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Higher fish consumption linked to lower RA disease activity
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In patients with rheumatoid arthritis, higher fish consumption was linked to lower disease activity, according to a recently published study.
“We report a statistically and clinically significant reduction in DAS28-CRP among subjects with [RA] who consumed fish [at least twice per] week compared to those who consumed fish never or [fewer than once per month], after adjustment for confounders,” Sara K. Tedeschi, MD, MPH, from the division of rheumatology, immunology and allergy at Brigham and Women’s Hospital and Harvard Medical School, and colleagues wrote. “Our observed difference in DAS28-CRP of 0.49 between the highest and lowest categories of fish consumption is approximately one-third the magnitude of previously reported pre- and post-treatment differences in DAS28 among methotrexate users.”
Researchers assessed 176 participants, for whom the median DAS28-CRP was 3.5. Participants who consumed fish at least twice per week had a significantly reduced DAS28-CRP compared with those who consumed fish less than once per month, with a difference of –0.49. For each added serving of fish per week, DAS28-CRP was reduced by 0.18, the researchers wrote. – by Will A. Offit
Disclosures: Tedeschi reports funding from the NIH. Please see the full study for a list of all other authors’ relevant financial disclosures.
Perspective
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Calvin R. Brown Jr., MD
Abundant experimental evidence supports the view that eicosanoids participate in development and regulation of immunological and inflammatory responses, including rheumatoid arthritis (RA). Many randomized, placebo-controlled and double-blind trials of fish oil in RA have documented clinical improvement, including reductions in duration of morning stiffness, number of tender joints, joint pain, time to fatigue and increased grip strength.
This new study finds that simply eating fish may help reduce the joint pain and swelling of RA. The investigators studied 176 people in a larger health study who had physical exams and blood tests and filled out food frequency questionnaires that indicated their consumption of various types of nonfried fish. After controlling for race, sex, BMI, smoking, education, fish oil supplement use, duration of RA symptoms and other health and behavioral characteristics, they found the average disease activity score in each group declined as fish intake increased.
As this is an observational study, it does not prove cause and effect. However, the observed reductions in pain and swelling from the lowest to the highest group in fish intake were clinically significant, with a magnitude of effect similar to some first-line pharmacotherapies.
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