The comprehensive relationship between combined anti-inflammatory and healthy diets and all-cause mortality in rheumatoid arthritis: results from National Health and Nutrition Examination Survey (NHANES) 2003–2018
Main finding · All-cause mortalityResult — go to the resultHazard ratio 0.70 95% CI 0.53–0.92Authors' conclusion
These findings suggest that combining a higher HEI-2015 with a lower DII score correlates with reduced all-cause mortality risk among patients with RA
Study context
- Population
- Patients with rheumatoid arthritis (RA) from NHANES 2003–2018; median age 59 years (IQR 48–69), 42.1% male
- Participants
- 2,069 patients
- Exposure
- Healthy and anti-inflammatory dietary pattern (higher Healthy Eating Index (HEI-2015), lower Dietary Inflammatory Index (DII)) vs unhealthy and pro-inflammatory pattern
- Outcome
- All-cause mortality
Methodological detailsNHANES 2003–2018 cohort analysis, weighted multivariable Cox regression, restricted cubic splines, Least Absolute Shrinkage and Selection Operator (LASSO), subgroup and sensitivity analyses
- NHANES 2003–2018 cohort analysis
- Weighted multivariable Cox regression
- Restricted cubic splines
- LASSO
- Subgroup and sensitivity analyses
Main finding
As reported in the abstract
Hazard ratio
0.70
95% CI 0.53–0.92
adjusted P = 0.01; trend P = 0.02
Healthy and anti-inflammatoryvs Unhealthy and pro-inflammatory
HR 0.70 (95% CI 0.53–0.92); adjusted P = 0.01; trend P = 0.02
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Mortality, low-risk vs high-risk dietary group (Kaplan-Meier)Significantly lower mortality in low-risk group | P < 0.001 |
All-cause mortality by DII and HEI-2015 quartiles
- Higher quartiles showed no significant mortality risk difference from the lowest quartiles
LASSO-Cox model of 12 dietary components predicting all-cause mortality
- AUC at 1 year
- 0.749 (0.682-0.815)
- AUC at 3 years
- 0.763 (0.724-0.802)
- AUC at 5 years
- 0.783 (0.749-0.802)
- AUC for all death events
- 0.868 (0.712-0.938)
Original publication
The comprehensive relationship between combined anti-inflammatory and healthy diets and all-cause mortality in rheumatoid arthritis: results from NHANES 2003–2018. Arthritis Res Ther. Published 23 December 2024. doi:10.
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