American Health & Medical Research Association
Pain, fatigue & chronic conditions

Diet trials for arthritis pain found real effects, smaller than promised

What happened when researchers assigned people with knee osteoarthritis, rheumatoid arthritis and Crohn's disease to eating patterns, and the questions that separate a tested claim from a hopeful one.

By the Health Research USA editorial team

Published Last updated October 2026

Written from the sources listed below; links checked October 2026. It touches on medicines, doses or health conditions and has not yet been reviewed by a licensed clinician, so use it to prepare for a conversation with yours. How we research and review

Sources31, listed below Reading time16 minutes
On this page
  1. Knee Arthritis: Weight Loss Has the Best Evidence
  2. Rheumatoid Arthritis: Four Decades of Small Diet Trials
  3. Crohn's Disease: A Strict Diet Against an Easy One
  4. Gluten and Fibromyalgia: Claims That Outran the Trials
  5. What a Diet Inflammation Score Measures
  6. Questions to Ask About a Diet Claim for a Painful Condition
  7. The Takeaway

In a 2022 trial, 823 North Carolina adults with knee arthritis and extra weight were randomly assigned to 18 months of a community-based diet-and-exercise program or to a comparison group. Those in the program lost about 8% of their body weight. Their knee pain ended up 0.6 points lower than the comparison group’s, on a 20-point scale where the researchers had set 1.6 points as the least change patients would notice.

That is not a failure. Weight loss remains among the best-supported steps for knee osteoarthritis. But the result shows how much smaller the measured effects of eating patterns are than the claims made for them.

Two beliefs crowd this subject. One says an anti-inflammatory diet can calm arthritis by itself. The other says food makes no difference to joint disease. When researchers assigned people with painful joint or bowel disease to an eating pattern and measured what happened, neither belief held up.

Knee arthritis: weight loss has the best evidence

In osteoarthritis, diet has mostly been tested as a route to weight loss. The American College of Rheumatology (ACR), which represents US rheumatologists, posted a summary of updated osteoarthritis recommendations in September 2026. For knee or hip osteoarthritis in people with overweight or obesity, it strongly recommends weight loss, on moderate-certainty evidence. The full paper is still to come, and the rest of that guideline, from exercise to injections, is laid out in our arthritis overview.

How much loss counts? The guideline’s superseded 2019 version said a loss of 5% or more could bring changes, with benefits that kept growing beyond that. The Centers for Disease Control and Prevention (CDC), on a page reviewed in January 2024, offers an example: a 12-pound loss for a 250-pound person, about 5%, can help.

One reason is mechanical. In a 2005 Wake Forest University analysis of how 142 older adults with knee arthritis and extra weight walked, each pound of weight lost was associated with about 4 pounds less force on the knee with every step. But force on a joint is a mechanism, not a feeling, and pain trials tell a more complicated story.

Diet alone did not beat exercise alone

The same Wake Forest group ran the IDEA trial, published in JAMA in 2013. It assigned 454 adults aged 55 and older with painful knee arthritis to 18 months of intensive dieting, exercise, or both. The diet groups lost far more weight: 11.4% with diet plus exercise and 9.5% with diet alone, against 2% with exercise alone.

Compared with the exercise group, the diet-only group had less force on the knee and lower levels of IL-6, a signaling protein the immune system uses in inflammation. Yet on pain, diet alone and exercise alone ended in a near tie, 4.8 and 4.7 on a 20-point scale. Only the combination did better, at 3.6, about a point ahead of exercise alone. A falling inflammation marker did not produce a knee that hurt less than exercise alone could manage.

Outside the research center, the effect shrank

The 2022 trial at the top of this article, called WE-CAN and also published in JAMA, tested a similar program in community settings. The WE-CAN investigators described the 0.6-point gap as “a statistically significant but small difference in knee pain over 18 months.” On the library’s evidence scale, that is a benefit measured but below the threshold that matters.

The trial counted harms, too. Of 10 study-related body injuries, 9 occurred in the diet-and-exercise group, as did all 6 trips or falls, though no serious adverse event was judged definitely related to the program. For older adults with sore knees, a more active plan carries a real if modest risk.

Where drugs entered the picture

Larger losses have come with medicine. STEP 9, a 68-week trial funded by the drug’s maker and reported in the New England Journal of Medicine in 2024, gave 407 adults with obesity and painful knee arthritis weekly injections of semaglutide, a GLP-1 receptor agonist, or a placebo. Both groups got diet and activity counseling.

Side effects ended treatment for 6.7% of the drug group, most often because of digestive problems, against 3% on placebo. The drug group lost 13.7% of body weight against 3.2%, and pain scores fell 41.7 points against 27.5 on a 0-to-100 scale. Notice that second number: counseling plus placebo injections cut pain substantially on their own.

The ACR’s 2026 summary adds a new conditional recommendation for GLP-1 drugs in people with knee osteoarthritis and obesity, to help reach a healthier weight alongside diet and exercise. The college describes conditional recommendations as an invitation to a careful conversation with each patient. Whether such a drug fits one person’s health and other medicines is a prescriber’s decision.

Rheumatoid arthritis: four decades of small diet trials

In rheumatoid arthritis (RA), the immune system turns on the lining of the joints. RA is where claims about inflammation-fighting diets cluster.

The fasting trial still cited today

In 1991 a University of Oslo team published a trial in The Lancet. Twenty-seven people with RA spent four weeks at a health farm, starting with a partial fast of 7 to 10 days, then ate a gluten-free vegan diet followed by a vegetarian one. Twenty-six others spent four weeks at a convalescent home eating normally. The diet group improved in joint counts, pain, stiffness and blood markers, and the gains held at one year.

Two details rarely survive retelling. The paper’s opening sentence notes that most patients relapse once they start eating again after a fast. And the authors described the regimen as a useful supplement to conventional medical treatment, an addition rather than a substitute.

What the reviews concluded

A 2009 Cochrane review led by Oslo researchers found the clearest result in the costs. Dropouts ran 10 percentage points higher on special diets, and dieters lost about 3 kilograms more than controls, harms the reviewers said should not be ignored.

The benefits were murkier. The review’s 15 trials, with 837 patients, were too different to combine. Fasting followed by a vegetarian diet rested on one trial at moderate risk of bias, showing pain scores about 1.9 points lower on a 10-point scale and no clear gain in function or morning stiffness. One Mediterranean diet trial showed a similar pain signal. Vegan and elimination diets were uncertain. The review’s searches ended in January 2008.

A 2025 meta-analysis in Joint Bone Spine pooled seven randomized trials of vegetarian or vegan diets from 1979 to 2023. It found a small improvement in pain and no significant change in disease activity or physical function, all on low-certainty evidence.

Newer trials, same pattern

  • A named anti-inflammatory diet. In a 2020 University of Gothenburg crossover trial, 50 people with RA ate a portfolio of proposed anti-inflammatory foods for 10 weeks and a typical Swedish diet for 10. The main analysis found no significant difference in disease activity, though the paper’s title says the trial indicated effects.
  • A Mediterranean diet. In a 2003 Swedish trial of 51 people on stable RA medicines, a disease activity score fell 0.56 points over 12 weeks in the Mediterranean group, with no significant change in controls.
  • A lifestyle bundle. A 2023 Amsterdam trial of 83 people combined a whole-food plant-based diet with physical activity and stress management for 16 weeks. Disease activity improved 0.9 points more than with usual care. The questionnaires people filled out about their own health did not change.
  • Intermittent fasting. A 2026 meta-analysis from a Chinese university hospital pooled three randomized trials in RA and related conditions and found disease activity scores about half a point lower, a finding its authors said is limited by too few, too varied trials.

The common thread: effects are modest, show up on one measure but not another, and often come packaged with weight loss, more activity or a stay away from home.

Where the rheumatologists landed

In 2022 the ACR issued its first guideline on diet, exercise and other integrative approaches for RA, published in 2023. Its three diet recommendations are all conditional:

  • A Mediterranean-style diet is recommended over no formally defined diet, based on low- to moderate-certainty evidence of less pain and no difference in physical function or disease activity.
  • Other formally defined diets receive a conditional recommendation against, because the panel found no consistent, clinically meaningful benefit for RA and weighed their burden and cost. Its discussion lists vegan, anti-inflammatory and elimination diets among those evaluated.
  • Standard dietary advice without supplements is preferred over adding supplements, a food-first approach.

The panel did not vote on weight loss but was unanimous that clinicians should discuss a healthy body weight, since obesity in RA is linked with higher disease activity and poorer response to treatment. It names registered dietitians as part of the care team. And it states that these approaches accompany disease-modifying antirheumatic drugs (DMARDs), the prescription medicines that treat the disease process. They do not replace them.

Fish oil, a supplement rather than an eating pattern, is a separate case: the National Center for Complementary and Integrative Health (NCCIH) said in 2022 there is some evidence of a modest benefit for RA symptoms. For osteoarthritis, a different disease, the ACR’s 2026 summary conditionally recommends against it. The large omega-3 trials are weighed in our piece on those studies.

Crohn’s disease: a strict diet against an easy one

Inflammatory bowel disease (IBD), which includes Crohn’s disease and ulcerative colitis, has some of the most careful diet trials.

In a US trial published in Gastroenterology in 2021, 194 adults with mild to moderate Crohn’s symptoms were assigned to a strict elimination plan called the specific carbohydrate diet or to a Mediterranean diet, with prepared meals for the first six weeks. At six weeks, 46.5% on the strict diet and 43.5% on the Mediterranean diet had symptoms in remission, statistically a tie. Among people who began with a high level of C-reactive protein (CRP), a blood marker of inflammation, only 2 of 37 and 1 of 28 saw it respond. The authors concluded the Mediterranean diet may be the better choice for most such patients, since it is easier to follow. The idea that stricter means better was tested here and not supported.

In a 2024 clinical practice update, the American Gastroenterological Association (AGA) advised a Mediterranean diet for everyone with IBD, unless there is a reason not to, for overall health. In the same document, the AGA wrote: “No diet has consistently been found to decrease the rate of flares in adults with IBD.” Eating less red and processed meat may reduce ulcerative colitis flares, it added, though that has not been shown for Crohn’s relapses. The update is an expert review, not a formally graded guideline.

The AGA does name one diet-based treatment with real standing: exclusive enteral nutrition, a period of drinking only liquid formula, which can induce remission in Crohn’s disease, with stronger evidence in children than adults. It is a medical therapy supervised by a care team.

Its cautions matter as much. People with narrowed sections of bowel, called strictures, may not tolerate raw, fibrous fruits and vegetables. Restriction plus the disease itself can cause malnutrition, so the AGA advises regular screening and a registered dietitian when signs appear.

The autoimmune protocol diet rests on far less. A 2017 study of it in IBD followed 15 people with no comparison group. Symptom scores improved, CRP did not change significantly, and the authors called for randomized trials. That is insufficient evidence.

Gluten and fibromyalgia: claims that outran the trials

Gluten does real harm in celiac disease. For people without it, two blinded trials in Gastroenterology tested the belief directly. In a 2018 study at Oslo University Hospital, 59 people who had gone gluten-free on their own ate bars containing gluten, fructans (fermentable carbohydrates that often share foods with gluten) or neither. Gluten produced no more gut symptoms than placebo; fructans did; and 22 of the 59 scored worst on the placebo bar. A 2013 Australian trial found gluten-specific effects in only 8% of 37 people and no change in any inflammation marker.

Those were gut trials, not joint trials. In RA, a 2001 Karolinska Institutet trial in Sweden tested a gluten-free vegan diet in 66 people. About a third of those assigned to it met a standard improvement threshold, against 4% on a balanced regular diet. But it removed gluten and all animal foods at once, so gluten alone can’t take the credit. Only 22 of the 38 stayed on it for nine months or more, and X-rays showed no slowing of joint damage in either group.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), as of its 2020 review, says there is no evidence a gluten-free diet promotes better health for the general population, that the diet can fall short on fiber, iron and calcium, and that doctors don’t recommend starting it before celiac testing because it can affect the results. Food-sensitivity testing and elimination diets are a story of their own.

Fibromyalgia has barely been tested. A 2019 review by Portuguese researchers found seven diet trials, only three randomized. Five reported better pain or function, but the studies were of poor quality and the authors said no conclusions could be drawn. That is insufficient evidence: not disproven, simply not tested well.

What a diet inflammation score measures

Many anti-inflammatory claims now cite the Dietary Inflammatory Index, developed at the University of South Carolina. Researchers scored 45 food components on whether they raised or lowered six blood markers of inflammation, drawing on 1,943 published studies. A diet gets a number from about +8, the most pro-inflammatory, to about -9.

In roughly 500 healthy adults in Worcester, Massachusetts, each one-point rise was associated with 8% to 10% higher odds of an elevated CRP. That is an observational link, and a modest one.

The more telling test came in 2026. In a University of Limerick trial of 40 adults with RA, 12 weeks of either a Mediterranean diet or Ireland’s healthy-eating advice improved participants’ scores. Yet patient-reported outcomes showed no significant difference, however much a person’s score had moved. The index grades what is on the plate, not the inflammation in your body or how your joints feel. Why even a blood marker like CRP falls short is covered in our inflammation explainer.

Questions to ask about a diet claim for a painful condition

These questions sort a tested claim from a hopeful one.

  1. Which condition was studied? A result in knee osteoarthritis says little about RA or Crohn’s disease.
  2. What did the comparison group eat? Improvement means little without a control group followed over the same months.
  3. Was it diet alone? Health-farm stays, exercise and stress management have all been folded into diet trials.
  4. Was weight loss doing the work? In knee arthritis that is the point. In RA it can explain a result credited to particular foods.
  5. What was measured? A lower blood marker or a better diet score is not less pain or easier stairs.
  6. How big was the difference? Compare it with the smallest change patients notice.
  7. How many people stuck with it? Results based only on finishers can flatter a diet.
  8. Does it set food against prescribed treatment? The ACR frames diet as a companion to disease-modifying drugs, and even the 1991 fasting team called its regimen a supplement to standard care.

When a diet question needs a clinician

  • Cutting out gluten for joint pain, fatigue or gut trouble. Because going gluten-free can skew celiac testing, the order of testing and diet change is worth settling with a primary care clinician.
  • A major diet change with RA or IBD. Which changes fit current medicines, and whether a registered dietitian can help, are questions for the rheumatologist or gastroenterologist.
  • Fasting while on regular medicine. The 1991 fast took place during a health-farm stay. Whether a fast is safe alongside a particular drug, such as one for diabetes, is the prescriber’s call.
  • Unplanned weight loss, leg swelling or lost muscle with IBD. The AGA lists these as signs that call for a malnutrition assessment.
  • A joint that is newly swollen, hot or red. That needs medical evaluation, not a dietary experiment.

The Takeaway

Food matters for painful joint disease, but less than the marketing says and in narrower ways. For knee or hip osteoarthritis with extra weight, weight loss is a strong ACR recommendation, works best with exercise, and delivered smaller relief in community settings than in a research center. For RA, the only named eating pattern the ACR supports is Mediterranean-style, conditionally, for a small pain benefit, alongside disease-modifying drugs rather than instead of them. When a diet promises to lower inflammation, ask one thing: did the people eating it hurt less or move better?

Sources

  1. American College of Rheumatology. “2026 Update of the American College of Rheumatology Recommendations for the Management of Osteoarthritis of the Knee, Hip, and Hand (guideline summary; approved by the ACR Board September 8, 2026; posted September 14, 2026; full manuscript pending).” assets.contentstack.io
  2. American College of Rheumatology. “American College of Rheumatology Updates Osteoarthritis Guidance, Reinforcing Personalized, Comprehensive Care (press release, September 14, 2026).” rheumatology.org
  3. American College of Rheumatology. “Osteoarthritis Guideline (2026 summary posted September 14, 2026).” rheumatology.org
  4. Arthritis Care & Research. “Kolasinski SL, Neogi T, Hochberg MC, et al. "2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee." Arthritis Care Res, 2020;72(2):149-162. PubMed. DOI: 10.1002/acr.24131 (superseded by the 2026 update; cited for the 2019 weight-loss explanation only).” pubmed.ncbi.nlm.nih.gov
  5. Arthritis & Rheumatology. “England BR, Smith BJ, Baker NA, et al. "2022 American College of Rheumatology Guideline for Exercise, Rehabilitation, Diet, and Additional Integrative Interventions for Rheumatoid Arthritis." Arthritis Rheumatol, 2023;75(8):1299-1311. PubMed. DOI: 10.1002/art.42507.” pubmed.ncbi.nlm.nih.gov
  6. American College of Rheumatology. “New Guideline Introduces Recommendations for Integrative Approach to RA Treatment (press release, November 7, 2022).” rheumatology.org
  7. Centers for Disease Control and Prevention. “Self-Care for Arthritis: Five Ways to Manage Your Symptoms (last reviewed January 17, 2024).” cdc.gov
  8. National Institute of Diabetes and Digestive and Kidney Diseases. “Diagnosis of Celiac Disease (last reviewed October 2020).” niddk.nih.gov
  9. National Institute of Diabetes and Digestive and Kidney Diseases. “Eating, Diet, & Nutrition for Celiac Disease (last reviewed October 2020).” niddk.nih.gov
  10. National Center for Complementary and Integrative Health. “Nutritional Approaches for Musculoskeletal Pain and Inflammation: What the Science Says (February 2022).” nccih.nih.gov
  11. JAMA. “Messier SP, Mihalko SL, Legault C, et al. "Effects of intensive diet and exercise on knee joint loads, inflammation, and clinical outcomes among overweight and obese adults with knee osteoarthritis: the IDEA randomized clinical trial." JAMA, 2013;310(12):1263-1273. PubMed. DOI: 10.1001/jama.2013.277669.” pubmed.ncbi.nlm.nih.gov
  12. JAMA. “Messier SP, Beavers DP, Queen K, et al. "Effect of Diet and Exercise on Knee Pain in Patients With Osteoarthritis and Overweight or Obesity: A Randomized Clinical Trial." JAMA, 2022;328(22):2242-2251. PubMed. DOI: 10.1001/jama.2022.21893.” pubmed.ncbi.nlm.nih.gov
  13. Arthritis & Rheumatism. “Messier SP, Gutekunst DJ, Davis C, DeVita P. "Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis." Arthritis Rheum, 2005;52(7):2026-2032. PubMed. DOI: 10.1002/art.21139.” pubmed.ncbi.nlm.nih.gov
  14. New England Journal of Medicine. “Bliddal H, Bays H, Czernichow S, et al. "Once-Weekly Semaglutide in Persons with Obesity and Knee Osteoarthritis." N Engl J Med, 2024;391(17):1573-1583. PubMed. DOI: 10.1056/NEJMoa2403664.” pubmed.ncbi.nlm.nih.gov
  15. The Lancet. “Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, et al. "Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis." Lancet, 1991;338(8772):899-902. PubMed. DOI: 10.1016/0140-6736(91)91770-u.” pubmed.ncbi.nlm.nih.gov
  16. Cochrane Database of Systematic Reviews. “Hagen KB, Byfuglien MG, Falzon L, Olsen SU, Smedslund G. "Dietary interventions for rheumatoid arthritis." Cochrane Database Syst Rev, 2009;(1):CD006400. PubMed. DOI: 10.1002/14651858.CD006400.pub2.” pubmed.ncbi.nlm.nih.gov
  17. Joint Bone Spine. “Jensen KY, Søndergaard CS, Thomsen T, et al. "Effects of vegetarian and vegan diets on disease activity, pain, fatigue, and physical function in patients with rheumatoid arthritis: A systematic review and meta-analysis." Joint Bone Spine, 2025;92(6):105958. PubMed. DOI: 10.1016/j.jbspin.2025.105958.” pubmed.ncbi.nlm.nih.gov
  18. American Journal of Clinical Nutrition. “Vadell AKE, Bärebring L, Hulander E, et al. "Anti-inflammatory Diet In Rheumatoid Arthritis (ADIRA)-a randomized, controlled crossover trial indicating effects on disease activity." Am J Clin Nutr, 2020;111(6):1203-1213. PubMed. DOI: 10.1093/ajcn/nqaa019.” pubmed.ncbi.nlm.nih.gov
  19. Annals of the Rheumatic Diseases. “Sköldstam L, Hagfors L, Johansson G. "An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis." Ann Rheum Dis, 2003;62(3):208-214. PubMed. DOI: 10.1136/ard.62.3.208.” pubmed.ncbi.nlm.nih.gov
  20. Rheumatology (Oxford). “Walrabenstein W, Wagenaar CA, van der Leeden M, et al. "A multidisciplinary lifestyle program for rheumatoid arthritis: the 'Plants for Joints' randomized controlled trial." Rheumatology (Oxford), 2023;62(8):2683-2691. PubMed. DOI: 10.1093/rheumatology/keac693.” pubmed.ncbi.nlm.nih.gov
  21. PeerJ. “Liu R, Zhang C, Li Y, Huang C. "Intermittent fasting for rheumatic diseases: a systematic review and meta-analysis of conflicting evidence from observational studies and randomized controlled trials." PeerJ, 2026;14:e21185. PubMed. DOI: 10.7717/peerj.21185.” pubmed.ncbi.nlm.nih.gov
  22. Rheumatology (Oxford). “Hafström I, Ringertz B, Spångberg A, et al. "A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens." Rheumatology (Oxford), 2001;40(10):1175-1179. PubMed. DOI: 10.1093/rheumatology/40.10.1175.” pubmed.ncbi.nlm.nih.gov
  23. Gastroenterology. “Lewis JD, Sandler RS, Brotherton C, et al. "A Randomized Trial Comparing the Specific Carbohydrate Diet to a Mediterranean Diet in Adults With Crohn's Disease." Gastroenterology, 2021;161(3):837-852.e9. PubMed. DOI: 10.1053/j.gastro.2021.05.047.” pubmed.ncbi.nlm.nih.gov
  24. Gastroenterology. “Hashash JG, Elkins J, Lewis JD, Binion DG. "AGA Clinical Practice Update on Diet and Nutritional Therapies in Patients With Inflammatory Bowel Disease: Expert Review." Gastroenterology, 2024;166(3):521-532. PubMed. DOI: 10.1053/j.gastro.2023.11.303.” pubmed.ncbi.nlm.nih.gov
  25. Inflammatory Bowel Diseases. “Konijeti GG, Kim N, Lewis JD, et al. "Efficacy of the Autoimmune Protocol Diet for Inflammatory Bowel Disease." Inflamm Bowel Dis, 2017;23(11):2054-2060. PubMed. DOI: 10.1097/MIB.0000000000001221.” pubmed.ncbi.nlm.nih.gov
  26. Gastroenterology. “Skodje GI, Sarna VK, Minelle IH, et al. "Fructan, Rather Than Gluten, Induces Symptoms in Patients With Self-Reported Non-Celiac Gluten Sensitivity." Gastroenterology, 2018;154(3):529-539.e2. PubMed. DOI: 10.1053/j.gastro.2017.10.040.” pubmed.ncbi.nlm.nih.gov
  27. Gastroenterology. “Biesiekierski JR, Peters SL, Newnham ED, et al. "No effects of gluten in patients with self-reported non-celiac gluten sensitivity after dietary reduction of fermentable, poorly absorbed, short-chain carbohydrates." Gastroenterology, 2013;145(2):320-328. PubMed. DOI: 10.1053/j.gastro.2013.04.051.” pubmed.ncbi.nlm.nih.gov
  28. Annals of Medicine. “Silva AR, Bernardo A, Costa J, et al. "Dietary interventions in fibromyalgia: a systematic review." Ann Med, 2019;51(sup1):2-14. PubMed. DOI: 10.1080/07853890.2018.1564360.” pubmed.ncbi.nlm.nih.gov
  29. Public Health Nutrition. “Shivappa N, Steck SE, Hurley TG, Hussey JR, Hébert JR. "Designing and developing a literature-derived, population-based dietary inflammatory index." Public Health Nutr, 2014;17(8):1689-1696. PubMed. DOI: 10.1017/S1368980013002115.” pubmed.ncbi.nlm.nih.gov
  30. Public Health Nutrition. “Shivappa N, Steck SE, Hurley TG, et al. "A population-based dietary inflammatory index predicts levels of C-reactive protein in the Seasonal Variation of Blood Cholesterol Study (SEASONS)." Public Health Nutr, 2014;17(8):1825-1833. PubMed. DOI: 10.1017/S1368980013002565.” pubmed.ncbi.nlm.nih.gov
  31. European Journal of Nutrition. “Curran M, Canning N, Wrenne A, et al. "Comparison of mediterranean and healthy eating guideline interventions on the dietary inflammatory index in rheumatoid arthritis: results from a dietary randomised controlled intervention trial." Eur J Nutr, 2026;65(4). PubMed. DOI: 10.1007/s00394-026-03987-9.” pubmed.ncbi.nlm.nih.gov