Dietetic intervention in psoriatic arthritis: the DIETA trial

Author(s)

Leite, Beatriz F. ; Morimoto, Melissa A. ; Gomes, Carina M. F. ; Klemz, Barbara N. C. ; Genaro, Patricia S. ; Shivappa, Nittin ; Hebert, James R. ; Damasceno, Nagila R. T. ; Pinheiro, Marcelo M.

• Document type: Journal article
• Source: ADVANCES IN RHEUMATOLOGY; v. 62, n. 1, p. 12-pg., 2022-04-06.

Abstract

Aim To evaluate whether dietary pattern changes, antioxidant supplementation or 5-10% weight loss could improve disease activity (skin and joint) in patients with psoriatic arthritis (PsA). Methods A total of 97 PsA patients were enrolled in this 12-week randomized, double-blinded, placebo-controlled trial. Patients were randomized into three groups: Diet-placebo (hypocaloric diet + placebo supplementation); Diet-fish (hypocaloric diet + 3 g/day of omega-3 supplementation; and Placebo. Food intake (3-day registry, Healthy Eating Index (HEI), and the Dietary Inflammatory Index (DII)), body composition (whole-body dual-energy X-ray absorptiometry (DXA), weight and waist circumference) and disease activity (PASI, BSA, BASDAI, DAS28-ESR, DAS28-CRP and MDA) were evaluated at baseline and after the 12-week intervention. Statistical analysis used the intention-to-treat approach. The P value was considered to indicate significance when below 0.05. Results After 12 weeks, DAS28-CRP and BASDAI scores improved, especially in the Diet-placebo group (- 0.6 +/- 0.9; p = 0.004 and - 1.39 +/- 1.97; p = 0.001, respectively). In addition, a higher proportion of patients achieved minimal disease activity (MDA) in all groups. The Diet-fish group showed significant weight loss (- 1.79 +/- 2.4; p = 0.004), as well as waist circumference (- 3.28 +/- 3.5, p < 0.001) and body fat (- 1.2 +/- 2.2, p = 0.006) reductions. There was no significant correlation between weight loss and disease activity improvement. Each 1-unit increase in the HEI value reduced the likelihood of achieving remission by 4%. Additionally, each 100-cal daily intake increase caused a 3.4-fold DAS28-ESR impairment. Conclusion A 12-week hypocaloric intervention provided suitable control of joint disease activity in patients with PsA, regardless of weight loss. Adding omega-3 supplementation caused relevant body composition changes but not disease activity improvement. Trial Registration: The study was recorded on Clinicaltrials.gov (NCT03142503). (AU)

• FAPESP's process: 12/18789-7 - Association between dietary intake, metabolic profile and oxidative stress in psoriasis and psoriatic arthritis patients
• Grantee: Beatriz Figueiredo Leite
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 12/18701-2 - Effectiveness of a dietary intervention program on the disease activity, metabolic profile and oxidative stress in patients with psoriatic arthritis and psoriasis activity: a clinical, randomized, placebo-controlled study
• Grantee: Marcelo de Medeiros Pinheiro
• Support Opportunities: Regular Research Grants