Familial Mediterranean fever (FMF) is an autoinflammatory disease marked by recurrent fever and serositis, with potential subclinical inflammation between episodes. While the Mediterranean diet is known for its anti-inflammatory properties, its specific effects on pediatric FMF patients are not fully defined. This cross-sectional observational study included 91 children aged 7 to 18 years diagnosed with FMF at the Pediatric Rheumatology Clinic of Dokuz Eylu University between June 2022 and February 2023. Participants completed standardized dietary questionnaires during outpatient visits.
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The study analyzed the relationship between adherence to the Mediterranean diet, eating behaviors, the frequency of disease attacks, disease severity, and selected clinical and inflammatory parameters using comparative statistical tests. Notable trends emerged regarding eating behaviors and body mass index (BMI) as well as nominal associations with exertional leg pain. The leukocyte count varied across the Mediterranean diet adherence categories but did not achieve statistical significance after Bonferroni correction. Furthermore, dietary adherence did not correlate with attack frequency or overall disease severity.
The findings indicate that the Mediterranean diet and related eating behaviors might have limited influence on acute disease activity. These patterns could, however, hold relevance for managing inter-attack clinical and inflammatory manifestations. The study contributes to understanding modifiable lifestyle factors in pediatric FMF, paving the way for future research into dietary impacts on this condition. While associations were identified in clinical symptoms and inflammatory markers, the relationship between diet and disease expression remains complex and multifaceted, warranting further investigation.
Data gathering for the study was ethically approved by the Dokuz Eylu University Non-Interventional Research Ethics Committee. Informed consent was acquired from all participants' guardians, and children provided assent when applicable. The study utilized the Mediterranean Diet Quality Index for Children and Adolescents (KIDMED) and the Food Behavior Scale (FBS) as assessment tools.
Demographic and clinical data were analyzed alongside dietary adherence to explore associations with inflammatory markers and clinical presentations. Despite some findings suggesting variations in dietary adherence corresponding with genotype distributions and clinical manifestations, the overall relationship between dietary factors and disease severity was not conclusive, highlighting the need for larger, more nuanced studies in this area.