Mediterranean diet and health outcomes in idiopathic inflammatory myopathies

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ID: 325131
2026
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Abstract
OBJECTIVES: The clinical relevance of Mediterranean diet (MedDiet) and determinants shaping adherence across disease phenotypes remain largely unexplored in idiopathic inflammatory myopathies (IIM). In this study, we evaluated MedDiet adherence across IIM subtypes, identified factors associated with it, and examined its association with patient-reported health outcomes. METHODS: Adults with self-reported specialist-diagnosed IIM participating in the international COVAD-3 survey were included. Mediterranean diet adherence was assessed using the 14-item Mediterranean Diet Adherence Screener (MEDAS). Linear regression models were used to identify demographic, disease-related, and socioeconomic predictors of MEDAS adherence. Additional multivariable models evaluated associations between MEDAS scores and patient-reported outcomes after adjustment for demographic, socioeconomic, disease-related, and treatment-related covariates. Phenotypes were explored using factorial analysis with hierarchical clustering. RESULTS: Among 859 participants with IIM, MedDiet adherence was generally modest and varied across disease subtypes, with the lowest adherence observed in inclusion body myositis. Female sex, autoimmune multimorbidity, and fewer household members were independently associated with higher MEDAS scores. In adjusted outcome models, higher MEDAS adherence was independently associated with better physical function (PROMIS PF-4), better global physical health (PROMIS GPH), lower disease activity, lower fatigue, and lower pain. These associations remained significant after adjustment for disease activity, glucocorticoid exposure, immunosuppressant use, food security and income adequacy. CONCLUSION: Higher MedDiet adherence was associated with more favourable patient-reported physical health, function, and symptom burden among individuals with IIM. However, because of the cross-sectional design, the direction and causality of these relationships cannot be determined. Prospective studies are needed to establish whether improving dietary adherence can influence clinical outcomes in IIM.
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Authors Sreoshy Saha, Lekshmi Minikumari Rahulan, Manali Sarkar, Maria Rosa Pellico, Elena Philippou, Rishi Balse, Praggya Yaadav, Tsvetelina Velikova, Abraham Edgar Gracia-Ramos, Aviya Lanis Levy, Karen Cheng, Dzifa Dey, Elena Nikiphorou, Jasmine Parihar, CoVAD study group, Dimitri Luz Felipe da Silva, Odirlei Andre Monticielo, Samuel Katsuyuki Shinjo, Simone Appenzeller, Vidya Sadanand Limaye, Jessica Day, Binit Vaidya, C. Dahou-Makhloufi, Leandro Gabriel Ferreyra Garrott, Valentina Vardanyan, Vidya Sadanand Limaye, Jessica Day, A T M Tanveer Hasan, Marharyta Volkava, Sonam Yangchen, Dimitri Luz Felipe da Silva, Odirlei Andre Monticielo, Samuel Katsuyuki Shinjo, Simone Appenzeller, Russka Shumnalieva, Rositsa Dacheva, Tsvetelina Velikova, Koy Rattanak, Fernando Kemta Lekpa, Océane Landon-Cardinal, Vanessa Ocampo, María Francisca Bozán Pérez, Antonia Valenzuela, Guochun Wang, Ho So, Iris Tang, Edmund K M Wong, Carlos Enrique Toro Gutiérrez, Sebastián Herrera Uribe, Carlo V. Caballero‐Uribe, Ivan Padjen, Željka Kardum, Konstantinos Parperis, Karen Schreiber, Jossiell Then Báez, Reem Hamdy Abdellatif Mohammed, Hala Lotfy, Walaa Abdel Rahman Saleh, Mervat Eissa, Tamer A. Gheita, Carlos Ríos, Sandra Meisalu, Becky Abdissa Adugna, Margherita Giannini, Julien Campagne, Alain Meyer, Francis Guillemin, Hannah Labinsky, Gerd‐Rüdiger Burmester, Johannes Knitza, Dzifa Dey, Alexandros Panagiotopoulos, Eirini Vasarmidi, Katerina Antoniou, Andrea Bran Ordóñez, Melinda Nagy-Vincze, Vikas Agarwal, Bhupen Barman, Yogesh Preet Singh, Arunkumar R Pande, Jasmine Parihar, Lekshmi M R, Meera Shah, Suryo Anggoro Kusumo Wibowo, Maryam Masoumi, Avin M.A Maroof, Asal Adnan Redha, Or Aharonov, Marta Mosca, Nicoletta Del Papa, Fabiola Atzeni, Marco Sebastiani, Franco Franceschini, Pier Paolo Sainaghi, Maria Giovanna Danielli, Vincenzo Venerito, Alessandro Giollo, Laura Andréoli, Alessia Alluno, Devis Benfaremo
Journal Lara D. Veeken
Year 2026
DOI
10.1093/rheumatology/keag424
URL
https://doi.org/10.1093/rheumatology/keag424
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