Background/Purpose:

Relatively little is
known about the link between diet and treatment results in SLE. Glucocorticoids
(GC) are used to control active SLE but minimized whenever possible in order to
avoid long-term side effects. The aim of this study was to investigate whether
diet influences GC treatment in SLE patients.

Methods:

This study included 111
SLE patients from SLE Vascular Impact Cohort (SLEVIC), Karolinska institutet,
Stockholm, Sweden. We linked dietary data from food frequency questionnaires with
data on GC treatment from medical records for the year preceding and the year
following the food survey. Associations between diet and GC treatment during
the two years period were analyzed with logistic regression, adjusted for age
and gender. GC treatment was considered a proxy for more active SLE; unchanged
or increased GC doses were considered unfavorable outcomes.

Results:

Higher dietary intake
of vitamin D was more common in patients treated with GC (OR=2.9). Alcohol was
inversely associated with GC treatment (OR=0.3-0.4). Higher intake of vitamin
B12, retinol, and calcium were related to unchanged/increased GC dose
(OR=3.0-4.6), but higher intake of fatty acid C18:2 and beta-carotene were found
in patients with decreased GC dose during year -1 to inclusion (OR=0.3 and 0.2
respectively). Finally, a positive association was seen between higher intake
of several nutrients and GC dose levels of >2.5, >5.0, and >7.5
mg/day.

Conclusion:

Higher dietary intake
of vitamin D did not protect against lupus activity. Higher intake of C18:2
(omega-6) and beta-carotene (anti-oxidant) may protect against unfavorable
outcomes (need for increases in GC dose). The inverse association between alcohol
intake and GC treatment/lupus activity may provide a partial explanation for
the link between moderate alcohol intake and improved cardiovascular health in
rheumatic diseases. The association between higher dietary intake and higher GC
dose levels indicated GC’s influence on increasing appetite.