Effect of food intake and ambient air pollution exposure on ankylosing spondylitis disease activity

Abstract Background: Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by axial arthritis. The genetic-environmental factors seem to be involved in the pathogenesis of the disease and the disease debilitates patients during the most productive stages of their lives. The aim of this study was to examine the relationships between two environmental factors, diet and air pollution with disease activity and functional impairment in AS. Methods: A case-control study was carried out. Thirty patients with AS and 30 age and sex-matched healthy controls were included. Disease scores including BASMI, BASDAI, BASFI, and BASG were calculated by means of the international Ankylosing Spondylitis Assessment working group consensus recommendations. The food intake was evaluated by semiquantitative food frequency questionnaire (147 items FFQ). Level of air pollution indices, PM10 and PM2.5 information was obtained from the Tehran air quality control network. Results: Total energy and fat intake, some vitamins (A, B1, B2, C) and mineral intake (potassium, calcium, iron, phosphorus, magnesium, zinc, copper and selenium) were significantly higher in patients with AS compared to controls. Fat component consumption especially Saturated Fat of Food was moderately correlated with BASFI score. PM2.5 long term exposure was strongly correlated with BASMI, BASFI and BASDAI scores of patients. Conclusion: High-fat diet and long term exposure to air pollution are associated with worse disease outcomes reported in patients with AS. This is an interesting area of investigation in AS pathogenesis and management.

[Health educational program based on stage of change theory and life style in patients suffering from knee arthritis: a clinical trial study]

Knee OA is possibly the most common causes of all specific RDs in most communities. This study aims to examine the effects of a theory based - based rehabilitation program based on stage of behavior change towards healthy life style among Iranian patients living with knee osteoporosis. This is a clinical trial study in which participants were recruited at Rheumatology Research Center of Tehran University of Medical Sciences From the eligible patients, 168 individuals were randomly divided to control or intervention group. Patients in the control group received just oral drug treatment while patients in the intervention group received oral drug treatment plus multidisciplinary rehabilitation program. The program involves three two-hour and two one - hour group sessions over a one week period, each was delivered by different specialists such as psychologist, rheumatologist, nutritionist, physiotherapist and health education specialist. Data on demographic characteristics and stage of behavior change were collected at 0, 3-, and 6 - month follow ups. Data were analyzed using repeated measure ANOVA. Totally from 146 patients entered into the study, 64 patients with mean age of 59.03 +/- 18.13 in intervention groups and 66 patients with mean age of 57.85 +/- 9.31 in control group continued the study. At initial of the study there were no differences between two groups in terms of demographic characteristics. However, intervention group was significantly better than control group in terms of nutrition behavior up to three months [P= 0.002], and six month [P= 0.013],as well as controlling risky behaviors regarding knee arthritis up to three months [P= 0.001]. The results of the study showed the educational program based on stage of change could control risky behaviors regarding knee arthritis