Moderate alcohol intake and eating more fruit, oily fish and cereals are linked to lower risk of rheumatoid arthritis, while tea and coffee may be linked to increased risk, new research shows.
A systematic review has looked at 30 different studies – between them involving nearly 10,000 people with rheumatoid arthritis – carried out between 2000 and 2024.
The work sheds fresh light on the relationship between 32 different food groups, drinks and nutrients and the risk of developing rheumatoid arthritis, with strong evidence that some food groups could help stave off the symptoms.
The findings show that some dietary factors – including oily fish and Vitamin D - could have a protective role and help stop people developing the disease. Eating more cereals including whole grains and breakfast cereals and fruit seems to be linked to a lower risk of rheumatoid arthritis, while drinking more tea could be linked to a higher risk.
But the results are not straightforward, according to research author Yuanyuan Dong, a PhD researcher in the university's School of Food Science and Nutrition. For example drinking two units of alcohol a week – the equivalent to a pint of lower-strength lager or beer or a standard glass of wine a week - may have a protective effect, but excessive consumption increases the risk of developing the condition.
My research investigates whether dietary factors contribute to the risk of rheumatoid arthritis by increasing inflammation and affecting the immune system.
The protective effect of alcohol diminished with higher intake, disappearing entirely at approximately 7.5 units of alcohol per week - about four pints of lower-strength beer/lager/cider per week or 3.5 standard glasses of wine.
Ms Dong said: "Rheumatoid arthritis is a typical multifactorial disease, driven by both genetic and environmental factors. My research investigates whether dietary factors contribute to the risk of rheumatoid arthritis by increasing inflammation and affecting the immune system.
"These findings offer a deeper understanding of how diet can impact rheumatoid arthritis risk and suggest potential dietary modifications for disease prevention and management."
And while every cup of tea drunk per day increased the risk by four per cent, the baseline risk from drinking tea was low, meaning that even with the 4% increase the overall risk remained low. Tea has many health benefits, the researchers stressed, and people should consider their overall diet and lifestyle when making choices about what to eat and drink.
The results are promising, showing that by eating higher amounts of foods like oily fish, cereals, vegetables and the nutrient vitamin D, people may be able to lower their chances of developing this painful and debilitating condition.
More research could even pinpoint how different types of tea might influence autoimmune diseases like rheumatoid arthritis, Ms Dong added.
The researchers are arguing that "one-size-fits-all" advice to follow a general "healthy diet" is not helpful for people who have autoimmune diseases, instead urging a more tailored approach that fits their specific needs.
Rheumatoid arthritis is a common autoimmune disease – caused by the immune system attacking healthy cells by mistake. Its symptoms include joint pain and stiffness, swelling and difficulty grasping or holding things. It can lead to long-term disability, but early diagnosis and treatment can significantly mitigate the effects. It affects half a million people in the UK and is more common among older people and women.
Key findings
Foods associated with a reduced rheumatoid arthritis risk:
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Oily fish, Vitamin D, and vegetables showed potential protective effects against rheumatoid arthritis development, but the association was non-linear with evidence showing moderate intake decreases risk but the effect plateaus or even diminishes if a person's intake is increased beyond this level.
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Increased consumption of fruits and cereals was linked to a reduced risk of rheumatoid arthritis.
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Low-to-moderate alcohol consumption (specifically beer) was associated with a reduced risk of rheumatoid arthritis, with each two unit/week increase in alcohol linked to a four per cent risk reduction. However the protective effect diminished with higher intake, the risk of RA began to rise once reached around 7.5 units of alcohol per week , indicating no protective effect at higher levels of consumption.
Foods associated with a higher rheumatoid arthritis risk:
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Tea consumption was associated with a four per cent increased risk per additional cup/day.
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Coffee also showed a less pronounced association with increased rheumatoid arthritis risk, suggesting the need for further investigation.
Co-author and PhD supervisor Janet Cade, Professor of Nutritional Epidemiology, added:
"This is a comprehensive study taking in the results of thirty different large-scale studies looking into the effects of diet on risk of developing rheumatoid arthritis. The results are promising, showing that by eating higher amounts of foods like oily fish, cereals, vegetables and the nutrient vitamin D, people may be able to lower their chances of developing this painful and debilitating condition.
"It is also interesting to see that drinking a moderate amount of alcohol – the equivalent of one pint of lower-strength lager or beer, or one glass of wine a week – can lower rheumatoid arthritis risk. However, tea and coffee consumption may increase risk a little.
"More research will help us pinpoint exactly why these foods have the effect we have observed and develop tailored nutritional advice for people living with rheumatoid arthritis and other autoimmune diseases."
