ArticleBMC musculoskeletal disorders2019
Association of fish intake and smoking with risk of rheumatoid arthritis and age of onset: a prospective cohort study.
Article in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 60 citations in OpenAlex.
- Dose-Response Associations Between Diet and Risk of Rheumatoid Arthritis: A Meta-Analysis of Prospective Cohort Studies.Nutrients · 2024Pooled it
- Pooled it
- Joint effects of one year of marine omega-3 fatty acid supplementation and participant dietary fish intake upon circulating lipid mediators of inflammation resolution in a randomized controlled trial.Nutrition (Burbank, Los Angeles County, Calif.) · 2024Trial
- Dietary protein, major dietary protein sources, and chronic joint diseases risk.Nutrition & metabolism · 2026Article
- The Role of Microbiome and Diet on Disease Activity and Immune-Inflammatory Status in Rheumatoid Arthritis.Nutrients · 2026Review
- Rheumatoid Arthritis: A Comprehensive Review of Etiology, Pathophysiology, and Innovative Therapeutic Advancements.Current pharmaceutical design · 2026Review
- Intake of one-carbon metabolism nutrients and risk of rheumatoid arthritis: a prospective UK biobank cohort study.European journal of nutrition · 2025Article
- Development and internal validation of a prediction model for rheumatoid arthritis: a case-control study.Scientific reports · 2025Article
- Advances in the Medical Treatment of Rheumatoid Arthritis.Hand clinics · 2025Review
- Nonlinear Association Between the C-Reactive Protein-Triglyceride-Glucose Index and Rheumatoid Arthritis Risk: The Mediating Role of Body Mass Index.Mediators of inflammation · 2025Article
- Genetic factors may load the gun, but environmental factors pull the trigger: MedDiet and DII in rheumatoid arthritis.Frontiers in nutrition · 2025Review
- Distinct mucosal endotypes as initiators and drivers of rheumatoid arthritis.Nature reviews. Rheumatology · 2024Review
- Integrative non-pharmacological care for individuals at risk of rheumatoid arthritis.Rheumatology international · 2024Review
- Lipoxygenase-derived oxylipins are enriched in anti-citrullinated protein antibody (ACPA)-positive individuals at risk for developing rheumatoid arthritis.Arthritis research & therapy · 2024Article
- Diets and Joint Symptoms: A Survey of Moroccan Patients With Chronic Inflammatory Rheumatic Disease.Cureus · 2024Article
- Diet as a Risk Factor for Rheumatoid Arthritis.Cureus · 2023Review
- Over-the-counter fish oil supplementation and pro-resolving and pro-inflammatory lipid mediators in rheumatoid arthritis.Prostaglandins, leukotrienes, and essential fatty acids · 2023Article
- Modifiable risk factors linked to the development of rheumatoid arthritis: evidence, immunological mechanisms and prevention.Frontiers in immunology · 2023Review
- Associations of the MUC5B promoter variant with timing of interstitial lung disease and rheumatoid arthritis onset.Rheumatology (Oxford, England) · 2022Article
- Global epidemiology of rheumatoid arthritis.Nature reviews. Rheumatology · 2022Review
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundPrior studies suggest that fish may be protective for rheumatoid arthritis (RA) risk perhaps through the anti-inflammatory effect of omega-3 fatty acid, but this relationship has not been clearly established. Therefore, we investigated fish intake and RA risk by serologic status, age of onset, and smoking using a prospective cohort study with large sample size, repeated measures of dietary intake, and lengthy follow-up.
methodsWe studied fish intake and RA risk among 166,013 women in two prospective cohorts, the Nurses' Health Study (NHS, 1984-2014) and NHSII (1991-2015). Fish intake was assessed using food frequency questionnaires at baseline and every 4 years. Incident RA during follow-up and serologic status were determined by medical record review. Pooled Cox regression models estimated hazard ratios (HR) and 95% confidence intervals (CI) for RA (overall and by serologic status and age at diagnosis) for fish intake frequency. We tested for a smoking-fish interaction for RA risk.
resultsDuring 3,863,909 person-years of follow-up, we identified 1080 incident RA cases. Increasing fish intake was not associated with all RA (≥4 servings/week: multivariable HR 0.93 [95%CI 0.67-1.28] vs. < 1 serving/month; p for trend = 0.42), seropositive RA (p for trend = 0.66), or seronegative RA (p for trend = 0.45), but had increased risk for RA diagnosed > 55 years old (p for trend = 0.037). Among women ≤55 years old, frequent fish intake (vs. infrequent) had HRs (95%CIs) of: 0.73 (0.52-1.02) for all RA, 0.85 (0.55-1.32) for seropositive RA, and 0.55 (0.32-0.94) for seronegative RA. Ever smokers with infrequent fish intake had highly elevated risk for RA onset ≤55 years (HR 2.59, 95%CI 1.65-4.06), while ever smokers with frequent fish intake had modestly elevated RA risk (HR 1.29, 95%CI 1.07-1.57; vs. never smokers/frequent fish intake; p for smoking-fish interaction = 0.039).
conclusionIn this large prospective cohort study, we found no clear protective effect of fish or marine omega-3 fatty acid intake on RA risk, overall or by serologic status. We found that fish intake attenuated the strong association of smoking for RA diagnosed ≤55 years of age, but this requires further study.
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