A pilot study of possible anti-inflammatory effects of the specific carbohydrate diet in children with juvenile idiopathic arthritis

Abstract

Background: To explore possible anti-inflammatory effects of the specific carbohydrate diet in children with juvenile idiopathic arthritis. This diet has shown anti-inflammatory effect in children with inflammatory bowel disease.

Methods: Twenty-two patients with juvenile idiopathic arthritis (age 6.3-17.3 years), with ≤2 inflamed joints and an erythrocyte sedimentation rate < 30 mm/h, were included in this explorative study. Fifteen children completing four weeks on the diet were evaluated. A dietician introduced parents and children to the diet, and two follow-ups were performed during the intervention. Conventional laboratory tests and multiplex analyses of 92 inflammatory proteins were used. Short-chain fatty acids in faecal samples were examined.

Results: The diet significantly decreased morning stiffness (p = 0.003) and pain (p = 0.048). Physical function, assessed through the child health assessment questionnaire, improved (p = 0.022). Arthritis improved in five of the seven children with arthritis; in those seven, multiplex analyses showed a significant decrease in nine inflammatory proteins, including TNF-alpha (p = 0.028), after four weeks. Faecal butyrate, analysed in all 15 participants, increased significantly (p = 0.020).

Conclusion: The specific carbohydrate diet may have significant positive effects on arthritis in children with juvenile idiopathic arthritis, but further studies are needed.

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

Keywords: Arthritis; Diet therapy; Juvenile idiopathic; Pilot study.

Fig. 1

a–d Levels of pain on visual analogue scale (0–100 mm) (a); Morning stiffness (minutes) (b); Child health assessment questionnaire, CHAQ (0–3) (c); Concentration of butyrate (mg/g) in faecal samples (d). All at inclusion and after two and four weeks of specific carbohydrate diet. *Wilcoxon matched-pair signed rank analysis comparing levels at inclusion with levels after four weeks of specific carbohydrate diet