Rheumatology Research Group, Vall d'Hebron Hospital Research Institute, Barcelona, Spain.
Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Eur J Clin Nutr. 2021 Sep;75(9):1368-1382. doi: 10.1038/s41430-021-00913-6. Epub 2021 Apr 23.
BACKGROUND/OBJECTIVES: Immune-mediated inflammatory diseases (IMIDs) are prevalent diseases. There is, however, a lack of understanding of the link between diet and IMIDs, how much dietary patterns vary between them and if there are food groups associated with a worsening of the disease.
SUBJECTS/METHODS: To answer these questions we analyzed a nation-wide cohort of n = 11,308 patients from six prevalent IMIDs and 2050 healthy controls. We compared their weekly intake of the major food categories, and used a Mendelian randomization approach to determine which dietary changes are caused by disease. Within each IMID, we analyzed the association between food frequency and disease severity.
After quality control, n = 11,230 recruited individuals were used in this study. We found that diet is profoundly altered in all IMIDs: at least three food categories are significantly altered in each disease (P < 0.05). Inflammatory bowel diseases showed the largest differences compared to controls (n ≥ 8 categories, P < 0.05). Mendelian randomization analysis supported that some of these dietary changes, like vegetable reduction in Crohn's Disease (P = 2.5 × 10, OR(95% CI) = 0.73(0.65, 0.80)), are caused by the disease. Except for Psoriatic Arthritis and Systemic Lupus Erythematosus, we have found ≥2 food groups significantly associated with disease severity in the other IMIDs (P < 0.05).
This cross-disease study demonstrates that prevalent IMIDs are associated to a significant change in the normal dietary patterns. This variation is highly disease-specific and, in some cases, it is caused by the disease itself. Severity in IMIDs is also associated with specific food groups. The results of this study underscore the importance of studying diet in IMIDs.
背景/目的：免疫介导的炎症性疾病（IMIDs）是常见疾病。然而，人们对饮食与 IMIDs 之间的联系、它们之间的饮食模式差异有多大以及是否存在与疾病恶化相关的食物组了解甚少。
受试者/方法：为了回答这些问题，我们分析了来自六种常见 IMIDs 的 n = 11308 名患者和 2050 名健康对照者的全国性队列。我们比较了他们每周主要食物类别的摄入量，并使用孟德尔随机化方法来确定哪些饮食变化是由疾病引起的。在每种 IMID 中，我们分析了食物频率与疾病严重程度之间的关系。
经过质量控制，本研究使用了 n = 11230 名招募的个体。我们发现，所有 IMIDs 中的饮食都发生了深刻的改变：每种疾病至少有三种食物类别发生显著改变（P < 0.05）。与对照组相比，炎症性肠病的差异最大（n ≥ 8 类，P < 0.05）。孟德尔随机化分析支持，这些饮食变化中的一些，如克罗恩病中蔬菜摄入量的减少（P = 2.5 × 10，OR（95%CI）= 0.73（0.65，0.80）），是由疾病引起的。除了银屑病关节炎和系统性红斑狼疮外，我们还发现其他 IMIDs 中有≥2 种食物组与疾病严重程度显著相关（P < 0.05）。
这项跨疾病研究表明，常见的 IMIDs 与正常饮食模式的显著变化有关。这种变化具有高度的疾病特异性，在某些情况下，是由疾病本身引起的。IMIDs 的严重程度也与特定的食物组有关。这项研究的结果强调了在 IMIDs 中研究饮食的重要性。
