An investigation into the relationship between dietary intake, symptoms and health- related quality of life in children and young people with juvenile idiopathic arthritis: A systematic review and meta-analysis

Abstract

Background: The association between diet, symptoms and health related quality of life in children and young people with Juvenile idiopathic arthritis (JIA) is not clearly understood. The objectives of this systematic review and meta-analysis were to explore the evidence for a relationship of dietary intakes and arthritis symptoms such as pain and inflammation, growth factors including weight and height and health related quality of life in children and young people with JIA.Method: The databases PubMed, CINAHL, PsycINFO, Web of Science and Cochrane were searched in October 2019, updated in September 2020 and October 2021. Searches were restricted to English language, human and age (2-18 years old). Studies were included if they measured the effect of dietary supplements, vitamins or minerals, or diet in general, on quality of life and/ or arthritis symptom management. Two researchers independently screened titles and abstracts. Full texts were sourced for relevant articles. PRISMA guidelines were used for extracting data. For variables (vitamin D and disease activity), a random-effects meta-analysis model was performed. Two authors using a standardized data extraction form extracted data independently.Results: 11793 papers were identified through database searching, 25 studies met our inclusion criteria with 1614 participants. There was a significant association between Ɯ-3 polyunsaturated fatty acids (PUFA) and Juvenile Arthritis Disease Activity Score (p<0.001). EEN which contains protein and Kre-Celazine nutritional supplement composed of a proprietary alkali buffered, creatine monohydrate and fatty acids mixture improved symptoms of JIA. Height and weight values in relation to healthy controls varied across studies (p=0.029).Conclusions : supplements such as Ɯ-3 FAs, Kre-Celazine and EEN may have an impact on JIA symptoms while other supplements including vitamin D were found to not be associated with improvement of JIA symptoms nor a better quality of life. In addition, some studies indicate children with arthritis had a significantly lower weight and height than healthy controls, while in other studies obesity was reported to be increased in children and young people with JIA. PROSPERO [CRD42019145587].

An Overview of Nutritional Aspects in Juvenile Idiopathic Arthritis

“…It is important to emphasize that the reviewed studies generally present results regarding a specific nutrient or restrictive diet in relation to body recovery and reducing inflammation in JIA patients. Moreover, the impact of nutrition is difficult to assess and interpret in children and adolescents, particularly those with JIA, due to family influence, dietary regulation, and data collection [ 79 ]. However, the importance of a healthy and adequate diet is recognized in JIA patients’ development, growth, and health maintenance.…”