Adherence to a Mediterranean diet and severity of pain and gastrointestinal symptoms in people with Rheumatoid Arthritis: a cross-sectional analysis

Briana Fahey; Tayla White; Evangeline Mantzioris; Elke Sokoya; Anthony Villani

doi:10.1016/j.nutos.2025.09.005

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Adherence to a Mediterranean diet and severity of pain and gastrointestinal symptoms in people with Rheumatoid Arthritis: a cross-sectional analysis

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Adherence to a Mediterranean diet and severity of pain and gastrointestinal symptoms in people with Rheumatoid Arthritis: a cross-sectional analysis

Briana Fahey, Tayla White, Evangeline Mantzioris, Elke Sokoya and Anthony Villani

Clinical Nutrition Open Science, Vol.64, pp.101-114

2025

DOI: https://doi.org/10.1016/j.nutos.2025.09.005

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Abstract

Mediterranean diet

rheumatoid arthritis

diet quality

pain

gastrointestinal symptoms

Background Diet quality may be an important modifiable risk factor for managing the intensity of symptoms and disease progression in people with Rheumatoid Arthritis (RA). Therefore, the objective of this study was to explore the independent associations between adherence to a Mediterranean diet (MedDiet) and severity of pain and gastrointestinal (GI) symptoms in adults with RA. Methods This was a cross-sectional online survey of community-dwelling adults (≥18 years) with a confirmed medical diagnosis of RA. MedDiet adherence was assessed using the Mediterranean Diet Adherence Screener (MEDAS); the Rheumatoid Arthritis Pain Scale (RAPS) was used to assess the intensity of pain; and severity of GI symptoms was assessed using the Structured Assessment of Gastrointestinal Symptoms Scale (SAGIS). Results A total of n = 80 participants commenced the online questionnaire (67 female; 12 males; 1 unspecified, 54.7 ± 13.8 years; BMI 29.1 ± 7.2 kg/m2), of which n = 70 completed in full and were included in the final analyses. Participants reported a low-moderate MedDiet adherence (4.9 ± 2.3; range: 1-11) and reported moderate levels of pain (RAPS: 81.4 ± 3.8; range: 0-144) and a low severity of GI symptoms (SAGIS: 10 (19); range 0-51). After adjusting for age, gender, BMI, physical activity duration, years active with disease and use of antirheumatic prescription medication, we found that MedDiet adherence was not related to pain (β: -0.10; 95% CI: -0.02, 0.01; P = 0.44) or severity of GI symptoms (β: -0.09; 95% CI: 0.06, 0.03; P = 0.49). Conclusion Adherence to a MedDiet was not related to severity of pain or GI disturbances in this sample of RA participants. Nevertheless, further exploration of how diet and nutrition can attenuate RA progression and symptom management is important for the development of evidence-based guidelines and dietary recommendations for patients with RA.

Details

Title: Adherence to a Mediterranean diet and severity of pain and gastrointestinal symptoms in people with Rheumatoid Arthritis: a cross-sectional analysis
Authors: Briana Fahey - University of the Sunshine Coast, Queensland, School of Health
Tayla White - University of the Sunshine Coast, Queensland, School of Health
Evangeline Mantzioris - University of South Australia
Elke Sokoya - Flinders University
Anthony Villani (Corresponding Author) - University of the Sunshine Coast, Queensland, School of Health - Nutrition & Dietetics
Publication details: Clinical Nutrition Open Science, Vol.64, pp.101-114
Publisher: Elsevier Ltd
Date published: 2025
DOI: 10.1016/j.nutos.2025.09.005
ISSN: 2667-2685
Copyright note: © 2025 Published by Elsevier Ltd on behalf of European Society for Clinical Nutrition and Metabolism. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Data Availability: Data that support these findings is available from the corresponding author upon reasonable request.
Grant note: School of Health at the University of the Sunshine Coast.
Organisation Unit: Healthy Ageing Research Cluster; School of Health; School of Health - Nutrition & Dietetics; Marketing and Communications
Language: English
Record Identifier: 991164844302621
Output Type: Journal article

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