Background/Purpose: Studies have shown that diet can modify the risk of developing rheumatoid arthritis [1], but the association between diet and spondyloarthritis (SpA) remains largely unexplored. Our goal was to determine whether there is an association between dietary factors and risk of incident SpA.

Methods: We conducted a case-control study in a large single-center biobank, which has recorded information on environmental exposures. Of those with logged data, we identified incident SpA by selecting patients with 2 diagnosis codes ≥30 days apart and prescription of a disease modifying antirheumatic drug (ankylosing spondylitis and psoriatic arthritis), or 2 codes ≥ 30 days apart + age < 45 years (inflammatory bowel disease associated arthritis). We defined index date as the date meeting the above criteria. We matched these cases with controls 5:1 on age, sex, year, and geography. We obtained dietary and supplement exposures from baseline and follow-up questionnaires and created logistic regression models adjusted for age, sex, race and ethnicity, education, and smoking.

Results: We identified 106 patients with incident SpA. They had a mean age of 51, 76% were female, and there was a median of 6.4 years between questionnaire and index date. Non-diet soda and certain supplements (folate, other b-vitamins, and fish oil) were associated with increased risk of incident SpA, while moderate alcohol use was associated with lower risk (Figure 1). There were trends of reduced risk with increased intake of fruits and vegetables and higher risk with milk/dairy, but these were not significant in this small cohort.  There was no significant association with high fat food, red meat, fish, poultry, diet soda, coffee, tea, or high alcohol intake.

Conclusion: In summary, certain supplements and non-diet soda were associated with increased risk of incident SpA. These findings could be relevant for understanding the pathogenesis of SpA and thus warrant further validation in a larger cohort.

References:
1. Kronzer VL, Lennon RJ, Sparks JA, Myasoedova E, Davis JM, Crowson CS. Association between work physical activity, dietary factors, and risk of rheumatoid arthritis. Semin Arthritis Rheum. PMID: 36166875

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/dietary-exposures-associated-with-incident-spondyloarthritis/