Higher levels of consumption of ultra-processed food in patients with rheumatoid arthritis (RA) have been associated with worse metabolic profiles and elevated cardiovascular risk, while higher levels of consumption of unprocessed or minimally processed foods are associated with lower low density lipoprotein (LDL) cholesterol and reduced 10-year cardiovascular disease risk, according to study results published in Clinical Rheumatology.
To assess the associations between processed food consumption and risk factors for cardiovascular disease in patients with RA, investigators in Sao Paulo, Brazil, conducted a cross-sectional study with 56 women (aged 62.5±7.9 years; body mass index, 28.4±5.1 kg/m2) focused on evaluation of food consumption according to level of processing (eg, unprocessed or minimally processed, processed, and ultra-processed) and associated levels of consumption of processed foods with risk factors for cardiovascular disease.
Unprocessed or minimally processed was the most prevalent food processing level in the study participants (42.6±12.6% of total energy intake [TEI]), followed by processed (24.2±11.9% TEI), ultra processed (18.1±11.8% TEI), and culinary ingredients (15.1±6.4% TEI). Adjusted regression models showed a negative association between higher consumption of unprocessed or minimally processed foods and Framingham risk score (β=-0.07 [95% CI, -0.14 to -0.006]; P =.034), 10-year risk of developing cardiovascular disease (β =-0.07 [95% CI, -0.12 to -0.02]; P =.013) and LDL (β=-1.09 [95% CI, -1.94 to -0.24]; P =.014). A positive association was found between higher consumption of ultra processed foods and glycated hemoglobin (β=0.04 [95% CI, 0.01-0.07]; P =.013). After adjustments were made for age and body mass index, the association between unprocessed or minimally processed foods and Framingham risk score was no longer significant. In contrast, after adjustments, the association between higher consumption of ultra processed foods and Framingham risk score became significant (β=0.06 [95% CI, 0.001-0.11]; P =.045).
Study investigators concluded, “Patients with RA consuming more ultra-processed foods showed higher glycated hemoglobin and Framingham risk score, whereas those consuming more unprocessed or minimally processed foods had lower 10-year risk of developing cardiovascular disease and LDL. A food pattern characterized by a high ultra-processed food consumption emerges as a novel, modifiable risk factor for cardiovascular diseases in RA. Prospective, controlled studies should address this hypothesis.”
Smaira FI, Mazzolani BC, Peçanha T, et al. Ultra-processed food consumption associates with higher cardiovascular risk in rheumatoid arthritis [published online January 4, 2020]. Clin Rheumatol. doi:10.1007/s10067-019-04916-4