Mediterranean Diet Benefits Spondyloarthritis Save

Can an antiinflammatory diet impact axial spondyloarthritis (axSpA)? A 6-month dietary intervention shows that adherence to a Mediterranean diet lowers disease activity in axSpA; but dietary adherence is often incomplete.

This prospective, 6 month trial assessed whether nutritional advice (at baseline, and every 2 months until month 6) on a Mediterranean diet. Adherence was scored using the PREDIMED questionnaire and disease activity was evaluated with ASDAS-CRP. 

A total of 161 patients were randomized to either nutritional advice (81) or no counseling (80) or controls; but 6 month complete information was available on 58% of the nutritional group and 74% of controls.

The group included 36.4% females, and 53% also had psoriasis.

There were no group differences in labs or anthropometric measures.

Adherence to the Mediterranean diet was moderate and improved more so in the nutritional group compared to controls (p = 0.020).

The nutritional group was more likely (OR 4.533) to show dietary adherence.  But increasing age and lower BMI were less likely to show PREDIMED improvement ≥ 20%.

The Mediterranean diet group was more likely to shows ASDAS-CRP improvement ≥ 20% compared to controls (p = 0.020).  Those with adherence to diet (PREDIMED improvement ≥ 20%) were more likely to show ASDAS-CRP improvement ≥ 20% (OR 6.75,1.8–25.3, p = 0.005). Psoriasis and disease duration were negatively but not significantly associated to the ASDAS-CRP improvement.

Adherence to the Mediterranean diet may benefit disease activity in axSpA patients, but lower BMI and older patients are less prone to modify their diet and benefit.