Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: a prospective cohort study of women -- Di Giuseppe et al. -- Annals of the Rheumatic Diseases

Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: a prospective cohort study of women -- Di Giuseppe et al. -- Annals of the Rheumatic Diseases

Ann Rheum Dis doi:10.1136/annrheumdis-2013-203338

• Clinical and epidemiological research

• Extended report

Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: a prospective cohort study of women

1. Daniela Di Giuseppe1,
2. Alice Wallin1,
3. Matteo Bottai2,
4. Johan Askling3,
5. Alicja Wolk1

+ Author Affiliations

1. ¹Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
2. ²Division of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
3. ³Clinical Epidemiology Unit, Department of Medicine, Karolinska Hospital, Stockholm, Sweden

1. Correspondence to Professor Alicja Wolk, Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, Stockholm 171 77, Sweden; Alicja.Wolk@ki.se

• Received 23 January 2013
• Revised 7 July 2013
• Accepted 9 July 2013
• Published Online First 12 August 2013

Abstract

Objectives To analyse the association between dietary long-chain n-3 polyunsaturated fatty acids (PUFAs) and incidence of rheumatoid arthritis (RA) in middle-aged and older women from the Swedish Mammography Cohort, a population-based prospective study.

Methods Data on diet were collected in 1987 and 1997 via a self-administered food-frequency questionnaire (FFQ). The risk of RA associated with dietary long-chain n-3 PUFAs and fish intake was estimated using Cox proportional hazard regression models, adjusted for age, cigarette smoking, alcohol intake, use of aspirin and energy intake.

Results Among 32 232 women born 1914–1948, 205 RA cases were identified during a mean follow-up of 7.5 years (1 January 2003 to 31 December 2010; 2 41 120 person-years). An intake of dietary long-chain n-3 PUFAs (FFQ1997) of more than 0.21 g/day (lowest quintile) was associated with a 35% decreased risk of developing RA (multivariable adjusted relative risk (RR) 0.65; 95% CI 0.48 to 0.90) compared with a lower intake. Long-term intake consistently higher than 0.21 g/day (according to both FFQ1987 and FFQ1997) was associated with a 52% (95% CI 29% to 67%) decreased risk. Consistent long-term consumption (FFQ1987 and FFQ1997) of fish ≥ 1 serving per week compared with < 1 was associated with a 29% decrease in risk (RR 0.71; 95% CI 0.48 to 1.04).

Conclusions This prospective study of women supports the hypothesis that dietary intake of long-chain n-3 PUFAs may play a role in aetiology of RA.