-
1.
Ethnic Differences in the Prevalence of Type 2 Diabetes Diagnoses in the UK: Cross-Sectional Analysis of the Health Improvement Network Primary Care Database.
Pham, TM, Carpenter, JR, Morris, TP, Sharma, M, Petersen, I
Clinical epidemiology. 2019;11:1081-1088
-
-
-
Free full text
Plain language summary
Type 2 diabetes mellitus is associated with substantial disease burden, including increased mortality risk and significant long-term morbidity. The aim of this study was to examine the prevalence of type 2 diabetes diagnoses based on primary care electronic health records. This study is a cross-sectional analysis of health records data from The Health Improvement Network primary care database. The sample comprised 51% women; most of the individuals in the sample (approximately 80%) were below 60 years of age. Results show that compared with those of White ethnicity, the likelihood of having a type 2 diabetes diagnosis was more than double among Asian people, 65% more likely among Black people, and 17% more likely among people of Mixed/Other ethnicity. Authors conclude that accurate estimates of ethnic prevalence of type 2 diabetes are important for ensuring that public health resources are allocated appropriately for diabetes screening and lifestyle interventions.
Abstract
AIMS/HYPOTHESIS Type 2 diabetes mellitus is associated with high levels of disease burden, including increased mortality risk and significant long-term morbidity. The prevalence of diabetes differs substantially among ethnic groups. We examined the prevalence of type 2 diabetes diagnoses in the UK primary care setting. METHODS We analysed data from 404,318 individuals in The Health Improvement Network database, aged 0-99 years and permanently registered with general practices in London. The association between ethnicity and the prevalence of type 2 diabetes diagnoses in 2013 was estimated using a logistic regression model, adjusting for effect of age group, sex, and social deprivation. A multiple imputation approach utilising population-level information about ethnicity from the UK census was used for imputing missing data. RESULTS Compared with those of White ethnicity (5.04%, 95% CI 4.95 to 5.13), the crude percentage prevalence of type 2 diabetes was higher in the Asian (7.69%, 95% CI 7.46 to 7.92) and Black (5.58%, 95% CI 5.35 to 5.81) ethnic groups, while lower in the Mixed/Other group (3.42%, 95% CI 3.19 to 3.66). After adjusting for differences in age group, sex, and social deprivation, all minority ethnic groups were more likely to have a diagnosis of type 2 diabetes compared with the White group (OR Asian versus White 2.36, 95% CI 2.26 to 2.47; OR Black versus White 1.65, 95% CI 1.56 to 1.73; OR Mixed/Other versus White 1.17, 95% CI 1.08 to 1.27). CONCLUSION The prevalence of type 2 diabetes was higher in the Asian and Black ethnic groups, compared with the White group. Accurate estimates of ethnic prevalence of type 2 diabetes based on large datasets are important for facilitating appropriate allocation of public health resources, and for allowing population-level research to be undertaken examining disease trajectories among minority ethnic groups, that might help reduce inequalities.
-
2.
A Narrative Review of The Role of Foods as Dietary Sources of Vitamin D of Ethnic Minority Populations with Darker Skin: The Underestimated Challenge.
Guo, J, Lovegrove, JA, Givens, DI
Nutrients. 2019;11(1)
-
-
-
Free full text
Plain language summary
Vitamin D is essential for healthy bones, and low vitamin D status is associated with an increased risk of chronic diseases such as cardiovascular disease and type 2 diabetes. Ethnic minority populations with darker skin are considered as a high-risk group for vitamin D deficiency, owing mainly to having less ability to synthesise vitamin D from sunlight due to the skin pigment melanin and/or reduced skin exposure due to clothing required by religious or cultural traditions. The aim of this literature review was to evaluate vitamin D intake and status of ethnic minority populations with darker skin. The authors examined previous observational studies and randomised controlled trials. Ethnic minority populations generally have a lower vitamin D status than white populations. Compared with Caucasians, there is evidence that Asians require approximately three times longer periods of sunlight exposure, and Africans six times the same exposure, to achieve the same blood levels of vitamin D. The main food sources for dietary vitamin D intake were different for ethnic minority populations and white populations. There is limited evidence on the impact of vitamin D supplementation on different ethnic groups. The authors concluded that food fortification could be explored to increase dietary vitamin D intake in ethnic minority populations who generally have lower levels of vitamin D.
Abstract
In recent years, vitamin D deficiency has attracted attention worldwide. Especially many ethnic minority populations are considered at high-risk of vitamin D deficiency, owing to a lesser ability to synthesis vitamin D from sunlight (ultraviolet B), due to the skin pigment melanin and/or reduced skin exposure due to coverage required by religious and cultural restrictions. Therefore, vitamin D intake from dietary sources has become increasingly important for many ethnic minority populations to achieve adequate vitamin D status compared with the majority of the population. The aim of the study was critically evaluate the vitamin D intake and vitamin D status of the ethnic minority populations with darker skin, and also vitamin D absorption from supplements and ultraviolet B. Pubmed, Embaase and Scopus were searched for articles published up to October 2018. The available evidence showed ethnic minority populations generally have a lower vitamin D status than the majority populations. The main contributory food sources for dietary vitamin D intake were different for ethnic minority populations and majority populations, due to vary dietary patterns. Future strategies to increase dietary vitamin D intake by food fortification or biofortification needs to be explored, not only for the majority population but more specifically for ethnic minority populations who are generally of lower vitamin D status.
-
3.
Trends in incidence of total or type 2 diabetes: systematic review.
Magliano, DJ, Islam, RM, Barr, ELM, Gregg, EW, Pavkov, ME, Harding, JL, Tabesh, M, Koye, DN, Shaw, JE
BMJ (Clinical research ed.). 2019;366:l5003
-
-
-
Free full text
-
Plain language summary
Incidence measures the proportion of people who develop diabetes over a period of time among the population at risk. The aim of this study is to systematically review literature which reports diabetes incidence trends. This study is a systemic review of 47 studies. A total of 62% (n=29) of the studies exclusively reported on type 2 diabetes, and 38% (n=18) reported on total diabetes. Findings show that the incidence of diagnosed diabetes increased in most populations from the 1960s to the early 2000s, after which a pattern emerged of levelling trends in 30% and declining trends in 36% of the reported populations. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Authors conclude that improvement of the collection, availability, and analysis of incidence data will be important to effectively monitor the epidemic and guide prevention efforts into the future.
Abstract
OBJECTIVE To assess what proportions of studies reported increasing, stable, or declining trends in the incidence of diagnosed diabetes. DESIGN Systematic review of studies reporting trends of diabetes incidence in adults from 1980 to 2017 according to PRISMA guidelines. DATA SOURCES Medline, Embase, CINAHL, and reference lists of relevant publications. ELIGIBILITY CRITERIA Studies of open population based cohorts, diabetes registries, and administrative and health insurance databases on secular trends in the incidence of total diabetes or type 2 diabetes in adults were included. Poisson regression was used to model data by age group and year. RESULTS Among the 22 833 screened abstracts, 47 studies were included, providing data on 121 separate sex specific or ethnicity specific populations; 42 (89%) of the included studies reported on diagnosed diabetes. In 1960-89, 36% (8/22) of the populations studied had increasing trends in incidence of diabetes, 55% (12/22) had stable trends, and 9% (2/22) had decreasing trends. In 1990-2005, diabetes incidence increased in 66% (33/50) of populations, was stable in 32% (16/50), and decreased in 2% (1/50). In 2006-14, increasing trends were reported in only 33% (11/33) of populations, whereas 30% (10/33) and 36% (12/33) had stable or declining incidence, respectively. CONCLUSIONS The incidence of clinically diagnosed diabetes has continued to rise in only a minority of populations studied since 2006, with over a third of populations having a fall in incidence in this time period. Preventive strategies could have contributed to the fall in diabetes incidence in recent years. Data are limited in low and middle income countries, where trends in diabetes incidence could be different. SYSTEMATIC REVIEW REGISTRATION Prospero CRD42018092287.
-
4.
Pharmaceutical Interventions in Chronic Fatigue Syndrome: A Literature-based Commentary.
Richman, S, Morris, MC, Broderick, G, Craddock, TJA, Klimas, NG, Fletcher, MA
Clinical therapeutics. 2019;41(5):798-805
-
-
-
Free full text
-
Plain language summary
Myalgic encephalomyelitis, also known as Chronic Fatigue Syndrome (ME/ CFS), is a disease characterized by an inability to exert oneself physically, often coupled with a combination of other symptoms, including sleep disorders, severe unpredictable pain, and compromised cognitive abilities. The aim of this review was to delineate a number of the more prominent treatments for ME/CFS into different categories and evaluate the methods and results of corresponding drug trials. Results indicate that: • antiviral drugs appear to show limited efficacy in treating ME/CFS over a broad demographic. • there is a lack of clinical research focusing on the use of specific cyclooxygenase-2 inhibitors [analgesic] to treat ME/CFS. • antidepressants may be of use in delivering improvements in the quality of life of patients with ME/CFS. • recalibration of endocrine-immune regulation may be involved in supporting the persistence of ME/CFS and may be responsible at least in part for its resistance to single agent interventions. Authors conclude that there is a great need for larger, longitudinal studies focused on a more clearly defined subset of ME/CFS as well as a greater consideration of potential synergies between interventions and the suitability of combination therapies.
Abstract
Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a debilitating disorder characterized by prolonged periods of fatigue, chronic pain, depression, and a complex constellation of other symptoms. Currently, ME/CFS has no known cause, nor are the mechanisms of illness well understood. Therefore, with few exceptions, attempts to treat ME/CFS have been directed mainly toward symptom management. These treatments include antivirals, pain relievers, antidepressants, and oncologic agents as well as other single-intervention treatments. Results of these trials have been largely inconclusive and, in some cases, contradictory. Contributing factors include a lack of well-designed and -executed studies and the highly heterogeneous nature of ME/CFS, which has made a single etiology difficult to define. Because the majority of single-intervention treatments have shown little efficacy, it may instead be beneficial to explore broader-acting combination therapies in which a more focused precision-medicine approach is supported by a systems-level analysis of endocrine and immune co-regulation.
-
5.
Use of Meditation and Cognitive Behavioral Therapies for the Treatment of Stress, Depression and Anxiety in Students. A Systematic Review and Meta-Analysis.
González-Valero, G, Zurita-Ortega, F, Ubago-Jiménez, JL, Puertas-Molero, P
International journal of environmental research and public health. 2019;16(22)
-
-
-
Free full text
Plain language summary
Research in the field of the mind is increasing, with students becoming key objects of study in the field of social sciences and health. The main aim of this study was to review the scientific literature in order to analyze the effect produced by cognitive-behavioural programs and meditation strategies on stress, anxiety, and depression in students. A secondary aim was to identify the determinants of treatment success. This study is a systemic review and meta-analysis of 34 articles which included 3296 participating students. A total of 22 effect sizes were calculated for stress treatment, 28 for anxiety and 28 for depression. Results show that interventions based on cognitive-behavioural programs, self-reflection, and mindfulness-based approaches produce satisfactory and significant results in relation to the reduction of stress, anxiety, and depression in students. Furthermore, taking into consideration the theoretical foundations of the studies analysed, meditation (mindfulness, yoga and tai chi), muscle relaxation and breathing, coaching, and cognitive-behavioural therapy are strategies that have shown effectiveness in improving mental health. Authors conclude that it is essential to focus attention on how to improve the mental health of students, including an increase in the number of interventions in the classroom.
Abstract
The prevalence of mental health problems within students due to high academic demands and learning difficulties is a current challenge the field of education. The aim of this study is to review the scientific literature in order to analyze the effect produced by cognitive-behavioral programs and meditation strategies on stress, anxiety, and depression in students. A further aim is to identify the determinants of treatment success. The bibliographic search was carried out using Web of Science, specifically in the categories of "Education and Educational Research" and "Psychology", obtaining a sample of 122 articles published between 2007 and 2018. Studies were included which had a pre-experimental or quasi-experimental design and included pre-test and post-test phases. Following application of inclusion criteria, 34 articles were selected for inclusion in a meta-analysis of the random effects of each variable. This obtained an average effect size of -0.41 for stress, -0.37 for anxiety, and -0.30 for depression. Three moderating variables were analyzed, with significant correlations being found for the type of treatment relating to stress (Q = 11.01, df = 2, p = 0.004, R2 = 0.294) and depression (Q = 6.14, df = 2, p = 0.048; R2 = 0.436). The stage of education of the individuals was also found to impact upon anxiety intervention success (Q = 13.093 df = 2, p = 0.0009, R2 = 0.196). Interventions mainly addressed the importance of meditation strategies, mindfulness programs, and cognitive-behavioral therapy to reduce stress, anxiety, and depression in students. This supports the need to increase research at an early age, considering the treatment of mental health as a key factor influencing academic performance and quality of life.
-
6.
Anxiety reduction through art therapy in women. Exploring stress regulation and executive functioning as underlying neurocognitive mechanisms.
Abbing, A, de Sonneville, L, Baars, E, Bourne, D, Swaab, H
PloS one. 2019;14(12):e0225200
-
-
-
Free full text
Plain language summary
Anxiety treatments currently involve medication and changing an individual’s beliefs through cognitive behavioural therapy (CBT). Art therapy (AT) is often used as a CBT treatment strategy, although little is known about its effectiveness. This randomised control trial of 47 adult women with anxiety aimed to understand the role of AT in anxiety treatment over three months. The results showed improvements in self-reported measures of anxiety, the ability to control emotions, memory and the ability to manage tasks with AT, however subjects were just as susceptible to stress following treatment. It was concluded that anxiety reduction was related to improvements in emotions, memory and task management and this was as a result of AT. This study could be used by healthcare professionals to recommend AT to individuals with symptoms of anxiety as part of their treatment management plan.
Abstract
OBJECTIVES To explore possible working mechanisms of anxiety reduction in women with anxiety disorders, treated with art therapy (AT). METHODS A RCT comparing AT versus waiting list (WL) condition on aspects of self-regulation. Stress regulation (heart rate and heart rate variability) and executive functioning (daily behavioural and cognitive performance aspects of executive functioning (EF)) were evaluated in a pre-post design. Participants were women, aged 18-65 years with moderate to severe anxiety symptoms. RESULTS Effectiveness of AT compared to WL was demonstrated in a higher resting HRV post treatment, improvements in aspects of self-reported daily EF (emotion control, working memory, plan/organize and task monitor), but not in cognitive performance of EF, stress responsiveness and down regulation of stress. The decrease in anxiety level was associated with improvements in self-reported daily EF. CONCLUSIONS AT improves resting HRV and aspects of EF, the latter was associated with art therapy-related anxiety reduction.
-
7.
Internet-Delivered Acceptance and Commitment Therapy for Anxiety Treatment: Systematic Review.
Kelson, J, Rollin, A, Ridout, B, Campbell, A
Journal of medical Internet research. 2019;21(1):e12530
-
-
-
Free full text
Plain language summary
Anxiety and its related conditions are highly prevalent on a global scale. A potential solution for people with anxiety is Acceptance and Commitment Therapy (ACT)—a psychological treatment that teaches mindfulness skills to help people accept their anxiety and commit to living in accordance with personal values. The aim of this study was to provide a comprehensive and up-to-date account on the empirical status of internet-delivered ACT for anxiety. This study is a systemic review of 20 studies. More than half of the studies were randomised control trials. Findings indicate small-to-large anxiety reductions among participants (suffering from generalized anxiety disorder, social anxiety disorder and illness anxiety disorder) after internet-derived ACT on standardized measures (studies n=18), thus indicating the beneficial impact of internet-derived ACT on anxiety. Authors conclude that their current findings indicate that internet-derived ACT can be an effective and acceptable treatment for some anxiety conditions among young to middle aged adults in Western societies.
Abstract
BACKGROUND Anxiety conditions are debilitating and prevalent throughout the world. Acceptance and Commitment Therapy (ACT) is an effective, acceptance-based behavioral therapy for anxiety. However, there are treatment barriers (eg, financial, geographical, and attitudinal), which prevent people from accessing it. To overcome these barriers, internet-delivered ACT (iACT) interventions have been developed in recent years. These interventions use websites to deliver ACT information and skill training exercises on the Web, either as pure self-help or with therapist guidance. OBJECTIVE This systematic review aimed to examine the therapeutic impact of iACT on all anxiety conditions. METHODS The EMBASE, MEDLINE, ProQuest Central, PsycINFO, Scopus, and Web of Science databases were searched up to September 2018. The titles and abstracts of remaining records after deduplication were screened by 2 authors with a total of 36 full-text articles being retained for closer inspection next to eligibility criteria. Empirical studies of all designs, population types, and comparator groups were included if they appraised the impact of iACT treatment on any standardized measure of anxiety. Included studies were appraised on methodological quality and had their data extracted into a standardized coding sheet. Findings were then tabulated, and a narrative synthesis was performed because of the heterogeneity found between studies. RESULTS A total of 20 studies met inclusion criteria. There were 11 randomized controlled trials (RCTs) and 9 uncontrolled pilot studies. Participants across all studies were adults. The anxiety conditions treated were as follows: generalized anxiety disorder (GAD), social anxiety disorder (SAD), illness anxiety disorder (IAD), and general anxiety symptoms, with or without comorbid physical and mental health problems. A total of 18 studies reported significant anxiety reduction after iACT treatment. This was observed in studies that delivered iACT with (n=13) or without (n=5) therapist guidance. The average attrition rate across all included studies during the active iACT treatment phase was 19.19%. In the 13 studies that assessed treatment satisfaction, participants on average rated their iACT experience with above average to high treatment satisfaction. CONCLUSIONS These findings indicate that iACT can be an efficacious and acceptable treatment for adults with GAD and general anxiety symptoms. More RCT studies are needed to corroborate these early iACT findings using empirical treatments in active control groups (eg, internet-delivered cognitive behavioral therapy). This would potentially validate the promising results found for SAD and IAD as well as address the full spectrum of anxiety disorders.
-
8.
Changes in Anxiety and Depression Traits Induced by Energy Restriction: Predictive Value of the Baseline Status.
Rodriguez-Lozada, C, Cuervo, M, Cuevas-Sierra, A, Goni, L, Riezu-Boj, JI, Navas-Carretero, S, Milagro, FI, Martinez, JA
Nutrients. 2019;11(6)
-
-
-
Free full text
Plain language summary
Anxiety and depression are among the most common mental health problems and are associated with obesity and other chronic illnesses. The number of these disorders has not been reduced despite the increased use of cognitive behavioural therapy and pharmacotherapy. Current evidence suggests diet quality as a modifiable risk factor for mental illnesses. Additional studies are required to investigate the effect of dietary patterns as well as weight loss on improving symptoms. The first aim of this study was to investigate the effect of weight loss on overweight and obese patients, using two calorie-restricted diets, on anxiety and depression symptoms. The second aim was to analyse the role of the baseline psychological features in predicting future weight loss. The study was a randomized, longitudinal, and controlled intervention trial which lasted for 16 weeks. The study indicates that weight loss via calorie-controlled diets could improve depression symptoms in obese and overweight patients. Participants that lost more weight showed a larger amelioration in depression symptoms. The study also suggests that greater anxiety symptoms at the beginning of the intervention could predict a higher weight loss. These results, in addition to the positive effect on body composition, show that weight loss could become part of a health improvement plan.
Abstract
Current evidence proposes diet quality as a modifiable risk factor for mental or emotional impairments. However, additional studies are required to investigate the effect of dietary patterns and weight loss on improving psychological symptoms. The aim of this investigation was to evaluate the effect of energy-restriction, prescribed to overweight and obese participants, on anxiety and depression symptoms, as well as the potential predictive value of some baseline psychological features on weight loss. Overweight and obese participants (n = 305) were randomly assigned for 16 weeks to two hypocaloric diets with different macronutrient distribution: a moderately high-protein (MHP) diet and a low-fat (LF) diet. Anthropometrical, clinical, psychological, and lifestyle characteristics were assessed at baseline and at the end of the intervention. The nutritional intervention evidenced that weight loss has a beneficial effect on trait anxiety score in women (β = 0.24, p = 0.03), depression score in all population (β = 0.15, p = 0.02), particularly in women (β = 0.22, p = 0.03) and in subjects who followed the LF diet (β = 0.22, p = 0.04). Moreover, weight loss could be predicted by anxiety status at baseline, mainly in women and in those who were prescribed a LF diet. This trial suggests that weight loss triggers an improvement in psychological traits, and that anxiety symptoms could predict those volunteers that benefit most from a balanced calorie-restricted intervention, which will contribute to individualized precision nutrition.
-
9.
Alpha-Linolenic and Linoleic Fatty Acids in the Vegan Diet: Do They Require Dietary Reference Intake/Adequate Intake Special Consideration?
Burns-Whitmore, B, Froyen, E, Heskey, C, Parker, T, San Pablo, G
Nutrients. 2019;11(10)
-
-
-
Free full text
Plain language summary
Fish and seafood are good sources of long-chain omega-3 fatty acids, like eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). A vegan diet does not include animal-sourced foods and is therefore void of EPA and DHA, unless algae-derived omega-3 supplements are consumed. Thus, vegans rely on the body's own production of long-chain fatty acids from plant-derived alpha-linolenic acid (ALA). However, adequate conversion can have several limitations. Vegan diets are generally rich in linoleic acid (LA), an omega-6 fatty acid, which in high levels can impede the conversion of ALA to EPA and DHA. Furthermore, the efficiency of conversion is influenced by gender, age or health conditions like obesity. This review sought to discuss whether vegans require special dietary recommendations for fatty acids and what these suggestions could be. Most studies assessing biological indicators of fatty acid status showed that vegans had lower levels of EPA and DHA compared to omnivores. Thus, the authors concluded that special consideration should be given to ALA and LA intake in vegan diets. In the absence of a set recommendation for a fatty acid ratio, a ratio of 4:1 (omega-6:omega-3) was proposed for vegans and omnivores. A reduction in LA and an increased intake of ALA of 2.2–4.4 g/day (or 1.1 g/day/1000 Kcals) was suggested to achieve such. This article is a useful guide when considering adequate fatty acid balance and omega-3 conversion for individuals following a vegan diet.
Abstract
Good sources of the long-chain n-3 fatty acids, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) include cold-water fish and seafood; however, vegan diets (VGNs) do not include animal-origin foods. Typically, US omnivores obtain enough dietary EPA and DHA, but unless VGNs consume algal n-3 supplements, they rely on endogenous production of long-chain fatty acids. VGN diets have several possible concerns: (1) VGNs have high intakes of linoleic acid (LA) as compared to omnivore/non-vegetarian diets. (2) High intakes of LA competitively interfere with the endogenous conversion of alpha-linolenic acid (ALA) to EPA and DHA. (3) High somatic levels of LA/low ALA indicate a decreased ALA conversion to EPA and DHA. (4) Some, not all VGNs meet the Dietary Reference Intake Adequate Intake (DRI-AI) for dietary ALA and (5) VGN diets are high in fiber, which possibly interferes with fat absorption. Consequently, health professionals and Registered Dietitians/Registered Dietitian Nutritionists working with VGNs need specific essential fatty acid diet guidelines. The purpose of this review was: (1) to suggest that VGNs have a DRI-AI Special Consideration requirement for ALA and LA based on VGN dietary and biochemical indicators of status and (2) to provide suggestions to ensure that VGNs receive adequate intakes of LA and ALA.
-
10.
Nutrition Interventions in Rheumatoid Arthritis: The Potential Use of Plant-Based Diets. A Review.
Alwarith, J, Kahleova, H, Rembert, E, Yonas, W, Dort, S, Calcagno, M, Burgess, N, Crosby, L, Barnard, ND
Frontiers in nutrition. 2019;6:141
-
-
-
Free full text
Plain language summary
Rheumatoid arthritis (RA) is a chronic autoimmune disease characterised by joint pain and inflammation with both genetic and modifiable risk factors. Research suggests a plant-based diet may play a role in management and remission. The aim of this review was to summarize the associations between plant-based diet patterns and RA symptoms. Current studies indicate an association between improvements in RA symptoms with weight loss and with plant-based diets. Based on these findings, the authors conclude excess weight and diets that include animal products may exacerbate symptoms associated with RA, whereas plant-based diets may help reduce pain and inflammation in these patients. The authors suggest further research is needed to test the effectiveness of plant-based diets on patients with RA.
Abstract
Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disease, affects roughly 1% of the world's population. RA pathogenesis remains unclear, but genetic factors account for 50-60% of the risk while the remainder might be linked to modifiable factors, such as infectious diseases, tobacco smoking, gut bacteria, and nutrition. Dietary triggers may play an inciting role in the autoimmune process, and a compromised intestinal barrier may allow food components or microorganisms to enter the blood stream, triggering inflammation. In addition, excessive body weight may affect pharmacotherapy response and the likelihood of disease remission, as well as the risk of disease mortality. Evidence suggests that changes in diet might play an important role in RA management and remission. Several studies have shown improvements in RA symptoms with diets excluding animal products. Studies have also shown that dietary fiber found in these plant-based foods can improve gut bacteria composition and increase bacterial diversity in RA patients, thus reducing their inflammation and joint pain. Although some of the trigger foods in RA patients are individualized, a vegan diet helps improve symptoms by eliminating many of these foods. This review examines the potential role of a plant-based diet in mediating RA symptoms. Further research is needed to test the effectiveness of plant-based diets on joint pain, inflammation, and quality of life in patients with RA.