similar to the cuisine of countries along the Mediterranean Sea, features plenty of foods like fruits and vegetables, potatoes, whole grains, beans, nuts, seeds and extra virgin olive oil, per the Cleveland Clinic.
It includes only moderate amounts of lean poultry, fish, seafood, dairy, and eggs — and very few fried food, sweets, red meats, and white flour products.
The Mediterranean diet has been linked to several other long-term benefits. For instance, it was found to reduce the risk of major cardiovascular events over five years by 30 percent compared to a regular low-fat diet in a 2018 study published in The New England Journal of Medicine.
Because the Mediterranean diet features foods rich in antioxidants, it may counterbalance some of the damaging oxidant effects caused by smoking — therefore reducing the risk of rheumatoid arthritis associated with smoking, note the researchers of the new study.
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Estruch R, et al. Primary Prevention of Cardiovascular Disease with a Mediterranean Diet Supplemented with Extra-Virgin Olive Oil or Nuts. The New England Journal of Medicine. June 21, 2018. doi: https://doi.org/10.1056/NEJMoa1800389.
Mediterranean Diet. Cleveland Clinic. September 9, 2019. https://my.clevelandclinic.org/health/articles/16037-mediterranean-diet.
Nguyen Y, et al. Mediterranean diet and risk of rheumatoid arthritis: findings from the French E3N-EPIC cohort study. Arthritis & Rheumatology. https://pubmed.ncbi.nlm.nih.gov/32909390.
Smoking and rheumatoid arthritis: What’s the risk? Mayo Clinic. March 26, 2020. https://www.mayoclinic.org/diseases-conditions/nicotine-dependence/expert-answers/rheumatoid-arthritis-smoking/faq-20119778.