European journal of nutrition · 2026
Plant-based diet quality and risk of giant cell arteritis and polymyalgia rheumatica: findings from the E3N prospective cohort study.
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Pacoureau Lucas, Barde François, Marques Chloé, Gelot Amandine, Correia Emmanuelle, Romana Mancini Francesca, Nguyen Yann, Seror Raphaèle
Аннотация
OBJECTIVES: Environmental determinants of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) remain poorly understood. We investigated whether adherence to plant-based dietary patterns (overall (PDI), healthful (hPDI), and unhealthful (uPDI)) is associated with incident GCA and PMR in a large prospective cohort.
METHODS: The E3N study follows 98,995 French women since 1990. Dietary intake was assessed in 1993 using a validated food frequency questionnaire. PDI, hPDI, and uPDI were constructed following the approach of Satija et al. Incident GCA and PMR cases were identified and validated through repeated questionnaires and medication reimbursement data. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards regression models adjusted for age, energy intake, and key confounders.
RESULTS: Among 60,187 eligible women, 602 incident cases were identified over a median of 17.6 years between dietary assessment and disease onset (142 GCA, 373 PMR, 87 undifferentiated). No association was observed between any plant-based diet index and overall GCA/PMR risk nor PMR risk separately. Higher adherence to the hPDI was inversely associated with GCA risk (HR tertile 3 vs. 1: 0.62 [0.39-0.97]; p-trend = 0.04). A non-linear pattern was observed for the overall PDI (HR tertile 2 vs. 1: 0.65 [0.43-0.98]). No association was found for the uPDI.
CONCLUSION: Adherence to a healthful plant-based diet was inversely associated with GCA risk but not PMR, suggesting disease-specific environmental pathways. These findings provide the first prospective evidence linking dietary quality to GCA risk, supporting further investigation of dietary exposures in inflammatory rheumatic diseases.
METHODS: The E3N study follows 98,995 French women since 1990. Dietary intake was assessed in 1993 using a validated food frequency questionnaire. PDI, hPDI, and uPDI were constructed following the approach of Satija et al. Incident GCA and PMR cases were identified and validated through repeated questionnaires and medication reimbursement data. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were estimated using Cox proportional hazards regression models adjusted for age, energy intake, and key confounders.
RESULTS: Among 60,187 eligible women, 602 incident cases were identified over a median of 17.6 years between dietary assessment and disease onset (142 GCA, 373 PMR, 87 undifferentiated). No association was observed between any plant-based diet index and overall GCA/PMR risk nor PMR risk separately. Higher adherence to the hPDI was inversely associated with GCA risk (HR tertile 3 vs. 1: 0.62 [0.39-0.97]; p-trend = 0.04). A non-linear pattern was observed for the overall PDI (HR tertile 2 vs. 1: 0.65 [0.43-0.98]). No association was found for the uPDI.
CONCLUSION: Adherence to a healthful plant-based diet was inversely associated with GCA risk but not PMR, suggesting disease-specific environmental pathways. These findings provide the first prospective evidence linking dietary quality to GCA risk, supporting further investigation of dietary exposures in inflammatory rheumatic diseases.