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Food intake, Healthy Eating Index and Dietary inflammatory index in patients with Psoriatic Arthritis
- Beatriz Leite, Melissa Morimoto, Patricia Genaro, Nitin Shivappa, James Hèbert, Marcelo Pinheiro
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E696
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Psoriatic Arthritis (PsA) is a chronic inflammatory disease that are associated with multiple comorbidities, particularly metabolic syndrome (MetS), obesity, hypertension and diabetes. These findings brought up a potential link between adiposity and psoriasis/ PsA. Though a healthy diet could improve some aspects related to MetS, as well as painful joints and skin lesions in patients with PsA, the aim of this study is to describe the main particularities related to food intake and nutrient consumption, including the dietary inflammatory index (DII) and the healthy eating index (HEI), in patients with PsA. A total of 97 patients with PsA were included in this cross-sectional study. Food intake was evaluated by using a 3-day food-record, HEI and the DII. Energy was adjusted using the residual method in order to control the effects of energy intake when evaluating micronutrient intake. Weight, waist of circumference, Body Mass Index (BMI) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were also evaluated. The inferential analysis included t-student test, Pearson's correlation and Tukey's test. Kolmogorov-Smirnov test was used to define normality. Level of significance was set as p < 0.05. Patients with PsA had hypercaloric diet and inadequate consumption of sodium, vitamin A, vitamin E, magnesium, zinc and copper when compared to Dietary Reference Intake. The HEI had low score (63.2 ± 10.2), suggesting that more than 90% of the patients had inappropriate diet and need nutritional intervention. Moreover, the DII score was high (+ 2.48 ± 0.9), highlighting a pro-inflammatory pattern. It was also observed an increase of BMI (mean 30.5 ± 5.7 kg/m2), waist circumference (103.13 ± 13.26 cm) and a high prevalence of MetS (54.6%). Our data showed patients with PsA had high prevalence of MetS, low quality of food intake, diet inadequacy and a pro-inflammatory pattern, especially regarding antioxidants intake.
Inflammation in Psoriatic Arthritis: The DIETA trial – Dietetic IntervEntion in psoriaTic Arthritis
- Beatriz Leite, Melissa Morimoto, Carina Gomes, Barbara Klemz, Patricia Genaro, Nagila Damasceno, Vera Szejnfeld, Marcelo Pinheiro
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E500
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- Article
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The oxidative stress has been considered one of the main aspects related to psoriatic arthritis (PsA), diabetes, hypertension, obesity, dyslipidemia and metabolic syndrome. Based in the premise that there is a close relationship between the metabolic and inflammatory domain in PsA patients, our aim was to evaluate the role of a 12-week nutritional intervention, including hypocaloric diet and antioxidant supplementation, on inflammatory markers and disease activity in patients with PsA.
A total of 97 patients diagnosed with PsA (CASPAR, 2006) were included in this randomized, double-blinded placebo-controlled trial. Patients were distributed in three different groups: control (C) that received placebo (3 g of soybean oil); diet plus supplementation (DS) with hypocaloric diet plus omega 3 supplementation (3g); diet (D) with hypocaloric diet plus placebo supplementation (3 g of soybean oil). It was evaluated skin (PASI and BSA) and joint activity (DAS28-CRP, DAS28-ESR, BASDAI) and biochemical parameters, such as inflammatory markers (CRP, ESR, adiponectin, TBARs) and glucose and fat metabolism serum levels (HbA1c, fasting glucose and insulin, total cholesterol and fractions, triglycerides, AGER, oxidized- LDL, electronegative LDL (-) and anti-LDL (-) autoantibody) at baseline (T0) and after 12-week intervention (T3). Descriptive statistics are expressed as mean, standard deviation and frequency. Results were then compared using Kruskal-Wallis, ANOVA, Wilocoxon, Man-Whitney and T-Student test and multiple regressions. Level of significance was set as p < 0.05.
At baseline there was an increase of inflammatory markers (CRP, ESR, TBARs, AGER, LDL modifications), decrease of anti-inflammatory (adiponectin) and high prevalence of hypercholesterolemia (41.2%) and peripheral insulin resistance (60%). Our data showed a significant correlation between electronegative LDL and PASI and a correlation between AGER and DAS28-ESR, indicating that a decrease of inflammatory parameters could be related to skin and joint improvement. However, after 12-week nutritional intervention there has no improvement of proinflammatory markers in the group. There was only a significant increase of adiponectin serum levels in all 3 groups, suggesting a benefit effect on chronic inflammation. According our results, omega 3 supplementation was not more effective to improve inflammation, oxidative stress and disease activity.