Preliminary findings from a small case-control study at the Mayo Clinic in Rochester, Minnesota, suggest an association between diet and the development of spondyloarthritis (SpA), researchers reported in a poster at the Rheumatology Winter Clinical Symposium.
The small study involving 106 cases of incident spondyloarthritis matched 5:1 to individuals without SpA on the basis of age, sex, year, and geography found that risk was significantly higher with consumption of nondiet soda (adjusted odds ratio [aOR], 1.76), and with use of certain supplements: folate (aOR, 2.56), B vitamins (1.98), and fish oil (1.83). Moderate alcohol use ranging from two servings per month up to five per week was associated with a significantly lower risk of SpA (aOR, 0.63).
“We have seen an association between diet and RA. There is also strong literature showing an association between the microbiome and spondyloarthritis. Putting these two together, we wanted to see if the same was true for spondyloarthritis,” Vanessa Kronzer, MD, a rheumatologist at Mayo Clinic and a coauthor of the poster, said in an email. “Our results … do suggest an association between diet and developing spondyloarthritis as we suspected, for example, with soda.”
The researchers enrolled patients through the Mayo Clinic Biobank, which aims to engage a population-based sample of primary care patients, and administered questionnaires that assessed dietary and supplement exposures. They identified incident SpA using two diagnosis codes for ankylosing spondylitis or PsA ≥ 30 days apart along with use of disease-modifying antirheumatic drugs. To identify inflammatory bowel disease–associated SpAs, they used two diagnosis codes ≥ 30 days apart and age < 45 years. Follow-up questionnaires were administered 5 years later, Dr. Kronzer said.
Controls were matched on age, sex, year and geography. Logistic regression models adjusted for age, sex, race and ethnicity, education, and smoking, the researchers reported in their poster.
Dr. Kronzer and coauthors reported finding no significant associations with high-fat food, red meat, fish, poultry, diet soda, coffee and tea, and high alcohol use. They reported finding “trends of reduced risk with fruits and vegetables but higher risk with milk/dairy” and said these trends “should be replicated in larger studies.”
The 106 patients with incident spondyloarthritis had a mean age of 51. Three-fourths were female.
The research was funded by the Rheumatology Research Foundation and the National Institute of Arthritis and Musculoskeletal and Skin Diseases. Dr. Kronzer and coauthors did not report any disclosures.