Association of Diet Quality With Risk of Incident Rheumatoid Arthritis in the Women's Health Initiative

Background Various foods and nutrients are linked with higher or lower rheumatoid arthritis (RA), yet these associations are inconsistent across studies. Limited research has been done evaluating the association between diet quality and RA larger-scale prospective study on postmenopausal women. Objective The objective of this study was to evaluate the association between quality and risk of incident RA in postmenopausal women. Design This was a prospective cohort study as part of the Women's Health Initiative (WHI), with an average follow-up time of 8.1 years. Baseline diet was measured food frequency questionnaire (FFQ). Diet quality was evaluated by the Healthy Index (HEI)-2015 total score. In addition, intake of food groups and nutrients that with HEI-2015 components was assessed. Participants/setting Postmenopausal women (N = 109 591) were included study, which was conducted at various clinical centers across the United States recruitment from 1993 to 1998. Women's Health Initiative participants who missing outcome data, had unreliable/missing FFQ data, or had RA at baseline excluded. Main outcome measures The primary outcome measure was incident RA. Statistical analyses performed Multivariable Cox proportional regression analysis was performed evaluating the association of diet quality with self-reported physician-diagnosed after adjusting for age, race, ethnicity, education status, income, and body mass (BMI). Results During 857 517 person-years of follow-up, 5823 incident RA cases identified. After adjustment for multiple comparisons, compared with quartile quartiles 2, 3, and 4 of the HEI-2015 total scores were associated with lower RA 1%, 10%, and 19%, respectively (P-trend < .001). Greater consumption of total fruits trend = .014), whole fruits (P-trend < .0002), total vegetables (P-trend = .008), and beans (P-trend < .0002), whole grains (P-trend = .008), and dairy (P-trend were significantly associated with lower rates of incident RA. Conversely, consumption of saturated fat (P-trend = .002) was significantly associated with rates of incident RA. Conclusion A higher-quality diet reflected by higher HEI-2015 total scores inversely associated with incident RA in postmenopausal women. J Acad Nutr Diet. 2024;124(11):1451-1473.