Researchers explored the disease activity of patients with axial spondylarthritis after various modifications to their diets.
In a study population consisting mostly of women with axial spondylarthritis (axSpA), most participants favored either fasting or some form of dieting, which resulted in an improved state of their rheumatic disease activity. With the Mediterranean diet and intermittent fasting standing out as the most popular patient methods for this study, the findings suggested dieting and fasting be used to complement routine care, especially for patients with rheumatic diseases.1 Research data was extracted from a poster presented at the American College of Rheumatology (ACR) Convergence 2024.
“AxSpA is a form of arthritis that mostly causes pain and swelling in the spine and the joints that connect the bottom of the spine to the pelvis (sacroiliac joint). Other joints can be affected as well. It is a systemic disease, which means it may affect other body parts and organs,” wrote the Arthritis Foundation.2
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With axSpA’s presence in the spine, it indeed has shown the ability to impact digestive health. For example, researchers of an Arthritis Research & Therapy study explored the association between axSpA and gut dysbiosis, which is an imbalance of microorganisms living in the gut.3 In the study, researchers found that gut dysbiosis was associated with worsened axSpA disease activity and discovered “an important link between disturbances in gastrointestinal homeostasis and axSpA.”4
Previous literature has explored axSpA’s impact on gut health, but ACR researchers wanted to address the limited data that exists involving how patients’ diets can affect axSpA disease activity, and overall rheumatic health.
Using the Diet and Fasting in SpA questionnaire, researchers recorded the knowledge, attitudes, and practices of patients with axSpA. | image credit: ibnu / stock.adobe.com
“A Mediterranean-style diet is generally suggested, although, the literature is non-conclusive. Small observational studies in rheumatoid arthritis have suggested that Ramadan fasting results in significantly lower disease activity scores. However, there is very limited data regarding the practice of fasting, such as intermittent fasting and types of diets in axSpA patients,” wrote authors of the poster.1
READ MORE: Digestive Health Resource Center
Using the Diet and Fasting in SpA questionnaire, researchers recorded the knowledge, attitudes, and practices of patients with axSpA. The questionnaire was delivered via email to patients with axSpA across Switzerland.
A total of 466 survey respondents were included in the study and a significant portion (72%) of them were women. Researchers also noted the study population’s median body mass index of 24.5 kg/m2, while more than 50% were between the ages of 41 and 60.1 “Most respondents were following some sort of diet, currently (55%) or in the past (66%), and many were undertaking some form of fasting, currently (31%) or in the past (48%),” continued the authors.
While researchers did note some conflicting feelings toward the dietary modifications explored in this study, they found that 59% of participants believed these practices improved axSpA disease activity, compared with 27% of individuals who felt dietary modifications could exacerbate inflammatory disease activity.
“Whereas 25% felt that fasting (mainly intermittent) could improve the inflammatory activity of their axSpA, 18% felt that fasting had led to a reduced requirement for treatment of their axSpA, whereas only 1% reported a deleterious effect on inflammation. If fasting was demonstrated to be effective for disease management in axSpA, 77% stated that they would agree to try the practice,” they wrote.
Between the gut’s link to other parts of the body and participants’ willingness to make dietary modifications, both fasting and specifically structured diets have been highlighted as valuable treatment options for various diseases. In the case of this poster from ACR Convergence 2024, these simple dietary adjustments can prove a world of difference for patients with axSpA, or any patient living with arthritis.
“Almost 50% of patients felt that the Mediterranean diet had beneficial effects on the inflammatory activity of their disease, while 57% that had tried intermittent fasting felt that it was beneficial. These findings provide encouraging signs that many patients are willing to adhere to dietary modification and to practice fasting, to complement routine care,” concluded the authors.1
For more coverage of ACR Convergence 2024, click here.
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