Abstract
Background
The prevalence of arthritis in the United States is substantial and on the rise. Long-chain
n-3 polyunsaturated fatty acids, which have anti-inflammatory properties, have been
shown to provide therapeutic benefit to arthritis patients; however, to date few have
examined these associations with arthritis risk.
Objective
The study objective was to examine the associations of long-chain n-3 polyunsaturated
fatty acids intake with osteoarthritis (OA) and rheumatoid arthritis (RA) risk among
postmenopausal women.
Design
This was a prospective cohort study.
Participants
The sample for this analysis consisted of 80,551 postmenopausal women, aged 55 to
79 years and with no history of arthritis, recruited into the Women’s Health Initiative
Observational Study and Clinical Trials cohort between 1993 and 1998. Women completed
a 120-item food frequency questionnaire at baseline.
Main outcome measures
After a median follow-up of 8 years, 22,306 incident OA and 3,348 RA cases were identified.
Statistical analyses performed
Adjusted Cox regression models were used to estimate hazard ratios and 95% CI for
the associations between dietary LCn-3PUFA intake and OA and RA risk.
Results
Individual and total long-chain n-3 polyunsaturated fatty acids (Quintile 5 vs Quintile
1: hazard ratio 1.04, 95% CI 0.99 to 1.09 for OA; hazard ratio 1.01, 95% CI 0.90 to
1.13 for RA) were not associated with OA and RA risk. Further, no associations were
observed between n-6 polyunsaturated fatty acids intake and either arthritis outcome.
Conclusions
This study is the first to examine associations of long-chain n-3 polyunsaturated
fatty acids intake with OA risk and the largest to examine associations with RA risk.
Despite their therapeutic potential, the study provides no evidence of benefit of
these nutrients in relation to arthritis risk.
Keywords
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References
Centers for Disease Control. Arthritis in general. 2015. https://www.cdc.gov/arthritis/basics/index.html. Accessed October 15, 2017.
- Prevalence of rheumatoid arthritis in the United States adult population in healthcare claims databases, 2004-2014.Rheumatol Intl. 2017; 37: 1551-1557
- Epidemiology of osteoarthritis: Literature update.Curr Opin Rheumatol. 2018; 30: 160-167
- Risk factors for rheumatoid arthritis.Ann Med. 2004; 36: 242-251
- Prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2010-2012.MMWR Morbid Mortality Wkly Rep. 2013; 62: 869-873
- Osteoarthritis: New insights. Part 1: The disease and its risk factors.Ann Intern Med. 2000; 133: 635-646
- Evolving concepts of rheumatoid arthritis.Nature. 2003; 423: 356-361
- Osteoarthritis, an inflammatory disease: Potential implication for the selection of new therapeutic targets.Arthritis Rheum. 2001; 44: 1237-1247
- Role of inflammation in the pathogenesis of osteoarthritis: Latest findings and interpretations.Ther Adv Musculoskelet Dis. 2013; 5: 77-94
- Synovitis: A potential predictive factor of structural progression of medial tibiofemoral knee osteoarthritis—results of a 1 year longitudinal arthroscopic study in 422 patients.Osteoarthritis Cartilage. 2005; 13: 361-367
- Presence of MRI-detected joint effusion and synovitis increases the risk of cartilage loss in knees without osteoarthritis at 30-month follow-up: The MOST study.Ann Rheum Dis. 2011; 70: 1804-1809
- Antioxidants and antiinflammatory dietary supplements for osteoarthritis and rheumatoid arthritis.Altern Ther Health Med. 2010; 16: 32-40
- Omega-3 fatty acid supplements improve the cardiovascular risk profile of subjects with metabolic syndrome, including markers of inflammation and auto-immunity.Acta Cardiologica. 2009; 64: 321-327
- Efficacy of omega-3 fatty acid supplementation on serum levels of tumour necrosis factor-alpha, C-reactive protein and interleukin-2 in type 2 diabetes mellitus patients.Singapore Med J. 2012; 53: 615-619
- Anti-inflammatory and cardioprotective effects of n-3 polyunsaturated fatty acids and plant sterols in hyperlipidemic individuals.Atherosclerosis. 2009; 204: 476-482
- Factors associated with multiple biomarkers of systemic inflammation.Cancer Epidemiol Biomarkers Prev. 2016; 25: 521-531
- Dietary docosahexaenoic and eicosapentaenoic acid: Emerging mediators of inflammation.Prostaglandins Leukot Essent Fatty Acids. 2009; 81: 187-191
- Association between polyunsaturated fatty acids and inflammatory markers in patients in secondary prevention of cardiovascular disease.Nutrition (Burbank, Los Angeles County, Calif). 2017; 37: 30-36
- Association between Omega3 and Omega6 fatty acid intakes and serum inflammatory markers in COPD.J Nutr Biochem. 2012; 23: 817-821
- Health implications of high dietary omega-6 polyunsaturated fatty acids.J Nutr Metab. 2012; 2012: 539426
- Long-term intake of dietary long-chain n-3 polyunsaturated fatty acids and risk of rheumatoid arthritis: A prospective cohort study of women.Ann Rheum Dis. 2014; 73: 1949-1953
- Design of the Women's Health Initiative Clinical Trial and Observational Study. The Women's Health Initiative Study Group.Control Clin Trials. 1998; 19: 61-109
- Implementation of the Women's Health Initiative study design.Ann Epidemiol. 2003; 13: S5-S17
- The Women's Health Initiative recruitment methods and results.Ann Epidemiol. 2003; 13: S18-S77
- The Women's Health Initiative calcium-vitamin D trial: Overview and baseline characteristics of participants.Ann Epidemiol. 2003; 13: S98-S106
- The Women's Health Initiative Dietary Modification trial: Overview and baseline characteristics of participants.Ann Epidemiol. 2003; 13: S87-S97
- The Women's Health Initiative postmenopausal hormone trials: Overview and baseline characteristics of participants.Ann Epidemiol. 2003; 13: S78-S86
- The Women's Health Initiative Observational Study: Baseline characteristics of participants and reliability of baseline measures.Ann Epidemiol. 2003; 13: S107-S121
- Measurement characteristics of the Women's Health Initiative food frequency questionnaire.Ann Epidemiol. 1999; 9: 178-187
- Effect of dietary alpha-linolenic acid on blood inflammatory markers: A systematic review and meta-analysis of randomized controlled trials.Eur J Nutr. 2018; 57: 877-891
- Adjustment for total energy intake in epidemiologic studies.Am J Clin Nutr. 1997; 65 (discussion 1229S-1231S): 1220S-1228S
- SAS version 9.3. SAS Institute Inc, Cary, NC2012
- Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivors.Breast Cancer Res Treat. 2009; 114: 155-167
- Body mass index and risk of rheumatoid arthritis: A meta-analysis of observational studies.Medicine. 2016; 95: e2859
- Validation of self-report of rheumatoid arthritis and systemic lupus erythematosus: The Women's Health Initiative.J Rheumatol. 2008; 35: 811-818
- Mediterranean diet and incidence of rheumatoid arthritis in women.Arthritis Care Res. 2015; 67: 597-606
- Fish consumption and risk of rheumatoid arthritis: A dose-response meta-analysis.Arthritis Res Ther. 2014; 16: 446
- Session 3: Joint Nutrition Society and Irish Nutrition and Dietetic Institute Symposium on Nutrition and autoimmune disease PUFA, inflammatory processes and rheumatoid arthritis.Proc Nutr Soc. 2008; 67: 409-418
- Diet and rheumatoid arthritis development: What does the evidence say?.Int J Clin Rheumatol. 2014; 9: 169-182
- Blood transfusion, smoking, and obesity as risk factors for the development of rheumatoid arthritis: Results from a primary care-based incident case-control study in Norfolk.England. Arthritis Rheum. 1997; 40: 1955-1961
- Modifiable risk factors for RA: Prevention, better than cure?.Rheumatology (Oxford, England). 2012; 51: 499-512
- Cigarette smoking and the risk of rheumatoid arthritis among postmenopausal women: Results from the Iowa Women's Health Study.Am J Med. 2002; 112: 465-471
- Body mass index and the risk of rheumatoid arthritis: A systematic review and dose-response meta-analysis.Arthritis Res Ther. 2015; 17: 86
- Habitual dietary intake of n-3 and n-6 fatty acids in relation to inflammatory markers among US men and women.Circulation. 2003; 108: 155-160
- Diet and risk of rheumatoid arthritis in a prospective cohort.J Rheumatol. 2005; 32: 1249-1252
- Protein, iron, and meat consumption and risk for rheumatoid arthritis: A prospective cohort study.Arthritis Res Ther. 2007; 9: R16
- A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain.Pain. 2007; 129: 210-223
- Osteoarthritis. Omega-3 fatty acids and synovitis in osteoarthritic knees.Nature Rev Rheumatol. 2012; 8: 314-315
- Fish oil and osteoarthritis: Current evidence.Am J Orthoped. (Belle Mead, NJ). 2015; 44: 302-305
- Fish oil in knee osteoarthritis: A randomised clinical trial of low dose versus high dose.Ann Rheum Dis. 2016; 75: 23-29
- The validity of self-reported rheumatoid arthritis in a large cohort: Results from the Black Women's Health Study.Arthritis Care Res. 2010; 62: 235-241
- Participant characteristics associated with errors in self-reported energy intake from the Women's Health Initiative food-frequency questionnaire.Am J Clin Nutr. 2002; 76: 766-773
Biography
J. L. Krok-Schoen is an assistant professor, James Comprehensive Cancer Center and School of Health and Rehabilitation Sciences, The Ohio State College of Medicine, The Ohio State University, Columbus.
Biography
T. M. Brasky is an assistant professor, James Comprehensive Cancer Center, The Ohio State University, Columbus.
Biography
M. B. Lustberg is an associate professor, James Comprehensive Cancer Center, The Ohio State University, Columbus.
Biography
R. P. Hunt is a statistical research associate Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Biography
M. L. Neuhouser is a member and program head of the Cancer Prevention Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA.
Biography
T. E. Rohan is a professor and chair, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY.
Biography
T. A. Baker is a professor, Department of Psychology, University of Kansas, Lawrence.
Biography
W. Li is a professor, University of Massachusetts School of Medicine, Boston.
Biography
L. Carbone is chief, Division of Rheumatology, Medical College of Georgia at Augusta University, Augusta.
Biography
R. H. Mackey is an assistant professor, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA.
Biography
L. Snetselaar is a professor and chair, Preventive Nutrition Education, College of Public Health, The University of Iowa, Iowa City.
Article info
Publication history
Published online: June 18, 2018
Accepted:
April 3,
2018
Received:
December 7,
2017
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT This work was supported by the National Heart, Lung, and Blood Institute; National Institutes of Health; and US Department of Health and Human Services grants nos. HHSN268201600018C, HHSN2682011000046C, HHSN268201100001C, HHSN268201100002C, HHSN268201100003C, and HHSN268201100004C.
Identification
Copyright
© 2018 by the Academy of Nutrition and Dietetics.
