Diet and Rheumatoid Arthritis Risk in the United Kingdom Women's Cohort

The Associations Between Diet and Rheumatoid Arthritis Risk in the United Kingdom

Rheumatoid arthritis (RA) is the most common inflammatory arthritis, affecting around 1% of the UK population. It affects around 400,000 adults and is characterised by synovial inflammation, cartilage and bone damage that requires lifelong treatment and represents a significant burden for both the individual and society. Diet can affect inflammatory status and RA risk, with varying risks for women on specific diets. Low to moderate levels of alcohol consumption may be associated with lower risk of RA, and those who do not consume enough fruit and vegetables could be at a greater risk than those with adequate intakes. Our research aim is to better understand the role of diet in reducing RA risk in United Kingdom women. The research will use existing dietary and lifestyle data from the United Kingdom Women's Cohort Study and hospital records of RA incidence.

Study Overview

• Status: Completed
• Conditions: Rheumatoid Arthritis (RA)
• Intervention / Treatment: Other: Dietary pattern; Other: Alcohol intake; Other: Fruit and vegetables intake; Other: Tea consumption; Other: Coffee consumption; Other: Fish intake; Other: Meat intake; Other: Vitamin D intake

Detailed Description

Background: Rheumatoid arthritis (RA) is a typical inflammatory arthritic disease that increases morbidity and mortality of cardiovascular diseases worldwide. Previous observational studies have shown potential for risk reduction through dietary factors modification, but associations between most of dietary factors and RA incidence are still uncertain, and evidence in United Kingdom populations is limited. Therefore, this study aims to assess associations between diet and RA incidence in the United Kingdom Women's Cohort.

Research plan and methods: The dietary and lifestyle data from the United Kingdom Women's Cohort, which recruited 35,372 middle-aged women between 1995-1998, will be used. These data were linked to Hospital Episode Statistics to provide data on the incidence of RA in participants.

Cox regression models will be applied to explore potential associations between dietary factors and RA incidence. Dietary factors will be modelled both as categorical and continuous variables so that models can be fit comparing the risk of RA between categories of intakes and per increment increase in exposure intake (linear dose-response). Restricted cubic splines will be used to model non-linear associations for dietary intake of alcohol, fruits, vegetables, tea, and coffee, since previous research has suggested possible non-linear associations for these variables.

• Study Type: Observational
• Enrollment (Actual): 35372

Contacts and Locations

Study Locations

• United Kingdom
  • West Yorkshire
    • Leeds, West Yorkshire, United Kingdom, LS2 9JT
      • University of Leeds Leeds

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

The UK Women's cohort profile is published here: https://doi.org/10.1093/ije/dyv173

Description

Inclusion Criteria:

• Female
• Ages 35 - 69 years at time of recruitment
• Able to provide informed consent

Exclusion Criteria:

• Male
• Not a resident of England
• Unable to link dietary and lifestyle data with hospital episode data
• Missing covariate data
• Rheumatoid arthritis records before or on the date of recruitment

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort

Intervention / Treatment

United Kingdom Women's Cohort; United Kingdom Women's Cohort Study. No interventions are to be administered in this observational prospective cohort study.

Other: Dietary pattern; (regular meat-eater, occasional meat-eater, fish-eater, vegetarian, and vegan; Mediterranean diet); Other: Alcohol intake; (Frequency and intake of beer, wine, sherry, and spirits were collected by asking the number of specified units (pints, glasses or measures) of each type of alcoholic beverage (beer or cider, wine, sherry or fortified wines, and spirits) per week.); Other: Fruit and vegetables intake; (Intake of fruits, vegetables, fruits and vegetables combined from food frequency questionnaire); Other: Tea consumption; (Intake of tea from food frequency questionnaire); Other: Coffee consumption; (Intake of caffeinated coffee and decaffeinated coffee from food frequency questionnaire); Other: Fish intake; (Intake of fish from food frequency questionnaire); Other: Meat intake; (Intake of red meat, processed meat, and poultry from food frequency questionnaire); Other: Vitamin D intake; (Estimated intake of vitamin D, derived from food frequency questionnaire and any recorded supplemental intake)

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Rheumatoid Arthritis incidence (first)	Incidence of first rheumatoid arthritis ascertained from linkage to Hospital Episode Statistics (HES) data.	Time Frame: age when the completed questionnaire was returned (1995-1998) until age at event, death, or end of study period (19 Mar 2019).

Collaborators and Investigators

• Sponsor: University of Leeds

Publications and helpful links

General Publications

• Cade JE, Burley VJ, Alwan NA, Hutchinson J, Hancock N, Morris MA, Threapleton DE, Greenwood DC. Cohort Profile: The UK Women's Cohort Study (UKWCS). Int J Epidemiol. 2017 Apr 1;46(2):e11. doi: 10.1093/ije/dyv173. No abstract available.

Helpful Links

• Study website

Study record dates

Study Major Dates

• Study Start (Actual): January 15, 1995
• Primary Completion (Actual): March 13, 2019
• Study Completion (Actual): March 13, 2019

Study Registration Dates

• First Submitted: October 31, 2024
• First Submitted That Met QC Criteria: October 31, 2024
• First Posted (Estimated): November 1, 2024

Study Record Updates

• Last Update Posted (Estimated): November 1, 2024
• Last Update Submitted That Met QC Criteria: October 31, 2024
• Last Verified: October 1, 2024

More Information

Terms related to this study

• Keywords: Cohort study; Nutrition; Rheumatoid Arthritis; Epidemiology; Body Mass Index; Alcohol consumption; Arthritis, Rheumatoid, Seropositive
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Joint Diseases; Rheumatic Diseases; Connective Tissue Diseases; Autoimmune Diseases; Immune System Diseases; Arthritis; Arthritis, Rheumatoid; Physiological Effects of Drugs; Bone Density Conservation Agents; Micronutrients; Vitamins; Vitamin D
• Other Study ID Numbers: fsydo_UKWCS

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: The full data access policy for the UK Women's Cohort Study is available via the study website (https://ukwcs.leeds.ac.uk/).
• IPD Sharing Time Frame: The full data access policy for the UK Women's Cohort Study is available via the study website (https://ukwcs.leeds.ac.uk/).
• IPD Sharing Access Criteria: The full data access policy for the UK Women's Cohort Study is available via the study website (https://ukwcs.leeds.ac.uk/).
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No