Impact of FDA-approved graphic front-of-package health warnings on attention, package choice, and quit intentions.

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterised by synovial joint inflammation, leading to pain, swelling, stiffness, and, if untreated, progressive joint damage. Globally, RA affects approximately 18.5 million people, with prevalence increasing with age. Women are disproportionately affected, with a female-to-male ratio of 2.5:1. In New Zealand an estimated 3.2% of the population, around 133,000 people, are living with RA. RA reduces quality of life (QOL) and increases the risk of co-morbidities arising from both disease progression and pharmacological treatments. These co-morbidities include CVD, certain cancers, osteoporosis, gastrointestinal and respiratory conditions. Disease modifying anti-rheumatic drugs remain the cornerstone of modern pharmacological treatment for RA. However, despite advances in drug therapies, many individuals continue to experience persistent symptoms and functional impairment. As a result, people with RA have an interest in exploring dietary strategies to manage symptoms, reduce disease impact, and enhance QOL. Interest in dietary interventions for RA has persisted for over a century, with numerous clinical studies conducted to evaluate their potential to decrease inflammation, address comorbidities, and improve quality of life. More recently, emerging evidence implicating gut microbiome alterations and changes in intestinal permeability in RA pathophysiology has further stimulated interest in diet strategies targeting these mechanisms. Several dietary intervention studies in RA cohorts have reported positive short-term outcomes such as reductions in pain and improved QOL measures. However, most studies have focused on quantitative outcomes and have rarely examined participants experiences. This represents a notable gap in the literature. Qualitative research can provide valuable insights into participants’ experiences of transitioning to and adapting to a new diet, navigating challenges, and identifying factors that facilitate motivation and adherence to study protocols.