Adherence to a Mediterranean diet and consistent physical activity are associated with reduced disease activity in patients with psoriatic arthritis (PsA), regardless of body mass index (BMI), according to a study published in Clinical Rheumatology.
Psoriatic arthritis and psoriasis (PsO) often come with a higher comorbidity burden, which can affect treatment responses and contribute to early mortality. While lifestyle factors like diet and exercise are known to influence overall health, their specific impact on PsA outcomes has been less clear.
The cross-sectional study aimed to explore how adherence to a Mediterranean diet and levels of physical activity influence disease severity and treatment efficacy in PsA patients. The study included 279 adults with PsA and 76 PsO controls, all recruited from a university hospital in Greece between 2017 and 2021. Participants completed questionnaires detailing their dietary habits and exercise routines, with adherence categorized as low, moderate, or high.
Key findings from the study include:
Patient Demographics: The median age of the 355 participants was 55 years, with 56.6% women. PsA patients had a higher percentage of females compared to PsO patients (62.0% vs. 36.8%; P < .001). The median disease duration for PsA was 2.1 years, and 60.8% of these patients had a polyarticular phenotype.
Comorbidities: PsA patients reported more comorbidities than PsO patients (73.7% vs. 57.3%; P < .038). PsA patients were also more likely to use medications such as methotrexate, leflunomide, glucocorticoids, and tumor necrosis factor inhibitors.
Exercise Patterns: A low level of exercise was reported by 72.4% of PsA patients and 67.1% of PsO patients. Increased physical activity was associated with lower disease activity scores, reduced tender and swollen joint counts, decreased erythrocyte sedimentation rate (ESR) values, and improved PsO severity measures.
Dietary Adherence: Slightly over half of the patients with PsA (56.6%) and PsO (52.6%) adhered to a Mediterranean diet. Higher dietary adherence was linked to lower ESR values, reduced PsO severity, and decreased body surface area affected by PsO.
The study also found that higher levels of exercise and adherence to a Mediterranean diet were associated with lower BMI. While BMI was positively correlated with disease activity scores, the beneficial effects of exercise remained significant even after adjusting for BMI. Dietary adherence was associated with reduced enthesitis severity (P = .015).
Despite these findings, the study’s observational, cross-sectional design limits the ability to establish causation.
The researchers concluded, “Integrating non-pharmacological approaches, such as dietary adjustments and increased physical activity, with conventional treatments could further enhance disease outcomes in psoriatic arthritis patients.”