Access to Healthy Food and Clinical Status at the Time of Juvenile Idiopathic Arthritis (JIA) Diagnosis

Objectives Lifestyle factors such as diet and physical activity may impact JIA disease activity and outcomes.[1] There is a suspicion that poor access to healthy food may contribute to worse JIA outcomes.[2,3] Recent research has highlighted significant disparities in food environments and accessibility to healthy food across Canada. Therefore, this study aims to explore the potential ecological relationship of poor food accessibility with clinical and growth parameters in Canadian children with JIA. Methods Data on newly diagnosed children with JIA over a 4-year period (2017-2021) from the Canadian Alliance of Pediatric Rheumatology Investigator (CAPRI) JIA Registry were examined for clinical measures and growth parameters at enrollment (<3m after diagnosis). Data were linked to neighborhood-level food accessibility derived from the Canadian Food Environment Dataset using household postal codes Association between food accessibility measures and clinical and growth parameters were examined with Spearman’s rho correlation tests. Clinical parameters included active joint count, parent global assessment (Parent GA), childhood health assessment questionnaire (CHAQ), self-reported pain, physician global assessment of disease activity (PGADA), clinical Juvenile Arthritis Disease Activity Score (cJADAS), Quality of my life (QoML), and the Juvenile Arthritis Quality of Life Questionnaire (JAQQ). Results Among 641 JIA patients, 150 (25.2%) were overweight or obese (>85%ile). Children with poorer accessibility to fresh and nutritious retail food in their neighborhood were found to have higher body weight (rs = −0.086, p = 0.040). Surprisingly at baseline, living in neighborhoods with increased densities of fast-food stores and convenience stores was not associated with higher measures of disease activity. Higher proportion of fast-food restaurants was associated with lower active joint counts (rs = −0.088, p = 0.035), and a trend toward lower PGADA (rs = −0.078, p = 0.063) and cJADAS (rs = −0.083, p = 0.052). No significant associations were found between reduced access to healthy food and PGADA, cJADAS, JAQQ, pain, Parent GA or CHAQ scores at baseline (Table 1). Table 1. Associations between baseline clinical variables and growth parameters with neighbourhood-level food accessibility measures (r s , p-value) Conclusion These preliminary results suggest that poor accessibility to healthy food was associated with higher weight at presentation of JIA. Overall, increased access to both healthy and unhealthy food is associated with lower disease activity. We speculate this association may be related to other benefits of urbanicity. Further analyses using linear mixed models will examine the relationship between food accessibility and changes in disease activity and weight over the first year of disease. [1.] Little E. J Altern Complement Med 2019;25:643-7. [2.] Zandonadi R. Nutrients 2022;14:4412. [3.] Lites T. MMWR Morb Mortal Wkly Rep 2023;72:788-92.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.