If you drink too much coffee, tea, and wine, will you be prone to rheumatoid arthritis? Research Express

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New studies show that coffee intake is associated with an increased risk of rheumatoid arthritis (RA) in a positive dose-effect relationship (_ptrend=0.
04); Intake of artificially sweetened soft drinks such as cola and sprite was also associated with an increased risk of RA (adjusted hazard ratio [aHR] = 1.
66); Intake of tea, alcoholic, and non-artificially sweetened sugary soft drinks was not
associated with RA risk.
Coffee drinkers are widely used, and researchers believe that limiting coffee intake may prevent the occurrence of RA, especially in
people at high risk of RA.

RA is the most common chronic inflammatory rheumatism, more common in women, and its cause is currently unknown
.
Many food ingredients are potentially associated with RA risk, and heavy consumption of coffee and soft drinks has been reported to be associated with an increased risk of RA, while heavy tea or moderate drinking may be associated with a reduced risk of RA, and the underlying mechanism may be related
to the pro-inflammatory or anti-inflammatory properties of specific beverages.
To assess the association between intake of specific beverages (coffee, tea, alcohol, and soft drinks) and the risk of RA, researchers from France conducted a prospective study in a large cohort, recently published in Rheumatology (Oxford) (impact factor 7.
046).

Study design

E3N is a large prospective cohort study conducted in France to investigate environmental factors associated with chronic diseases, with a total of 98,995 female participants
since 1990.
Based on this cohort, the food frequency questionnaire was used to collect participants' beverage intake, analyze the correlation between it and RA risk, and calculate HR and 95% confidence interval (CI)
by Cox proportional hazards model.
The beverage intake categories and intake stratification are as follows:

➤ Coffee intake categories include caffeinated coffee, decaffeinated coffee, and chicory coffee
.
Overall coffee intake was divided into ≤1, 1-2.
5, 2.
5-4 and ≥4 cups per day (1 cup = 125 mL), of which caffeinated coffee was divided into ≤1, 1-2, 2-3.
5 and ≥3.
5 cups
per day.

➤Tea intake is divided into < 1, 1-3 and ≥3 cups per day (1 cup = 125mL).

➤ Alcohol intake is divided into ≤ 1, 1-5, 5-12 and ≥ 12 cups per week (1 cup = 10g ethanol).

➤ Sugary soft drinks include "100% fruit juice", sugary sodas, and fruit drinks, and artificially sweetened soft drinks include artificially sweetened soda or artificially sweetened

➤ Fruit drinks, the intake is divided into < 229mL, 229-770mL and >770mL
per week.

Study results

A total of 62,630 women with a mean age of 52.
5 (±6.
5) years were included in the study, including 481 patients with
RA.

Coffee intake is associated with an increased risk of RA

The results after adjusting for confounding factors showed that coffee intake was associated with an increased risk of RA, with a positive dose-effect relationship (ptrend=0.
04).

Analysis of smoking history subgroups showed that people with an average coffee intake of 2.
5 to 4 cups per day had a 64% increased risk of RA in people with no smoking history compared with ≤ 1 cup per day (aHR=1.
64, 95% CI [1.
13 to 2.
38]).

Caffeinated coffee intake was more strongly associated with the risk of RA, with a significant positive dose-effect relationship
in both the general population (ptrend=0.
04) and the non-smoking population (ptrend=0.
005).
Among people with no history of smoking, people with an average caffeinated coffee intake of ≥3.
5 cups/day had a 62% increased risk of RA compared with those with ≤ 1 cup/day (aHR = 1.
62, 95% CI [1.
12 to 2.
34]).

Decaf coffee or chicory coffee consumption was not associated with RA risk, but few consumers consumed such coffee
.

Tea and alcohol intake were not associated with RA risk

Neither tea nor alcohol intake was associated with
the risk of RA.
However, drinking 1 to 3 drinks per week was associated with a reduced risk of RA in people with no smoking history (aHR=0.
63, 95% CI [0.
43 to 0.
91]).

Intake of artificially sweetened soft drinks is associated with an increased risk of RA

Intake of artificially sweetened soft drinks was associated with an increased risk of RA (aHR=1.
66, 95% CI [1.
12 to 2.
45]) and was limited to people with no smoking history (aHR=2.
07, 95% CI [1.
20 to 3.
56]
).
Intake of non-artificially sweetened sugary soft drinks, including 100% fruit juices, sugar-sweetened sodas, and fruit drinks, was not
associated with the risk of RA.

Research conclusions and discussion

This study assessed the association
between specific beverage intake and the risk of RA in a large French female cohort.
The results showed that coffee intake (especially caffeinated coffee) had a positive dose-effect relationship with RA risk, and that intake of artificially sweetened soft drinks also increased the risk of RA, while intake of tea, alcohol, and non-artificially sweetened sugary soft drinks was not associated
with RA risk.
In addition, moderate alcohol consumption in people with a history of smoking was associated with
a reduced risk of RA.
Based on the results of this study, the researchers believe that limiting coffee intake may prevent the occurrence of RA, especially in
people at high risk of RA.

Coffee intake is associated with an increased risk of RA, and first, one underlying mechanism is that caffeine may affect the body's gut microbiome, one of the hypotheses is that certain bacteria will transfer from the gut to the systemic circulation, triggering systemic inflammation and promoting the development of
autoimmunity.
Second, coffee consumption was associated with a higher prevalence of periodontitis, which was associated with a risk of RA, especially in
people with no history of smoking.
Furthermore, high coffee intake may be associated with certain poor lifestyle or dietary habits, such as lack of sleep or smoking
.
This study corrected for confounding factors such as smoking, body mass index (BMI), physical activity and Mediterranean diet score (MDS), and the results still suggest that coffee intake is an independent factor
in the development of RA in the population.
In addition, this study also found that the intake of artificially sweetened soft drinks was associated
with an increased risk of RA.
This is the first study to report this association, and the underlying mechanism may be that artificially sweetened soft drinks cause changes
in the gut microbiota.

References: Ascione S, Barde F, Artaud F, et al.
Association between beverage consumption and risk of rheumatoid arthritis: a prospective study from the French E3N Cohort[J].
Rheumatology (Oxford).
2022 Sep 30:keac544.
doi: 10.
1093/rheumatology/keac544.
Epub ahead of print.
PMID: 36179075.