{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T03:32:20Z","timestamp":1779939140607,"version":"3.53.1"},"reference-count":50,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T00:00:00Z","timestamp":1634688000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100007899","name":"University of Arizona","doi-asserted-by":"publisher","award":["Rose J. Levy Geriatric Nursing Award, College of N"],"award-info":[{"award-number":["Rose J. Levy Geriatric Nursing Award, College of N"]}],"id":[{"id":"10.13039\/100007899","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Nutr Health"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:p>Objective:This study examined associations between diet quality and disease activity in adults with rheumatoid arthritis (RA). Perceived stress was also compared to diet and disease activity. Methods: In a cross-sectional design, 50 adults with RA were recruited. The Arizona Food Frequency Questionnaire was used to measure dietary intake (four weeks) and diet quality scores were calculated with the Healthy Eating Index \u2013 2015. Perceived stress was measured with the Perceived Stress Scale. Disease activity was measured with the Health Assessment Questionnaire-Disability Index and Pain Scale, erythrocyte sedimentation rate (ESR), high-sensitivity C-reactive protein, and Disease Activity Score Including 28 Joints-ESR. Results: Diet quality (56; SD\u2009\u00b1\u200912) in participants was lower than the national mean (59). Age ( p\u2009=\u20090.015) and gender ( p\u2009=\u20090.003) were associated with higher diet quality. The belief that diet affects RA disease activity was reported by 44% of the participants, and these participants were significantly more likely to report dietary changes ( p\u2009&lt;\u20090.0001). Higher educational level (at least some college) was associated with this belief ( B\u2009=\u2009\u22121.535, p\u2009=\u20090.023). Participants with lower diet quality also had significantly higher pain ( B\u2009=\u2009\u22120.396, p\u2009=\u20090.022) and ESR scores ( p\u2009=\u20090.019). Women were more likely to have higher HAQ-DI scores ( B\u2009=\u20090.570, p\u2009=\u20090.001). Perceived stress was significantly associated with HAQ-DI and pain scores ( B\u2009=\u20090.445, p\u2009=\u20090.001 and B\u2009=\u20090.289, p\u2009=\u20090.042, respectively). Medical cannabis was reportedly used by 8% of participants. Conclusion: In RA patients, lower diet quality may be associated with more pain and inflammation, and perceived stress may be associated with higher disability and disease activity.<\/jats:p>","DOI":"10.1177\/02601060211044311","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T17:52:06Z","timestamp":1634752326000},"page":"581-590","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Diet quality and disease activity in rheumatoid arthritis"],"prefix":"10.1177","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6275-7875","authenticated-orcid":false,"given":"Maureen E.","family":"McGarrity-Yoder","sequence":"first","affiliation":[{"name":"School of Nursing, Northern Arizona University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen C.","family":"Insel","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracy E.","family":"Crane","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thaddeus W.W.","family":"Pace","sequence":"additional","affiliation":[{"name":"College of Nursing, University of Arizona, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,10,20]]},"reference":[{"key":"bibr1-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1177\/1759720X17720366"},{"key":"bibr2-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1111\/spc3.12309"},{"key":"bibr3-02601060211044311","unstructured":"Arizona Uo (2018)\n                      Questionnaires - Diet Questionnaires\n                      . Available at: http:\/\/uacc.arizona.edu\/research\/shared-resources\/bmisr\/questionnaires#SWFFQ"},{"key":"bibr4-02601060211044311","doi-asserted-by":"publisher","DOI":"10.3390\/nu10101535"},{"key":"bibr5-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1177\/0260106016688223"},{"key":"bibr6-02601060211044311","volume-title":"Nutritional Genomics: The Impact of Dietary Regulation of Gene Function on Human Disease","author":"Bidlack WR","year":"2012"},{"key":"bibr7-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2010.10.008"},{"key":"bibr8-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1186\/1477-7525-1-20"},{"key":"bibr9-02601060211044311","doi-asserted-by":"publisher","DOI":"10.4088\/JCP.14m09660"},{"key":"bibr10-02601060211044311","volume-title":"Biomarkers of Diet and Nutritional Health. Biological Measures of Human Experience Across the Lifespan","author":"Crane T","year":"2017"},{"key":"bibr11-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-12-382049-5.00012-7"},{"key":"bibr12-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-018-4172-5"},{"key":"bibr13-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1017\/S136898001000008X"},{"key":"bibr14-02601060211044311","doi-asserted-by":"publisher","DOI":"10.5114\/reum.2017.71629"},{"key":"bibr15-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1007\/s00296-017-3726-1"},{"key":"bibr16-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2018.06.111"},{"key":"bibr17-02601060211044311","doi-asserted-by":"publisher","DOI":"10.2298\/VSP1501021J"},{"key":"bibr18-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1038\/s41584-018-0025-5"},{"key":"bibr19-02601060211044311","first-page":"70","volume":"17","author":"Kennedy E","year":"2008","journal-title":"Asia Pacific Journal of Clinical Nutrition"},{"key":"bibr20-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1002\/art.21575"},{"key":"bibr21-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1016\/j.jand.2018.05.021"},{"key":"bibr22-02601060211044311","first-page":"799","volume":"35","author":"Kuriya B","year":"2017","journal-title":"Clinical and Experimental Rheumatology"},{"key":"bibr23-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1016\/j.anr.2012.08.004"},{"key":"bibr24-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2017-000458"},{"key":"bibr25-02601060211044311","first-page":"54","volume":"91","author":"Lisitsyna T","year":"2013","journal-title":"Klinicheskaia Meditsina"},{"key":"bibr26-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1111\/1756-185X.13130"},{"key":"bibr27-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1038\/nature14432"},{"key":"bibr28-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-1591(03)00033-3"},{"key":"bibr29-02601060211044311","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2018.00141"},{"key":"bibr30-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-213286"},{"key":"bibr31-02601060211044311","unstructured":"National Institute of Health NCI (n.d.)\n                      Dietary assessment instrument profiles.\n                      Available at: https:\/\/dietassessmentprimer.cancer.gov\/profiles\/"},{"key":"bibr32-02601060211044311","unstructured":"(NIH) NIoH (n.d.)\n                      The Health Assessment Questionnaire (HAQ) Disability Index (DI) of the Clinical Health Assessment Questionnaire (Version 96.4)\n                      . 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Available at: https:\/\/www.fns.usda.gov\/resource\/healthy-eating-index-hei"},{"key":"bibr47-02601060211044311","first-page":"65","volume":"32","author":"van Riel PLCM","year":"2014","journal-title":"Clinical and Experimental Rheumatology"},{"key":"bibr48-02601060211044311","author":"Wilson-Morkeh H","year":"2019","journal-title":"The Journal of Rheumatology"},{"key":"bibr49-02601060211044311","doi-asserted-by":"publisher","DOI":"10.1186\/s12937-018-0354-x"},{"key":"bibr50-02601060211044311","volume-title":"Biopsychosocial model on determinants of symptom experience of rheumatoid arthritis","author":"Yoder M","year":"2018"}],"container-title":["Nutrition and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02601060211044311","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/02601060211044311","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/02601060211044311","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:25:43Z","timestamp":1777656343000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/02601060211044311"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,10,20]]},"references-count":50,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1177\/02601060211044311"],"URL":"https:\/\/doi.org\/10.1177\/02601060211044311","relation":{},"ISSN":["0260-1060","2047-945X"],"issn-type":[{"value":"0260-1060","type":"print"},{"value":"2047-945X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,10,20]]}}}