| 1. |
- Lourdudoss, Cecilia, et al.
(författare)
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Are dietary vitamin D, omega-3 fatty acids and folate associated with treatment results in patients with early rheumatoid arthritis? Data from a Swedish population-based prospective study.
- 2017
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Ingår i: BMJ Open. - : BMJ. - 2044-6055. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Dietary intake of vitamin D and omega-3 fatty acids (FA) may be associated with superior response to antirheumatic treatments. In addition, dietary folate intake may be associated with worse response to methotrexate (MTX). The aim of this study was to investigate the association between dietary vitamin D, omega-3 FA, folate and treatment results of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA).METHODS: This prospective study was based on data from the Epidemiological Investigation of Rheumatoid Arthritis (EIRA) study, and included 727 patients with early RA from 10 hospitals in Sweden. Data on dietary vitamin D, omega-3 FA and folate intake based on food frequency questionnaires were linked with data on European League Against Rheumatism (EULAR) response after 3 months of DMARD treatment. Associations between vitamin D, omega-3 FA, folate and EULAR response were analysed with logistic regression adjusted for potential confounders.RESULTS: The majority of patients (89.9%) were initially treated with MTX monotherapy and more than half (56.9%) with glucocorticoids. Vitamin D and omega-3 FA were associated with good EULAR response (OR 1.80 (95% CI 1.14 to 2.83) and OR 1.60 (95% CI 1.02 to 2.53), respectively). Folate was not significantly associated with EULAR response (OR 1.20 (95% CI 0.75 to 1.91)). Similar results were seen in a subgroup of patients who were initially treated with MTX monotherapy at baseline.CONCLUSIONS: Higher intake of dietary vitamin D and omega-3 FA during the year preceding DMARD initiation may be associated with better treatment results in patients with early RA. Dietary folate intake was not associated with worse or better response to treatment, especially to MTX. Our results suggest that some nutrients may be associated with enhanced treatment results of DMARDs.
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| 2. |
- Lourdudoss, Cecilia
(författare)
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Association between diet and treatment results in patients with rheumatoid arthritis and systemic lupus erythematosus
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are chronic autoimmune inflammatory diseases. The causes of these diseases are unknown and evidence indicates that a combination of both genetic and environmental factors contribute to their etiology. Several studies have reported dietary benefits for patients with RA as well as SLE. Nevertheless, many of these studies have mainly focused on the dietary impact on the disease status, and the affect on treatment has not often been considered. The majority of patients with RA and SLE are dependent on treatment. Therefore, the dietary aspects in regards to treatment need to be explored further. Thus, the aim of this thesis was to examine the association between diet and treatment results in patients with RA and SLE. This thesis included five papers (Papers I-V) and was based on data of participants from three registers; Epidemiological Investigation of Rheumatoid Arthritis (EIRA), SLE Vascular Impact Cohort (SLEVIC) and Swedish Mammography Cohort (SMC). All participants from EIRA, SLEVIC and SMC were asked to complete food frequency questionnaires (FFQ) regarding their dietary habits. Dietary data from completed FFQ were linked with clinical data obtained from either Swedish Rheumatology Quality register (SRQ) or medical records. The associations between diet and clinical outcomes were analyzed with logistic regression and prospective dietary changes were analyzed with mixed models and cluster analysis. The main results of this thesis showed that 1) vitamin D and omega-3 fatty acids (FA) were associated with better response to treatment in RA patients, 2) beta-carotene (antioxidant), linoleic acid (omega-6 FA) and vitamin B6 were inversely associated with increased doses of glucocorticoids in SLE patients, 3) women who have been diagnosed with RA did not remarkably change their diet due to their disease, 4) omega 3 FA was inversely associated with non-inflammatory pain after anti-rheumatic treatment in RA patients and 5) riboflavin, phosphorus, selenium and thiamin were inversely associated with carotid plaque in SLE patients. Results from this thesis presented several associations between specific dietary nutrients and clinical outcomes of RA and SLE, in particular concerning treatment results. In summary, diet may play a role in response to anti-rheumatic treatment in patients with RA and SLE.
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| 3. |
- Lourdudoss, Cecilia, et al.
(författare)
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Dietary Intake of Polyunsaturated Fatty Acids and Pain in Spite of Inflammatory Control Among Methotrexate-Treated Early Rheumatoid Arthritis Patients.
- 2018
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Ingår i: Arthritis care & research. - : Wiley. - 2151-464X .- 2151-4658. ; 70:2, s. 205-212
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate potential associations between dietary intake of polyunsaturated fatty acids (FAs) and pain patterns in early rheumatoid arthritis (RA) patients after 3 months of methotrexate (MTX) treatment.METHODS: We included 591 early RA patients with MTX monotherapy from a population-based prospective case-control study, the Epidemiological Investigation of Rheumatoid Arthritis. Dietary data on polyunsaturated FAs (food frequency questionnaires) were linked with data on unacceptable pain (visual analog scale [VAS] >40 mm), noninflammatory/refractory pain (VAS >40 mm and C-reactive protein [CRP] level <10 mg/liter), and inflammatory pain (VAS >40 mm and CRP level >10 mg/liter) after 3 months. Statistical analysis included logistic regression.RESULTS: After 3 months of MTX treatment, 125 patients (21.2%) had unacceptable pain, of which 92 patients had refractory pain, and 33 patients had inflammatory pain. Omega-3 FA intake was inversely associated with unacceptable pain and refractory pain (odds ratio [OR] 0.57 [95% confidence interval (95% CI) 0.35-0.95] and OR 0.47 [95% CI 0.26-0.84], respectively). The omega-6:omega-3 FA ratio, but not omega-6 FA alone, was directly associated with unacceptable pain and refractory pain (OR 1.70 [95% CI 1.03-2.82] and OR 2.33 [95% CI 1.28-4.24], respectively). Furthermore, polyunsaturated FAs were not associated with either inflammatory pain or CRP level and erythrocyte sedimentation rate at followup. Omega-3 FA supplementation was not associated with any pain patterns.CONCLUSION: Omega-3 FA was inversely associated with, and the omega-6:omega-3 FA ratio was directly associated with, unacceptable and refractory pain, but not with inflammatory pain or systemic inflammation. The inverse association between omega-3 FA and refractory pain may have a role in pain suppression in RA.
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| 4. |
- Lourdudoss, Cecilia, et al.
(författare)
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Long-Term Dietary Changes after Diagnosis of Rheumatoid Arthritis in Swedish Women : Data from a Population-Based Cohort
- 2018
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Ingår i: International Journal of Rheumatology. - : Hindawi Limited. - 1687-9260 .- 1687-9279. ; 2018
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate long-term dietary changes after rheumatoid arthritis (RA) diagnosis in Swedish women, compared to women without RA.Methods: This study included 21,602 women from the Swedish Mammography Cohort (SMC), who completed dietary questionnaires in 1997 and 2009. Between 1997 and 2009, 191 women were diagnosed with RA. Dietary changes after RA diagnosis were analyzed based on intake of 82 food items. Statistical analysis included linear mixed models.Results: Women with RA, compared to women without RA, had significantly lower intake (mean servings per week) of animal products such as black pudding, egg, kidney, and liver paste (2.94±2.73 versus 2.45±1.82, p=0.010) and dairy products (35.14±20.02 versus 28.42±16.10, p=0.040) in 1997 and of cereals and grains (31.01±15.54 versus 28.00±14.98, p=0.009) in 2009. However, multivariable adjusted changes in dietary intake from 1997 to 2009 did not show any significant difference in intake. Nevertheless, women without RA increased their intake of whole wheat bread, wheat/oat bran, and rice more than women with RA.Conclusion: Women who had been diagnosed with RA had similar dietary patterns over time as the general population; these women did not remarkably change their diet over time due to their disease. Dietary recommendations for RA patients are needed.
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