Healthy diet may improve measures of disease activity in psoriatic arthritis
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PHILADELPHIA — While a high prevalence of metabolic disorders was observed among patients with psoriatic arthritis, measures of disease activity was associated with adherence to healthy diet recommendations, such as low sugar and whole-fruit consumption.
The findings from the Dietary Intervention in PsA (DIPSA) study, a randomized controlled trial, were presented at ACR Convergence 2022.
According to Lihi Eder, MD, PhD, clinician-scientist at Women’s College Research Institute and associate professor of medicine at the University of Toronto, and colleagues, the goal of DIPSA was to understand the efficacy of Mediterranean diet and DASH-low caloric diet as adjunct therapy compared with standard of care. The study population included patients with PsA and a Disease Activity in Psoriatic Arthritis (DAPSA) score greater than 10 who were overweight or obese, as defined by a BMI greater than 25. Eligible patients also had to be receiving stable therapy.
The analysis included the first 32 enrolled patients, out of an expected 90. Medical history, physical exam and laboratory tests determined the presences of cardiometabolic abnormalities and participants completed a 24-hour diet history of foods and beverages consumed during three separate weekdays. The researchers then calculated each participant’s Healthy Eating Index 2015 (HEI-2015), which is a diet quality score evaluating adherence to dietary guidelines for Americans and includes 13 food components. Of these groups, nine are encouraged and four are to be limited and are based on a range of low to high, scored from zero to five to 10.
According to the poster, the mean age of participants was 53.3 years and 71.9% were women. The mean DAPSA score was 23.6, mean count of tender joints were 6.6, and mean count of swollen joints were 1.1. Obesity was reported in 71.9% of participants, dyslipidemia in 41.9%, hypertension in 37.5% and metabolic syndrome in 46.9%.
Higher adherence scores were observed among female patients at 91% compared with male patients at 57% (P < 0.05). However, no differences in adherence were seen between age and level of education groups. The overall mean HEI-2015 was 59.3, Eder and colleagues reported. When analyzing by food groups from HEI-2015, the lowest adherence was observed for wholegrain and total sodium consumption.
“We found a significant correlation between certain food groups and measures of disease activity,” Eder said during the presentation.
Lower consumption of added sugar correlated with lower fatigue and lower PSAID scores. Additionally, greater whole fruit consumption corresponded with lower swollen joint counts. Finally, consumption of unsaturated and saturated fatty acids was consistent with higher enthesitis scores.
“The DIPSA study will determine the role of dietary intervention as adjunct therapy in patients with psoriatic arthritis,” Eder said.
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Eder L, et al. Abstract 1007. Presented at: ACR Convergence 2022; November 11-14, 2022; Philadelphia (hybrid meeting).
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