POS1503-HPR RELATIONSHIP BETWEEN NUTRITIONAL STATUS, ADHERENCE TO THE MEDITERRANEAN DIET AND DISEASE ACTIVITY IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: G. Kaner, G. Çalik, V. Gerdan, E. Eren
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Diet quality playing an important role in the rheumatoid arthritis (RA) management. There is currently conflicting data on the benefits of Mediterranean diet (MD) in RA, and there is insufficient evidence to suggest a function of MD in the prevention and treatment of RA [1-3]. <h3>Objectives:</h3> The aim of this study was to determine the nutritional status of patients with RA, to assess adherence to the MD and to determine its relationship with disease activity. <h3>Methods:</h3> This cross-sectional study was conducted with patients diagnosed with RA who applied to the rheumatology outpatient clinic at the University Hospital. The study population consisted of 74 participants aged 28-64 years who had been diagnosed with RA according to the 2010 ACR/EULAR classification criteria. A questionnaire form was applied to the participants by face-to-face interview method. The 24-hour dietary recall method was used to assess participants' dietary intake. The MD Adherence Screener was used to assess participants' adherence to the MD. The Health Assessment Questionnaire (HAQ) was used to assess participants' functional status. The DAS28 Disease Activity Score was used to determine disease activity. <h3>Results:</h3> Of the total number of RA patients, 21.6% were classified as high adherers to the MD (33.8% moderate and 44.6% poor). Half of the participants (51.4%) were taking corticosteroids (prednisone), and the majority (89.5%) were using the 4 mg dose. When the disease activity of the study participants was assessed using the DAS28 score; more than half of the participants (51.4%) had moderate disease activity. The median percentage of carbohydrate intake was higher in patients with low adherence to the MD [50.0 (41.5-59.5)] than in those with moderate adherence [44.0 (35.5-53.0)] (p=0.021). The mean percentage of fat intake was lower in those with low MD adherence [32.2±10.36] than those with moderate adherence [40.1±8.49] (p=0.021). The mean dietary fiber intake of participants with high adherers (25.0±9.65 g) was significantly higher than that of participants with low (17.6±8.40 g) and moderate adherers (18.0±8.73 g) (p&lt;0.05). The median dietary intake of vitamin C was significantly higher in participants with high MD adherence [127.5 (57.6-183.4) mg] than in participants with low adherence [52.8 (20.8-87.8) mg] (p=0.006). There was a significant negative correlation between the number of swollen joints and the intake of carbohydrates and fiber (p&lt;0.05). There was a significant negative correlation between the number of tender joints and the intake of dietary fiber, polyunsaturated fatty acids, omega-3, vitamin B1, vitamin B6, magnesium, phosphorus and iron (p&lt;0.05). There was a significant positive correlation between ESR (mm/h) and the percentage of total fat (%) and monounsaturated fatty acids (g) (p&lt;0.05). There was a significant negative correlation between the DAS28 score and the intake of dietary fiber (p&lt;0.05). The HAQ score showed a negative correlation with the intake of omega-3 and vitamin B6. There was a significant positive correlation between the MD adherence score and dietary fiber, vitamin C, vitamin B<sub>2</sub>, potassium, and iron (p&lt;0.05). <h3>Conclusion:</h3> About half of the patients with RA were found to have a low adherence to the Mediterranean diet. The consumption of dietary fiber could suppress disease activity in RA patients. Further research is needed to investigate the therapeutic ability of the diet. <h3>REFERENCES:</h3> [1] Cutolo M, Nikiphorou E. Nutrition and Diet in Rheumatoid Arthritis. Nutrients 2022, 14(4): 888. [2] Cassotta M, Forbes-Hernandez T.Y, Cianciosi D, et al. Nutrition and Rheumatoid Arthritis in the 'Omics' Era. Nutrients 2021, 13(3): 763. [3] Gioia C, Lucchino B, Tarsitano MG, et al. Dietary habits and nutrition in rheumatoid arthritis: can diet influence disease development and clinical manifestations? Nutrients. 2020;12(5):1456. <b>DAS28:</b> Disease Activity Score in 28 joints with ESR, <b>ESR:</b> Erythrocyte Sedimentation Rate, <b>HAQ:</b> Health Assessment Questionnaire, <b>MD:</b> Mediterranean Diet <sup>⁑</sup>Spearman correlation, <sup>₸</sup>Pearson correlation The bold values indicate significance at p&lt;0.05 <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>