Effects of the Mediterranean diet in the treatment of rheumatoid arthritis

Abstract

INTRODUCTION It has been suggested that environmental and lifestyle factors may contribute to the severity and progression of inflammation in rheumatoid arthritis. An intervention that generates high interest, due to its supposed anti-inflammatory properties, is the Mediterranean diet. METHODS We conducted a search in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple sources of information, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the identified reviews, analyzed data from the primary studies, performed a meta-analysis, and prepared a summary table of results using the GRADE method. RESULTS AND CONCLUSIONS We identified seven systematic reviews that together included four primary studies, only one of which corresponded to a randomized trial. We conclude that the Mediterranean diet might make little or no difference to joint pain or disease activity, and slightly increase weight in people with rheumatoid arthritis, but the certainty of the evidence is low. On the other hand, it is not possible to clearly establish whether the Mediterranean diet has any effect on functionality, morning stiffness, or quality of life, since the certainty of the existing evidence has been assessed as very low.