Female Sjögren’s Patients Don’t Need Special Diet, Norwegian Study Finds

Women with primary Sjögren’s syndrome (pSS) do not need to follow specific dietary guidelines to  maintain good nutrition and oral health, a Norwegian study suggests.

Furthermore, the patients adequately follow the recommended dietary intakes, which do not seem to influence salivary secretion, the study found.

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

Sjögren syndrome is an autoimmune disorder, meaning a condition caused by an attack of the immune system to the body’s own tissues.

In Sjögren’s the immune system primarily attacks the glands that produce tears (the lacrimal glands) and saliva (the salivary glands), compromising the glands’ ability to secrete these fluids.

As a result, patients typically display dry eyes and dry mouth, the latter especially contributes to increased risk of dental decay and oral infections. Additionally, patients often experience reduced ability to taste and smell, difficulty in swallowing, gastroesophageal reflux, and involvement of the pancreas and liver.

All these symptoms may affect food intake among patients. However, knowledge about the eating habits of patients is limited, and the few studies available show contradictory results or provide little information.

However, such insight is essential to determine if specific dietary recommendations will improve the nutrition and oral health of Sjögren’s syndrome patients.

To address that need, researchers examined the diet of a well-characterized group of 20 Norwegian Sjögren’s patients, all women, and compared it with the dietary habits of a national reference group of 761 women.

In addition, researchers analyzed if patients’ eating habits were in accordance with the Nordic Nutrition Recommendations and studied their associations with body composition and oral health.

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

Questionnaires, salivary secretion, smell and taste testing were used to access oral health and related quality of life.

Sjögren’s patients had a significantly higher intake of butter, margarine and oil, spices, sugar and sweets,  compared with the reference group, which consumed significantly  more bread.

That likely explains why patients displayed a higher intake of fat and fewer carbohydrates.

However, patients’ diet provided them an equivalent amount of daily energy, compared with the control group. Interestingly, patients ingested twice as much fish than the control group.

The mean intake (excluding supplements) of vitamins A, E, B6, B12, C, thiamine, riboflavin, potassium, magnesium, zinc, copper, and phosphate was above the recommended values, except for vitamin D, folate, calcium, iron, and selenium.

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.

A high proportion of patients complied with the recommended ingestion of micronutrients – essential nutrients required in small amounts such as vitamins and minerals. Importantly, for unsaturated fat, all patients complied with the recommendations.

None of the Sjögren’s patients was classified as underweight or malnourished, but 40 percent were overweight or obese.

Importantly, the intake of various food categories did not influence tasting or salivary secretion.

Patients with low and high salivary secretion rates did not differ significantly in their eating habits, although consumption of beverages was highest among those with severe dry mouth.

Regarding smell, patients with reduced ability had a lower intake of energy and total fat, when compared to  those with normal sense of smell.

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.

However, as overall compliance with dietary recommendations was good and salivary secretion was not associated with specific food or nutrient intake, “specific dietary guidelines are probably not needed to ensure adequate nutritional health among pSS-patients,” researchers concluded.