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  • 1. Di Giuseppe, Daniela
    et al.
    Ljung, Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Meat Consumption and Risk of Rheumatoid Arthritis in Women: A Population-Based Cohort Study2018In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 70, no S9, article id 203Article in journal (Other academic)
    Abstract [en]

    Background/Purpose: Mixed results have been reported for the association between meat consumption and the risk of developing rheumatoid arthritis (RA). The aim of this study was to evaluate the association between red meat, particularly processed meat, and the risk of RA using data from a population-based cohort of women.

    Methods: We prospectively followed 35,600 women aged 48-83 years from the Swedish Mammography Cohort (SMC), between 2003 and 2014. Meat consumption was assessed with a 96-item self-administered questionnaire in 1997. A corresponding questionnaire data from 1987 was available, enabling identification of long-term meat consumption. The relative risk (RR) of RA associated with meat consumption and its 95% confidence interval (CI) were estimated using Cox proportional hazard regression models. Multivariable models were adjusted for age, body mass index, educational level, physical activity, use of dietary supplements, energy intake, and smoking.

    Results: During the 12 years of follow-up (381 456 person years), 368 new cases of rheumatoid arthritis were identified. Meat consumption was not associated with the development of RA in age-adjusted (RR=0.96 (95% CI: 0.69-1.32)) or multivariable adjusted (RR=1.08 (95%CI: 0.77-1.53)) models (Table 1). No association was observed either for consumption of type-specific meat, such as red meat (RR=1.08 (95% CI: 0.77-1.50)), processed meat (RR=0.84 (95% CI: 0.59-1.22)), or poultry (RR=0.88 (95% CI: 0.60-1.31)). , Women with a consistent long-term consumption of meat of >7 servings/week over a period of 10 years had no increased risk of RA, HR 1.19 (95% CI: 0.78-1.80), compared to women with a consistent consumption of <=4 servings/week.

    Conclusion: In this large population-based cohort study, meat consumption, in total, by sub-types, or over time, was not associated with the risk of RA development in women.

  • 2. Exarchou, S.
    et al.
    Lindström, U.
    Sigurdardottir, V
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Askling, J.
    Eriksson, J. K.
    Forsblad d'Elia, H.
    Turesson, C.
    Kristensen, L. E.
    Jacobsson, L.
    Validity of ankylosing spondylitis and spondyloarthritis diagnoses in the swedish national patient register2014In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 32, no 5, p. 802-802Article in journal (Other academic)
  • 3.
    Fischer, Alexandra
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Blomberg, Anders
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
    Adherence to a Mediterranean-like Diet as a Protective Factor Against COPD: A Nested Case-Control Study2019In: COPD: Journal of Chronic Obstructive Pulmonary Disease, ISSN 1541-2555, E-ISSN 1541-2563Article in journal (Refereed)
    Abstract [en]

    A diet rich in nutrients has been suggested to have protective effects against the development of chronic obstructive pulmonary disease (COPD). Since the traditional Mediterranean diet is high in nutrients, including antioxidants, vitamins, and minerals, it is of interest to study as a protective factor against COPD. Our aim was therefore to study its associations with development of COPD using population-based prospective data from the Vasterbotten Intervention Programme (VIP) cohort. Data on diet from 370 individuals, who later visited the Department of Medicine at the University Hospital, Umea, Sweden, with a diagnosis of COPD, were compared to 1432 controls. Adherence to a Mediterranean diet was assessed by a modified version of the Mediterranean diet score (MDS). Cases were diagnosed with COPD 11.1 years (mean) (standard deviation [SD] 4.5 years) after first stating their dietary habits in the VIP at a mean age of 55.5 years (SD 6.6 years). Higher MDS was associated with a higher level of education and not living alone. After adjustment for co-habiting and education level, individuals with an intermediate MDS and those with the highest MDS had a lower odds of developing COPD (odds ratio [OR] 0.73, 95% confidence interval [CI] 0.56-0.95; OR 0.56, 95% CI 0.37-0.86, respectively). These results remained also after adjustment for smoking intensity, i.e., numbers of cigarettes smoked per day (OR 0.73, 95% CI 0.53-0.99; OR 0.59, 95% CI 0.35-0.97), respectively). To conclude, adherence to a Mediterranean-like diet seems to be inversely associated with the development of COPD.

  • 4.
    Hörnberg, Kristina
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Innala, Lena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Wållberg-Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Aerobic capacity over 16 years in patients with rheumatoid arthritis: relationship to disease activity and risk factors for cardiovascular disease2017In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 12, no 12, article id e0190211Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to analyse the change in aerobic capacity from disease onset of rheumatoid arthritis (RA) over 16.2 years, and its associations with disease activity and cardiovascular risk factors. Twenty-five patients (20 f/5 m), diagnosed with RA 1995-2002 were tested at disease onset and after mean 16.2 years. Parameters measured were: sub-maximal ergometer test for aerobic capacity, functional ability, self-efficacy, ESR, CRP and DAS28. At follow-up, cardiovascular risk factors were assessed as blood lipids, glucose concentrations, waist circumference, body mass index (BMI), body composition, pulse wave analysis and carotid intima-media thickness. Aerobic capacity [median (IQR)] was 32.3 (27.9-42.1) ml O2/kg x min at disease onset, and 33.2 (28.4-38.9) at follow-up (p>0.05). Baseline aerobic capacity was associated with follow-up values of: BMI (rs = -.401, p = .047), waist circumference (rs = -.498, p = .011), peripheral pulse pressure (rs = -.415, p = .039) self-efficacy (rs = .420, p = .037) and aerobic capacity (rs = .557, p = .004). In multiple regression models adjusted for baseline aerobic capacity, disease activity at baseline and over time predicted aerobic capacity at follow-up (AUC DAS28, 0-24 months; β = -.14, p = .004). At follow-up, aerobic capacity was inversely associated with blood glucose levels (rs = -.508, p = .016), BMI (rs = -.434, p = .030), body fat% (rs = -.419, p = .037), aortic pulse pressure (rs = -.405, p = .044), resting heart rate (rs = -.424, p = .034) and self-efficacy (rs = .464, p = .020) at follow-up. We conclude that the aerobic capacity was maintained over 16 years. High baseline aerobic capacity associated with favourable measures of cardiovascular risk factors at follow-up. Higher disease activity in early stages of RA predicted lower aerobic capacity after 16.2 years.

  • 5. Jiang, Xia
    et al.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Alfredsson, Lars
    Klareskog, Lars
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Bengtsson, Camilla
    High sodium chloride consumption enhances the effects of smoking but does not interact with SGK1 polymorphisms in the development of ACPA-positive status in patients with RA2016In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, no 5, p. 943-945Article in journal (Refereed)
  • 6. Jiang, Xia
    et al.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Alfredsson, Lars
    Klareskog, Lars
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Bengtsson, Camilla
    Sodium Chloride Consumption, Together with Smoking, Is Associated with ACPA Positivity2015In: Arthritis & Rheumatology, ISSN 2326-5191, E-ISSN 2326-5205, Vol. 67, article id 2018Article in journal (Other academic)
  • 7. Lindström, U.
    et al.
    Exarchou, S.
    Sigurdardottir, V.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Askling, J.
    Eriksson, J. K.
    Forsblad-d'Elia, Helena
    Department of Rheumatology and Inflammation Research, Sahlgrenska Academy at University of Gothenburg.
    Turesson, C.
    Kristensen, L. E.
    Jacobsson, L.
    Validity of ankylosing spondylitis and undifferentiated spondyloarthritis diagnoses in the Swedish National Patient Register2015In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 44, no 5, p. 369-376Article in journal (Refereed)
    Abstract [en]

    OBJECTIVES: Epidemiological studies of spondyloarthritis (SpA), using ICD codes from the Swedish National Patient Register (NPR), offer unique possibilities but hinge upon an understanding of the validity of the codes. The aim of this study was to validate the ICD codes for ankylosing spondylitis (AS) and undifferentiated SpA (uSpA) in the NPR against the established classification criteria [modified New York (mNY), Assessment of SpondyloArthritis international Society (ASAS), Amor, and European Spondyloarthropathy Study Group (ESSG) criteria].

    METHOD: All patients with an ICD-8/9/10 code of AS or uSpA in the NPR 1966-2009 at a visit to a specialist in rheumatology or internal medicine or corresponding hospitalization, alive and living in Sweden 2009, were identified (n = 20 089). Following a structured procedure to achieve geographical representativeness, 500 random patients with a diagnosis of AS or uSpA in 2007-2009 were selected. Based on a structured review of clinical records, positive predictive values (PPVs) for fulfilling the criteria sets were calculated.

    RESULTS: For those having received an ICD code for AS, the PPVs for fulfilling the mNY criteria or any set of SpA criteria were 70% and 89%, respectively. For those with an uSpA diagnosis (and never an AS diagnosis), the corresponding PPVs were 20% and 79%. The subset with both AS and uSpA diagnoses (overlap = 12%) were as likely to fulfil the mNY criteria as the group that had been coded as AS only.

    CONCLUSIONS: The diagnosis codes for AS or uSpA had high PPVs, suggesting that our case identification in the Swedish NPR can be used for nationwide, population-based, epidemiological studies of these diseases.

  • 8.
    Lindström, Ulf
    et al.
    Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg.
    Exarchou, S
    Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund.
    Sigurdardottir, V
    Department of Rheumatology, Falun Hospital, Falun.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Askling, J
    Clinical Epidemiology Unit, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Eriksson, JK
    Clinical Epidemiology Unit, Rheumatology Unit, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Forsblad d'Elia, Helena
    Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy, Gothenburg.
    Turesson, C
    Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund.
    Kristensen, LE
    Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund.
    Jacobsson, L
    Section of Rheumatology, Department of Clinical Sciences, Lund University, Lund.
    Validity of ankylosing spondylitis and spondyloarthritis diagnoses in the Swedish National Patient Register2014In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, p. 625-626Article in journal (Other academic)
    Abstract [en]

    Background: Epidemiological studies of spondyloarthritis (SpA) are scarce. Using ICD-codes from the Swedish National Patient Register (NPR) offers unique possibilities for such studies. For this purpose, the validity of these ICD-codes needs to be determined.Objectives: To validate the ICD-codes for ankylosing spondylitis (AS) and SpA in the NPR against established classification criteria (modified New York (mNY), ASAS, Amor and ESSG criteria).Methods: All patients with an ICD-code of AS or SpA in the NPR 1966-2009 at a visit to a specialist in rheumatology or internal medicine, or corresponding hospitalization, were identified (n=20074). Following a structured procedure to achieve geographical representativeness, 500 random patients with a registered diagnosis of AS or SpA in 2007-2009 were selected. A structured review of clinical records, with extraction of necessary information for the established classification criteria was performed and positive predictive values (PPV) were calculated.Results: In this cohort 11472 (34% women) patients had received an AS diagnosis and 11004 (56% women) a SpA diagnosis. The overlap group having received both types of diagnoses had similar frequencies for fulfillment of mNY criteria, symptoms and signs of back disease as the group having been coded as AS only.Of those being coded as AS only, the PPV for fulfilling the mNY, any criteria set and any of the included criteria elements were 70%, 89% and 96% respectively.Of those with SpA (without AS ever) the corresponding PPV values were 20%, 79% and 99% respectively.Conclusions: A diagnosis of AS or SpA (without AS) had a high validity, suggesting that case identification based on ICD-codes in the Swedish NPR can be used for epidemiological studies of these diseases.

  • 9.
    Ljung, Lotta
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Smeds, Johan
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Ketonen, Maria
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Forsblad-d'Elia, Helena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Patterns of comorbidity and disease characteristics among patients with ankylosing spondylitis: a cross-sectional study2018In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 37, no 3, p. 647-653Article in journal (Refereed)
    Abstract [en]

    The knowledge of the development of comorbidities in patients with ankylosing spondylitis (AS) is limited. The aim of this study was to analyse associations between AS disease characteristics and comorbidity and to evaluate patterns of comorbidities in patients with AS. Patients with AS, fulfilling the modified New York Criteria, were identified (n =3D 346, mean age 56 +/- 15 years, 75% men, 99% HLA B27 positive). Through a review of the patient records, data on disease activity parameters, laboratory results, disease manifestations, and diagnoses of any clinically significant comorbidity was obtained. Four categories of comorbidities of interest were identified: A. arrhythmias, conduction disorders, and valvular heart disease; B. atherosclerosis and atherosclerotic CVD; C. spinal and non-spinal fractures; and D. obstructive sleep apnoea syndrome. Associations between AS disease characteristics and comorbidities in categories were assessed in logistic regression models. Differences in proportions of comorbidities was analysed using two-sided chi-square. Age was associated with all four categories of comorbidities, and male sex with arrhythmias, conduction disorders, valvular heart disease, and obstructive sleep apnoea syndrome. Early disease onset and long disease duration, respectively, were associated with arrhythmias, conduction disorders, and valvular heart disease. Obstructive sleep apnoea syndrome was associated with features of the metabolic syndrome. Patients with atherosclerotic cardiovascular disease had an increased risk of most other comorbidities, similar to, but more pronounced than patients with arrhythmias, conduction disorders and valvular heart disease. Comorbid conditions motivate clinical awareness among patients with AS. Longitudinal studies are needed to establish preventive measures.

  • 10.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Kost och ankyloserande spondylit2012In: Best practice Reumatologi, ISSN 1903-6590, Vol. 4, no 10, p. 18-21Article, review/survey (Other academic)
  • 11.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    On diet in ankylosing spondylitis2011Doctoral 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. 

  • 12.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Bengtsson, Camilla
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Klareskog, Lars
    Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Alfredsson, Lars
    Institute of Environmental Medicine, Karolinska Institutet, Stockholm.
    High sodium intake among smokers is a risk factor for acpa positivity in RA2014In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, no Supplement 2, p. S136-S136Article in journal (Other academic)
  • 13.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Ekergård, Helena
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Sundelin, Gunnevi
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Exercise habits among patients with ankylosing spondylitis: A questionnaire based survey in the County of Västerbotten, Sweden2002In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 31, no 3, p. 163-167Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: This study aimed at evaluating exercise habits among patients with ankylosing spondylitis, their clinical status and what mainly restrains these patients from exercising.

    METHODS: In a cross-sectional design study 189 patients completed a self-administrated questionnaire regarding their exercise habits and their clinical status.

    RESULTS: A majority of the patients reported that they performed exercises. The most popular form of exercise was walking. Pool exercise was perceived to relieve the symptoms more than any other exercise and was also rated as the most enjoyable form of exercise. The main obstacle to exercise was lack of time, followed by fatigue. A small number of patients experienced aggravation of symptoms with exercise.

    CONCLUSION: A majority of AS patients exercise, although the frequency of the exercise was low for many patients. The main obstacle to exercise was lack of time and fatigue.

  • 14.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Cardiovascular risk factors among patients with ankylosing spondylitis in comparison to the general population2012In: Annals of the Rheumatic diseases: supplement 3, 2012, Vol. 71, p. 648-Conference paper (Refereed)
  • 15.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Kost och andra kardiovaskulära riskfaktorer hos patienter med ankyloserande spondylit2011In: Abstrakt Medicinska riksstämman Stockholm 2011, 2011Conference paper (Refereed)
  • 16.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. University Hospital, Umeå.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Modifiable cardiovascular risk factors in patients with ankylosing spondylitis2014In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 33, no 1, p. 111-117Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to evaluate whether modifiable cardiovascular disease (CVD) risk factors, e.g. atherogenic blood lipids, hypertension and lifestyle-related factors such as smoking, diet and physical inactivity, differ among patients with ankylosing spondylitis (AS) in comparison to the general population. Eighty-eight patients diagnosed with AS were identified by analysis of the databases of a previous community intervention programme, the Västerbotten intervention programme. The patients were compared with 351 controls matched for age, sex and study period. These databases include the results of blood samples analysed for cholesterol, triglycerides and plasma glucose, as well as data on hypertension, height, weight, smoking and dietary habits and physical activity. No significant differences were found between patients and controls regarding hypertension, body mass index, physical activity, diet or smoking. 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 correlated inversely with the intake of total fat (r s = −0.25, p < 0.05), monounsaturated fats (r s = −0.29, p < 0.05) and positively correlated to the intake of carbohydrates (r s = 0.26, p < 0.05). These associations were not apparent among the controls. In the cohort of AS patients studied, no differences were found regarding the modifiable risk factors for CVD compared with the general population. Hence, the increased presence of CVD in patients with AS may be caused by other factors such as differences in metabolism and medication such as NSAID or the chronic low-grade inflammation present in the disease.

  • 17.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    School of social and health sciences, Halmstad university, Halmstad, Sweden.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Wållberg-Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Diet and cardiovascular risk factors among patients with ankylosing spondylitis in comparison with the general populationManuscript (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.

  • 18.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    School of social and health sciences, Halmstad university, Halmstad, Sweden.
    Kokkonen, Heidi
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Cederholm, Tommy
    Division of clinical nutrition and metabolism, department of public health and caring science, Uppsala university, Uppsala, Sweden.
    Wållberg-Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Plasma phospholipid fatty acid content is related to disease activity in ankylosing spondylitis2012In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 39, no 2, p. 327-333Article in journal (Refereed)
    Abstract [en]

    Objectives: To investigate the fatty acid composition in the diet, plasma phospholipids, and adipose tissue among a cohort of patients with ankylosing spondylitis (AS), and to determine their correlation to disease activity and blood lipids in a cross-sectionally designed study.

    Methods: Diet was assessed using a food frequency questionnaire on 66 patients with AS. The polyunsaturated fatty acids (PUFAs) in plasma phospholipids and gluteal adipose tissue were measured using gas chromatography. Disease status was quantified using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), high sensitivity C-reactive protein and pro-inflammatory cytokines.

    Results: Diet did not correlate to disease activity assessed by the BASDAI, but there were negative correlation between the dietary intake of long-chained omega-3 fatty acids and ESR (rs=-0.27, p<0.05). The plasma phospholipid content of arachidonic acid (AA) correlated significantly with the BASDAI score (rs=0.39, p<0.01). There were correlations between the intake of long-chained omega-3 fatty acids and high-density lipoproteins as well as to serum triglycerides (rs=0.26 and rs=-0.25; respectively, p<0.05).

    Conclusion: There was a positive correlation between levels of AA in plasma phospholipids and disease activity assessed by BASDAI in patients with AS. A western diet does not appear to influence this correlation, but seems to affect blood lipids involved in atherogenic processes. 

  • 19.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Dahlqvist, Solbritt Rantapää
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Diet and Other Lifestyle Related Factors and the Risk of Developing Rheumatoid Arthritis2012In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 64, no 10, p. S1141-S1141Article in journal (Other academic)
  • 20.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Rantapää Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Dietary sodium increases the risk for rheumatoid arthritis among smokers2014In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, p. 329-329Article in journal (Refereed)
  • 21.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology. University Hospital, Umeå.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Rantapää Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Interaction between dietary sodium and smoking increases the risk for rheumatoid arthritis: results from a nested case-control study2015In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 54, no 3, p. 487-493Article in journal (Refereed)
    Abstract [en]

    OBJECTIVE: Recent studies in animal models and on human cells have shown an effect of sodium chloride (NaCl) on Th17 cells promoting inflammation. The aim of this study was to evaluate the impact of NaCl intake on the risk of development of RA.

    METHODS: A nested case-control study was performed using population-based prospective data from the Västerbotten Intervention Programme. The study included 386 individuals who had stated their dietary habits as part of a community intervention programme a median of 7.7 years before the onset of symptoms of RA. For comparison, 1886 matched controls were identified from the same database and co-analysed.

    RESULTS: No significant association was found between sodium intake and the development of RA when all of the individuals were included. In analyses stratified for smoking status at the time of the examination, sodium intake more than doubled the risk for RA among smokers [odds ratio (OR) 2.26 (95% CI 1.06, 4.81)]. This was not observed among non-smokers. Additive interaction analysis of smoking and cases with the highest tertile of sodium intake revealed that 54% of the increased risk of developing RA from these exposures was due to interaction between them [attributable proportion 0.54 (95% CI 0.26, 0.82)]. The risk was further increased for the development of anti-CCP-positive and/or HLA shared epitope-positive RA.

    CONCLUSION: Although we were unable to confirm our stated hypothesis, our results that high sodium consumption among smokers was associated with the risk of RA may provide new insights into the impact of smoking in RA development.

  • 22.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Rantapää Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Interaktion mellan salt och rökning ökar risken för reumatoid artrit2014In: ReumaBulletinen, ISSN 2000-2246, Vol. 96, no 2, p. 22-Article in journal (Refereed)
  • 23.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Rantapää Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology. Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Medicine.
    Kost och livsstil som riskfaktorer för att utveckla reumatoid artrit2012In: Abstrakt Medicinska riksstämman Stockholm 2012, 2012Conference paper (Refereed)
  • 24.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Diet and alcohol as risk factors for rheumatoid arthritis: a nested case-control study2015In: Rheumatology International, ISSN 0172-8172, E-ISSN 1437-160X, Vol. 35, no 3, p. 533-539Article in journal (Refereed)
    Abstract [en]

    The aim of this study was to investigate whether alcohol and diet, assessed as both macronutrients and dietary patterns, increased the risk of development of rheumatoid arthritis (RA) through a nested case-control design in the Vasterbotten Intervention Program (VIP) cohort. Individuals in the VIP who had developed RA after the dietary survey were identified from medical records at the department of rheumatology at the University Hospital, UmeAyen (n = 386), and matched to 1,886 controls from the same database. Diet was assessed as food groups, as macronutrients and as scores of dietary patterns, namely the carbohydrate-restricted diet score, the Mediterranean diet score and the healthy diet indicator score. When analysing the dietary patterns, consumption of food groups and different macronutrients, a significant association was found in the highest tertile of carbohydrate-restricted diet among the cases with a subsequent anti-CCP-positive disease 1.40 (1.02-1.92), as well as in the highest tertile of protein consumption among smokers (OR = 1.80, 95 % CI 1.09-2.95). However, after additional adjustment for sodium intake, these associations were no longer statistically significant. No association was observed between alcohol consumption and the risk of RA. To summarize, there were no significant associations between diet, or alcohol consumption, and the risk of development of RA within this cohort. The lack of any significant associations of alcohol consumption may be explained by a low consumption in the studied population overall or alternatively by methodological issues raised recently.

  • 25.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology.
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine.
    Dietary patterns, macronutrients and alcohol as risk factors for rheumatoid arthritis2014In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, p. 1144-1145Article in journal (Other academic)
  • 26.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Ingegerd
    Umeå University, Faculty of Medicine, Department of Odontology, Cariology.
    Rantapää-Dahlqvist, Solbritt
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Dietary Sodium Increases The Risk For Rheumatoid Arthritis Among Smokers – Results From a Nested Case-Control Study.2013In: Arthritis and Rheumatism, ISSN 0004-3591, E-ISSN 1529-0131, Vol. 65, no Special Issue, Supplement 10, p. S966-S966, Meeting Abstract: 2271Article in journal (Other academic)
  • 27.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Kvist, Lillemor
    Malmbergets vårdcentral.
    Grupprehabilitering vid Fibromyalgi: effekter på vårdkonsumtion, välbefinnande och symtom.2009In: Abstrakt Sjukgymnastdagarna, Stockholm, 2009, 2009Conference paper (Refereed)
  • 28.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Ljung, Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. Karolinska Institutet, Clinical Epidemiology Division, Dept. Medicine Solna, Stockholm, Sweden.
    Di Giuseppe, Daniela
    Consumption of dairy products and risk of rheumatoid arthritis among women: a population-based prospective cohort study2019In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, p. 1047-1048Article in journal (Other academic)
    Abstract [en]

    Background: Conflicting results have been reported regarding the association between consumption of milk and dairy products and the risk for development of rheumatoid arthritis (RA).

    Objectives: The aim of this study was to investigate the association between consumption of milk and dairy products and the development of RA in a large population-based cohort of women.

    Methods: In a prospective cohort study 35,600 women aged 48-83 years, from the Swedish Mammography Cohort (SMC), were followed between 2003 and 2015. Consumption of dairy products was assessed in 1997 at a mean age of mean age of 61.5 years (SD 9.1 years) with a 96-item self-administered questionnaire. The risk (hazard ratio; HR) of RA development associated with consumption of dairy products was estimated using Cox proportional hazard regression models with adjustment for age, alcohol intake, smoking, energy intake, meat and fish consumption.

    Results: During the follow-up of 12 years, 368 individuals were identified with a new diagnosis of RA. Comparing high consumption with low consumption of dairy products, no association between consumption of dairy products and the development of RA was observed: HR for the fully adjusted model=1.12 (95% CI: 0.78-1.59 (Table 1). Also when evaluating milk and cheese consumption separately, no association with the risk of RA was observed: HR for the highest milk consumption=1.10 (95% CI: 0.82-1.44) and highest cheese consumption HR=1.20 (95% CI: 0.81-1.79), compared with low consumption (fully adjusted models, table 1).

    Conclusion: In this large population-based cohort study, consumption of dairy products was not associated with risk to develop RA.

  • 29.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Ljung, Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. Clinical Epidemiology Section, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.
    Wallberg-Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Exercise habits and C-reactive protein may predict development of spinal immobility in patients with ankylosing spondylitis2018In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 37, no 10, p. 2881-2885Article in journal (Refereed)
    Abstract [en]

    To assess predictors for spinal immobility in a long-term clinical study of patients with AS, data from annual clinical measurements of spinal mobility in 54 patients (41 men, mean of age at end of follow-up 54.7 years) with ankylosing spondylitis were co-analysed with data regarding lifestyle factors as well as laboratory measurements from a previous cross-sectional study. Spinal immobility was graded on the basis of recently published age-, sex- and length-specific reference intervals. Exercise habits and high-sensitivity C-reactive protein (hsCRP) were independently associated with the development of subnormal spinal immobility (p = 0.019 and p = 0.021). In multiple regression models, approximately 25% of the spinal immobility could be attributed to disease duration (p ae 0.011), levels of hsCRP (p ae0.004) and exercise in leisure time (p ae 0.019). The mean concentration of hsCRP was 4.2 mg/L (range 0.2-8.4 mg/L) in the study cohort. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR) and physical activity at work were not associated with spinal immobility. The results indicate that exercise habits may have an impact in preventing the development of spinal immobility in AS independently of disease duration and inflammation. This corresponds well with the accumulated knowledge from long-term clinical experience among rheumatologists, health professionals and patients. Consequently, exercise should remain an important part of the non-pharmacological treatment and self-care for patients with AS. Furthermore, modest inflammatory activity, measured as a slightly elevated hsCRP concentration, appears to affect subsequent spinal immobility in AS.

  • 30.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Ljung, Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Exercise habits and C-reactive protein are associated with long term spinal immobility in ankylosing spondylitis2017Conference paper (Refereed)
  • 31.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Ljung, Lotta
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Wållberg-Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Spinal mobility in long standing ankylosing spondylitis: application of newly developed reference intervals on clinical data2016In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 75, p. 1290-1290Article in journal (Refereed)
  • 32.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Physiotherapy.
    Nilsson, Margaretha
    Medicinsk rehabilitering Gällivare sjukhus.
    Utbrändhet, dess relation till angränsande diagnoser och möjligheter till sjukgymnastisk intervention2002In: Nordisk fysioterapi, ISSN 1402-3024, Vol. 6, no 2, p. 89-94Article, review/survey (Refereed)
    Abstract [en]

    Professional burnout has been shown to negatively affect human physiology regarding to the body stress response. Until present no scientific evaluated treatment is available. Research, however, point out that physiotherapy and physical training is an important part of the future treatment on this diagnosis. Research also suggest that knowledge from treatment of chronic fatigue syndrome could be used. In this diagnosis physical training and cognitive therapy is the only treatment that has shown evidence-based effectiveness.

  • 33.
    Sundström, Björn
    et al.
    Department of Medical Rehabilitation, Gällivare Hospital.
    Stålnacke, K
    Department of Medicine/Rehabilitation, Kiruna Hospital.
    Hagfors, Linda
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Johansson, Gunnar
    Umeå University, Faculty of Social Sciences, Department of Food and Nutrition.
    Supplementation of Omega-3 fatty acids in patients with ankylosing spondylitis2006In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 35, p. 359-362Article in journal (Refereed)
    Abstract [en]

    Objective: To study the effect of supplementation with omega‐3 fatty acids on disease variables and drug consumption in patients with ankylosing spondylitis (AS).

    Methods: Twenty‐four patients were randomized to either a low‐dose (1.95 g omega‐3/day) or a high‐dose (4.55 g omega‐3/day) supplement. Disease activity, functional impairment, erythrocyte sedimentation rate (ESR), and drug consumption were assessed during visits at baseline and at weeks 7, 14, and 21.

    Results: Eighteen patients completed the study, nine patients from each group. The patients in the high‐dose group exhibited a significant decrease in disease activity according to the Bath Ankylosing Disease Activity Index (BASDAI; p = 0.038), which was not seen in the low‐dose group. Significant differences were not found on drug consumption or in functional capacity in either of the groups. No significant differences were found when comparing the results between the high‐ and low‐dose groups.

    Conclusion: Omega‐3 fatty acids in adequate doses may have the capacity to decrease the disease activity of AS. However, larger and better controlled studies are needed before any further conclusions can be made on the extent of this capacity.

    Read More: http://informahealthcare.com/doi/abs/10.1080/03009740600844357

  • 34.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Cederholm, Tommy
    Uppsala University.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Long-chain polyunsaturated fatty acid composition in diet, plasma and adipose tissue among patients with ankylosing spondylitis2010In: Clinical and experimental rheumatology, Pacini Editore SpA , 2010, Vol. 28, p. 625-625Conference paper (Other academic)
  • 35.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Cederholm, Tommy
    Department of Public Health and Caring Sciences, Uppsala University, Uppsala.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Plasma phospholipids are related to disease activity in ankylosing spondylitis2011In: Annals of the Rheumatic Diseases 2011;70(Suppl3):739, 2011, p. 739-Conference paper (Refereed)
  • 36.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Fat composition in diet, plasma and adipose tissue among patients with ankylosing spondylitis2010In: Ann Rheum Dis 2010;69 (Suppl3):698, 2010Conference paper (Refereed)
  • 37.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    Högskolan i Halmstad, Sektionen för hälsa och samhälle .
    Gastric complaints in Ankylosing Spondylitis: is the silent gut inflammation really silent?2009In: Ann Rheum Dis 2009; 68: 636, Ann Rheum Dis, 2009Conference paper (Refereed)
  • 38.
    Sundström, Björn
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Wållberg-Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Reumatology.
    Johansson, Gunnar
    School of Social and Health Sciences, Halmstad University, Halmstad, Sweden.
    Diet, disease activity, and gastrointestinal symptoms in patients with ankylosing spondylitis2011In: Clinical Rheumatology, ISSN 0770-3198, E-ISSN 1434-9949, Vol. 30, no 1, p. 71-76Article in journal (Refereed)
    Abstract [en]

    The aims of this study were to investigate, firstly, the relationship between diet and disease activity and, secondly, the presence of gastrointestinal symptoms and their relationship to diet among patients with ankylosing spondylitis (AS) using a cross-sectional design. One hundred sixty-five individuals diagnosed with AS were invited to complete a self-administered postal questionnaire regarding demographic data, diet, medication, and gastrointestinal symptoms in addition to two established disease assessment questionnaires, i.e., the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI). No significant correlation between diet and disease activity was found. Overall, 27% of the patients reported aggravating gastrointestinal problems when consuming certain foodstuff(s). The 30% of patients who reported suffering from gastrointestinal pain had significantly greater disease activity and poorer functional status according to their BASDAI and BASFI scores (p < 0.01 and p = 0.01, respectively). Patients who reported gastrointestinal pain had a significantly higher consumption of vegetables (p < 0.01) and lower consumption of milk and soured milk (p = 0.04). No significant correlation was found between the use of non-steroidal anti-inflammatory drugs (NSAID) and gastrointestinal symptoms. In multiple regression models, BASDAI and the consumption of vegetables were independent and statistically significant predictors of gastrointestinal pain. To conclude, in a group of Swedish AS patients, no correlation between diet and disease activity could be detected. There were, however, correlations between diet and gastrointestinal pain. Gastrointestinal problems were also found to be prevalent in AS, independent of NSAID usage.

  • 39.
    Ångström, Lars
    et al.
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Hörnberg, Kristina
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Sundström, Björn
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Wållberg Jonsson, Solveig
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology.
    Södergren, Anna
    Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Rheumatology. Umeå University, Faculty of Medicine, Wallenberg Centre for Molecular Medicine at Umeå University (WCMM).
    Aerobic capacity is associated with cardiovascular risk factors and disease activity in early rheumatoid arthritis: a cross sectional study2018In: Article in journal (Other academic)
1 - 39 of 39
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