Increased cereal fiber intake may reduce rheumatoid arthritis risk
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Key takeaways:
- Cereal was the only source of fiber significantly inversely correlated with RA onset.
- Dietary Inflammatory Index was a “significant, albeit not predominant” mediator in the fiber-RA relationship.
Individuals with higher cereal fiber intake are less likely to develop rheumatoid arthritis, according to data published in Nature Scientific Reports.
The researchers additionally concluded that the Dietary Inflammatory Index score is a “crucial intermediary” in this relationship, highlighting the role of diet in preventing and managing RA.
“Current theories suggest that a diet rich in dietary fiber can mitigate inflammation and thus reduce the risk of RA,” Huijuan Wan, of the University of South China, in Hengyang, and colleagues wrote. “However, there is still a gap in research regarding the extent and nature of the [Dietary Inflammatory Index’s (DII)] mediating role in the relationship between dietary fiber intake and RA risk.”
To investigate links between dietary fiber — of varying sources — and rheumatoid arthritis, as well as any influence from the Dietary Inflammatory Index, Wan and colleagues conducted a cross-sectional study of data from the CDC’s National Health and Nutrition Examination Survey from 2011 to 2020. Their analysis comprised 15,114 people (mean age, 46.37 years; 57.74% female), approximately 7% (n = 1,053) of whom had RA.
Each participant’s fiber intake was assessed through two 24-hour dietary recall sessions, while RA status was self-reported via questionnaires. Dietary Inflammatory Index scores were calculated based on individual dietary markers and corresponding z-scores, the researchers wrote. Relationships between these variables were assessed through multivariate logistic regression and mediation analysis.
According to the researchers, the median total fiber intake among patients with RA was 13.6 g per day, and ranged from 0 to 97.4 g per day, compared with 14.7 g per day, and a range of 0 to 134.8 g per day, among those without RA.
After adjusting for multiple covariates, the researchers found that cereal was the only fiber intake source shown to be significantly inversely correlated with RA onset (OR = 0.85; 95% CI, 0.76-1.02), while vegetable and fruit fibers showed “tenuous and inconclusive links,” with ORs of 0.98 (95% CI, 0.87-1.1) and 1.03 (95% CI, 0.96-1.1), respectively, they wrote. The association with cereal fiber intake was stronger in a sensitivity analysis (OR = 0.72; 95% CI, 0.61-0.85).
In addition, the researchers reported a “significant, albeit not predominant mediating role” for the Dietary Inflammatory Index in the relationship between RA onset and fiber intake. Estimated proportions of mediation were 36.12% in the relationship between RA and total fiber intake and 40.35% between RA and cereal fiber intake specifically (P < .001 for both).
The study unveils two “critical” insights, Wan and colleagues concluded.
“Firstly, it establishes a clear correlation between suboptimal fiber intake and an increased prevalence of RA, identifying cereal fiber as the primary mitigating factor,” they wrote. “Secondly, our analysis highlights the DII as a critical intermediary in the association between fiber consumption and the onset of RA. Notably, while the DII’s mediating role falls below 50%, its direct impact considerably surpasses the indirect effect, emphasizing its integral role in the fiber-RA incidence connection.”
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