Two-Year Follow-Up of a Multidisciplinary Lifestyle Intervention for Rheumatoid Arthritis and Osteoarthritis.

Abstract

Objective: The Plants for Joints intervention (PFJ), including a whole-food plant-based diet, exercise, and stress reduction, reduced signs and symptoms of rheumatoid arthritis (RA) or metabolic syndrome-associated hip or knee osteoarthritis (MSOA) compared to usual care. This study examined outcomes two years later.

Methods: After two 16-week randomized controlled trials in people with 1) RA or 2) MSOA, control groups received the active PFJ intervention. All participants were then followed in a two-year observational extension study. Primary outcomes were DAS28 (RA) and WOMAC (MSOA). Secondary outcomes included body composition, metabolic outcomes, medication changes, and adherence to intervention recommendations. Within-group differences were assessed using linear mixed models, comparing the start and end of the intervention to two years post-intervention.

Results: 48 (62%) of 77 RA participants and 44 (69%) of 64 MSOA participants completed the extension study. Two years post-intervention the DAS28 in RA participants (-0.9 points 95% CI -1.2, -0.6) and WOMAC score in MSOA participants (-8.8 points 95% CI -12.6, -5.1) were significantly lower than start intervention. Also, CRP in the RA group, and weight, BMI, waist circumference, and diastolic blood pressure in the MSOA group, were significantly lower compared to start intervention. Primary endpoints remained similar from the end of the intervention to the end of the extension study. During the extension study, medication use decreased slightly, and participants continued to follow the intervention recommendations.

Conclusion: Two years after the PFJ intervention, improvements in RA disease activity, MSOA symptoms and functioning, and intervention adherence were sustained.