Dietary guidelines and nutritional health among Sjogren's patients

This study, “Dietary Intake, Body Composition, and Oral Health Parameters among Female Patients with Primary Sjögren’s Syndrome,” was published in the journal Nutrients in July 2018. 

Patients with pSS display a wide range of symptoms and low secretion of saliva, which, in particular, contributes to increased risk of dental caries and oral infections. Moreover, digestive manifestations with dysphagia and dysmotility of the pharynx are common, and both the pancreas and the liver may be affected. There is also a higher risk of gastroesophageal reflux disease among pSS-patients compared with the general population.

All these symptoms could affect food intake among patients. This Norwegian study was undertaken as there was limited knowledge about dietary intake and body composition among patients with primary Sjögren’s syndrome (pSS). 

We therefore examined the dietary intake among a well-characterized cohort of Norwegian female pSS-patients and compared it with the dietary intake of a national reference group and with the Nordic dietary recommendations. In addition, we studied associations between dietary intake/body composition and oral health among the patients.

They did the study with 20 female patients and a reference group of Nordic female participants matching the pSS-patients in age. 

To assess their dietary intake, each patient was interviewed on three separate days and asked to recall their food intake in the past 24 hours.

Many tools were used to access oral health and related quality of life including questionnaires, salivary secretion, smell and taste testing. 

Results

The pSS patients had a lower energy percentage from carbohydrates and a higher energy percentage from fat compared to the reference group. The lower intake of carbohydrates was due to a lower bread intake, while the higher intake of fat was due to a higher intake of butter, margarine, and oil. Researchers proposed a possible explanation for the higher intake of fats in Sjögren’s patients, saying that fat can help lubricate the mouth, aiding in chewing and swallowing.

The patients ate more than twice as much fish as the reference group. 

Their intakes of macro- and micronutrients was good. Compliance with the recommended nutrient intakes “was good overall, with exceptions for saturated fat, fibre, vitamin D, folate, and iron, which is in agreement with the general Norwegian female population,” the researchers wrote.

The diet of those with pSS provided them with an equivalent amount of daily energy as the control group. 

Forty-percent of the pSS patients were overweight/obese. 

Increased intake of beverages was observed in patients with severe xerostomia and/or low oral health.

Reduced fat intake was found in hyposmic patients. Hyposmia is a reduced ability to smell and to detect odors.

In conclusion, the dietary intake among the patients was not much different from the reference group and complied with recommendations. 

So their findings were that no specific dietary guidelines are probably needed to ensure adequate nutrition among such pSS patients.