Objectives Studies on diet as a complementary treatment in children with juvenile idiopathic arthritis (JIA) are limited. We have previously reported initial findings from a study exploring the potential anti-inflammatory effects of a 1-month specific carbohydrate diet (SCD) in children with JIA. This paper presents the full-year follow-up results, primarily focusing on changes in medication needs before and after the intervention. Methods Twenty-eight patients with JIA, with low disease activity, were included. The results of disease activity, physical function, pain, morning stiffness, and inflamed joints from the 1-month intervention, as well as long-term effects, were evaluated. The medical burden during the year before and 1 year after the dietary intervention was compared with three times as many retrospective patients with JIA. Results Despite adherence challenges, twenty-one children completed at least 1 month on the diet with a significant improvement in clinical variables that appeared to persist for several months. Sixteen children completed a 1-year follow-up, and the medical burden was compared with that of 48 matched retrospective controls. We observed no significant group-level changes in medication use from the dietary intervention. In six participants, the need for medical escalation was eliminated following the dietary intervention, and this effect was maintained for 1 year. Conclusion The SCD shows promise in alleviating symptoms in children with JIA, both in the short and long-term. While no significant group-level changes were observed, some participants avoided treatment escalations, suggesting individual benefits. However, larger-scale studies using a less complicated diet are necessary to draw definitive conclusions. Clinical Trials Identifier NCT04205500, 2019/12/17, retrospectively registered. URL: <a href="https://register.clinicaltrials.gov">https://register.clinicaltrials.gov</a>.<Table Float="No" ID="Taba"> <tgroup cols="2"> <colspec align="left" colname="c1" colnum="1" /> <colspec align="left" colname="c2" colnum="2" /> <tbody> <row> <entry nameend="c2" namest="c1"> Key Points • The specific carbohydrate diet (SCD) allowed some participants to avoid planned medication escalations, indicating its potential role in managing JIA symptoms. • Most participants faced difficulties with long-term adherence to the restrictive SCD, highlighting the need for more sustainable dietary strategies. • Further studies are needed to identify specific dietary components that drive benefits and to explore underlying mechanisms for effective dietary recommendations in pediatric rheumatology. </entry> </row> </tbody> </tgroup> </Table>

One-year follow-up of a short specific carbohydrate diet intervention in children with juvenile idiopathic arthritis: A retrospectively controlled study with focus on medical burden

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2025年4月2日

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Naima Hagström,
Anders Öman,
Afsaneh Koochek,
Henrik Arnell,
Lillemor Berntson

摘要

Objectives

Studies on diet as a complementary treatment in children with juvenile idiopathic arthritis (JIA) are limited. We have previously reported initial findings from a study exploring the potential anti-inflammatory effects of a 1-month specific carbohydrate diet (SCD) in children with JIA. This paper presents the full-year follow-up results, primarily focusing on changes in medication needs before and after the intervention.

Methods

Twenty-eight patients with JIA, with low disease activity, were included. The results of disease activity, physical function, pain, morning stiffness, and inflamed joints from the 1-month intervention, as well as long-term effects, were evaluated. The medical burden during the year before and 1 year after the dietary intervention was compared with three times as many retrospective patients with JIA.

Results

Despite adherence challenges, twenty-one children completed at least 1 month on the diet with a significant improvement in clinical variables that appeared to persist for several months. Sixteen children completed a 1-year follow-up, and the medical burden was compared with that of 48 matched retrospective controls. We observed no significant group-level changes in medication use from the dietary intervention. In six participants, the need for medical escalation was eliminated following the dietary intervention, and this effect was maintained for 1 year.

Conclusion

The SCD shows promise in alleviating symptoms in children with JIA, both in the short and long-term. While no significant group-level changes were observed, some participants avoided treatment escalations, suggesting individual benefits. However, larger-scale studies using a less complicated diet are necessary to draw definitive conclusions.

Clinical Trials Identifier NCT04205500, 2019/12/17, retrospectively registered. URL: https://register.clinicaltrials.gov.

Key Points

• The specific carbohydrate diet (SCD) allowed some participants to avoid planned medication escalations, indicating its potential role in managing JIA symptoms.

• Most participants faced difficulties with long-term adherence to the restrictive SCD, highlighting the need for more sustainable dietary strategies.

• Further studies are needed to identify specific dietary components that drive benefits and to explore underlying mechanisms for effective dietary recommendations in pediatric rheumatology.