Change search
ReferencesLink to record
Permanent link

Direct link
Diet and cardiovascular risk factors among patients with ankylosing spondylitis in comparison with the general population
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
School of social and health sciences, Halmstad university, Halmstad, Sweden.
Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background: An increased risk of cardiovascular diseases (CVD) has been reported among patients with Ankylosing Spondylitis (AS).  As of today, little is known what causes this increase.  The aim of this study was to evaluate whether diet and traditional CVD risk factors differ among AS patients in comparison to the general population.

Material and method: Eighty-nine patients diagnosed with AS by fulfilling the modified New York criteria were identified in the databases of a community intervention programme, the Västerbotten Intervention Programme (VIP).  The patients were compared with 356 controls matched for age, sex and study period.  As part of the VIP, participants have completed questionnaires regarding diet, physical activity and smoking.  Additionally, the VIP included measurement of blood pressure, height and weight, and blood samples analysed for cholesterol, serum triglycerides and blood glucose.

Results: No significant differences were found between patients and controls regarding diet, physical activity, exercise frequency or smoking habits; nor in measurements of body mass index (BMI), weight or blood pressure.  However, levels of serum triglycerides (p<0.01) and cholesterol (p<0.01) were significantly lower in the patient group.  Among the patients, the level of triglycerides was inversely correlated to the intake of total fat (rs = -0.25, p<0.05), monounsaturated fats (rs = -0.29, p<0.05) and positively correlated to the intake of carbohydrates (rs = 0.26, p<0.05).  These correlations were not seen among the controls.

Conclusions: The patients exhibited significantly lower levels of cholesterol and triglycerides compared with controls.  There were correlations between diet and atherogenic blood lipids among the patients which were not found in the control group.  The results suggest that there may be differences in fat metabolism among patients with AS in comparison to the general population.

Keyword [en]
ankylosing spondylitis, cardiovascular, diet
National Category
Medical and Health Sciences Rheumatology and Autoimmunity
Research subject
Medicine, rheumatology
URN: urn:nbn:se:umu:diva-48554OAI: diva2:451475
Available from: 2011-10-26 Created: 2011-10-22 Last updated: 2011-10-28Bibliographically approved
In thesis
1. On diet in ankylosing spondylitis
Open this publication in new window or tab >>On diet in ankylosing spondylitis
2011 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to examine the role of diet in ankylosing spondylitis (AS). Patients were examined in: i) a postal questionnaire survey of dietary habits and gastrointestinal (GI) symptoms; ii) a study on biomarkers of diet and disease activity; iii) a comparison of cardiovascular risk factors with the general population using data from the Västerbotten Intervention Programme (VIP), and; iv) a 21-week omega-3 fatty acid supplementation study regarding the effects on disease activity.

The postal survey (111 respondents) revealed no correlation between dietary habits and disease activity measured by the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). However, GI problems, and in particular GI pain, were prevalent in patients with AS irrespective of NSAID usage.Gastrointestinal pain was predicted by higher BASDAI and a higher consumption of vegetables. Overall, 30 (27%) of the patients experienced an aggravation of gastric symptoms when consuming certain foods. In the study of biomarkers (n=66) no correlation was found between diet and disease activity as assessed by BASDAI. There were, however, positive correlations between BASDAI and the content of arachidonic acid (AA) in plasma phospholipids (rs=0.39, p<0.01) and the estimated activity of the enzyme delta-5-desaturase (rs=0.37, p<0.01). This may reflect a process involved in the inflammation associated with AS that requires further investigation. Comparing data from the VIP for patients (n=89) and controls showed no significant differences regarding diet, physical activity or smoking. Nonetheless, more pronounced correlations between blood lipids and diet were identified among patients than in controls. Furthermore, the levels of cholesterol and triglycerides were lower in patients compared with controls. Lastly, in the supplementation study, a high-dose of long-chain omega-3 fatty acids (4.55 grams/day) was found to lower disease activity, as measured by BASDAI, whereas low-dose treatment (1.95 grams/day) caused no change.

In conclusion, within a group of Swedish AS patients we found no correlation between ordinary dietary habits and disease activity. Diet in western populations of patients with AS may, however, be of importance for gastric symptoms and for cardiovascular risk factors. The finding of a lowered disease activity in patients on high-dose supplementation with long-chain omega-3 fatty acids indicates that a radical dietary shift may influence disease activity. The findings of a positive correlation between disease activity and plasma AA, and the decreased levels of blood lipids imply the need for further studies into fatty acid metabolism in AS. 

Place, publisher, year, edition, pages
Umeå: Umeå universitet, 2011. 50 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1440
diet, ankylosing spondylitits, omega-3, cardiovascular
National Category
Rheumatology and Autoimmunity
Research subject
Medicine, rheumatology
urn:nbn:se:umu:diva-48557 (URN)978-91-7459-272-6 (ISBN)
Public defence
2011-11-18, Utbildningsnod XI, lokal 135, Umeå Universitet, UMEÅ, 09:00 (Swedish)
Available from: 2011-10-28 Created: 2011-10-22 Last updated: 2011-10-28Bibliographically approved

Open Access in DiVA

No full text

Search in DiVA

By author/editor
Sundström, BjörnJohansson, IngegerdWållberg-Jonsson, Solveig
By organisation
Medical and Health SciencesRheumatology and Autoimmunity

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Total: 67 hits
ReferencesLink to record
Permanent link

Direct link