A 12-week randomized controlled trial of the dietary approaches to stop hypertension (DASH) diet in seropositive rheumatoid arthritis: Effects on disease activity and outcomes

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dc.authorid0000-0002-8769-2657
dc.authorid0000-0001-5132-2518
dc.authorid0000-0001-6208-3540
dc.authorid0000-0002-4842-0683
dc.contributor.authorÖzüpek, Gökçen
dc.contributor.authorAltay, İkbal Süheyla
dc.contributor.authorKalyoncu Atasoy, Zeynep Begüm
dc.contributor.authorTorun, Ege Sinan
dc.date.accessioned2026-11-11T08:43:08Z
dc.date.available2026-11-11T08:43:08Z
dc.date.issued2026
dc.departmentEnstitüler, Lisansüstü Eğitim Enstitüsü, Beslenme ve Diyetetik Programı
dc.departmentFakülteler, Sağlık Bilimleri Fakültesi, Beslenme ve Diyetetik Bölümü
dc.description.abstractBackground & aims: Dietary interventions may improve rheumatoid arthritis (RA) outcomes through anti-inflammatory and metabolic pathways. This study aimed to evaluate the effects of the Dietary Approaches to Stop Hypertension (DASH) diet on disease activity and treatment outcomes in patients with seropositive RA. Methods: In this 12-week parallel-group randomized controlled trial, 82 patients with seropositive RA were randomly assigned to a DASH diet intervention (n = 40) or a control group maintaining their usual diet (n = 42). The primary outcome was change in disease activity assessed using the Disease Activity Score in 28 joints based on erythrocyte sedimentation rate (DAS-28 E SR). Secondary outcomes included change in DAS-28 based on C-reactive protein (DAS-28 CRP), as well as tender and swollen joint counts, ESR, CRP, visual analogue scale (VAS) scores for pain and general health, the Health Assessment Questionnaire (HAQ), and the Short Form-36 (SF-36). Adherence to the intervention was evaluated using the DASH diet score. Assessments were performed at baseline and at weeks 4, 8, and 12. Data were analyzed according to the intention-to-treat principle. Repeated clinical outcomes were analyzed using robust mixed ANOVA or generalized estimating equations (GEE), as appropriate. Results: Of the 82 randomized patients, 49 completed the 12-week study. Adherence to the DASH diet increased significantly in the intervention group compared with the control group (p < 0.001). From baseline to Week 12, DAS-28 ESR decreased by 0.92 points in the DASH group versus 0.17 points in the control group, corresponding to a 0.75-point greater reduction (group × time interaction, p = 0.001). Significant between-group differences in change were also observed for DAS-28 CRP (− 0.62), ESR (− 3.90 mm/h), VAS-pain (− 2.19), VAS-general health (− 2.12), and HAQ (− 0.38) (all group × time p˂0.05). For SF-36, significant between-group differences in change were observed for physical functioning (+10.15), role-physical (+47.30), bodily pain (+22.17), vitality (+18.52), role-emotional (+38.61), and mental health (+12.06) (all group × time p < 0.05). CRP, tender and swollen joint counts did not show significant group × time interactions (p > 0.05). Furthermore, in the intervention group, improvements in DASH diet adherence were negatively correlated with changes in DAS-28 ESR and DAS-28 CRP scores (both p < 0.05). Conclusions: A 12-week DASH dietary intervention may provide clinically meaningful improvements in disease activity and patient-reported outcomes in patients with seropositive RA. These findings support the potential role of the DASH dietary pattern as a promising dietary approach to complement the management of RA. However, the relatively high attrition rate should be considered when interpreting the findings. Trial registration: This trial is registered with Clinicaltrials.gov (ID: NCT07170033). https://clinicaltrials.gov/study/NCT07170033
dc.identifier.citationÖzüpek, G., Altay, İ. S., Kalyoncu Atasoy, Z. B., & Torun, E. S. (2026). A 12-week randomized controlled trial of the dietary approaches to stop hypertension (DASH) diet in seropositive rheumatoid arthritis: Effects on disease activity and outcomes. Clinical Nutrition, 66, pp. 1-11. https://doi.org/10.1016/j.clnu.2026.106811
dc.identifier.doi10.1016/j.clnu.2026.106811
dc.identifier.endpage11
dc.identifier.issn1532-1983
dc.identifier.issn0261-5614
dc.identifier.pmidPMID: 42863421
dc.identifier.scopus2-s2.0-105052771039
dc.identifier.scopusqualityQ1
dc.identifier.startpage1
dc.identifier.urihttps://doi.org/10.1016/j.clnu.2026.106811
dc.identifier.urihttps://hdl.handle.net/20.500.13055/1706
dc.identifier.volume66
dc.identifier.wosWOS:001904684900001
dc.identifier.wosqualityQ1
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.indekslendigikaynak.otherSCI-E - Science Citation Index Expanded
dc.institutionauthorÖzüpek, Gökçen
dc.institutionauthorAltay, İkbal Süheyla
dc.institutionauthorid0000-0002-8769-2657
dc.institutionauthorid0000-0001-5132-2518
dc.language.isoen
dc.publisherElsevier
dc.relation.ispartofClinical Nutrition
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.subjectArthritis
dc.subjectRheumatoid
dc.subjectDiet
dc.subjectFunctional Status
dc.subjectInflammation
dc.subjectPain
dc.titleA 12-week randomized controlled trial of the dietary approaches to stop hypertension (DASH) diet in seropositive rheumatoid arthritis: Effects on disease activity and outcomes
dc.typeArticle
dspace.entity.typePublication

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