POS0210-HPR PATIENTS WITH ANKYLOSING SPONDYLITIS HAVE AN IMPAIRED DIETARY INTAKE – PRELIMINARY RESULTS FROM PATIENTS IN SWEDEN

Background

Ankylosing Spondylitis (AS) is one of most common chronic inflammatory rheumatic diseases, affecting about 0.2 % of the population. As of today, there is no specific dietary guideline for managing AS patients, and no RCT-studies on diet intervention have been published. Furthermore, there is a lack of data on the relevance of dietary quality on disease outcomes in AS patients.

Objectives

The aim of this study was to assess dietary nutrient intake in AS patients and examine whether it differs compared to persons without AS.

Methods

AS patients (modified NY criteria) at the rheumatology clinic in Region Västerbotten, northern Sweden, were invited to take part in the Backbone study which investigates disease severity and comorbidities [1]. In total, 155 patients were included. Nutritional intake was assessed by the semi-quantitative food frequency questionnaire MiniMealQ [2]. Controls were collected from the Swedish CArdioPulmonary BioImage Study (n = 30154) (3), a study that invited randomly selected participants from the Swedish population register, 50-64 years of age. Out of the 155 patients with AS, 81 (52.3%) were in the same age-span. Four controls were collected for each AS patient, matched on age (± 1 year), sex and geographic location. Data on dietary intake was available for 318 controls. Statistical comparisons between patients with AS and controls were done by T-test, Fisher’s exact test and by exact conditional logistic regression analysis, adjusted for country of birth, educational level, single household, weight, smoking status and energy intake. Variables already adjusted for energy intake (energy percentages, fiber density and energy intake itself), were analyzed without additional adjustment for energy intake.

Results

Characteristics of the AS patients and controls are shown in the Table 1. AS patients had a higher proportional intake of carbohydrate coupled with a lower fiber density, a lower intake of marine omega-3 fatty acids (Figure 1). Further, a lower intake of vitamin-D, E and K was seen as well as a lower intake of selenium, folate, magnesium, phosphorus, potassium, vitamin-A and β-carotene (a marker of vegetable and fruit intake).

Conclusion

Our results suggest that AS patients have an impaired dietary intake. Notably, intake was lower in several nutrients theorized to have anti-inflammatory properties (fiber density, marine-omega-3 fatty acids, vitamin-D and selenium). Further, we propose that nutrition screening might be incorporated in the management of AS patients since they appear to have an increased risk of nutritional deficiencies.

References

[1]Forsblad-d’Elia H et al. Biomechanical Properties of Common Carotid Arteries Assessed by Circumferential 2D Strain and β Stiffness Index in Patients With Ankylosing Spondylitis. The Journal of rheumatology. 2021;48(3):352-60. [2]Christensen SE et al. Two New Meal- and Web-Based Interactive Food Frequency Questionnaires: Validation of Energy and Macronutrient Intake. J Med Internet Res. 2013;15(6):e109. [3]Bergström G et al. The Swedish CArdioPulmonary BioImage Study: objectives and design. J Intern Med. 2015;278(6):645-59.

Acknowledgements

We would like to thank research nurse Viktoria von Zweigbergk for her work with the Backbone study.

Disclosure of Interests

None Declared.