Nutritional Knowledge, Attitudes, and Practices of Patients With Chronic Inflammatory Rheumatism: Insights From a Patient Survey.

Introduction The objectives of this study are to assess the knowledge, attitudes, and practices of patients with chronic inflammatory rheumatism (CIR) about diet. Aiming to identify their level of understanding of the role of nutrition in symptom management, explore their perceptions about different types of foods, and analyze their current dietary habits. The study also aims to assess the impact of this knowledge and dietary changes on their CIR management. Material and methods This is a descriptive and analytical study carried out by the Moroccan Association for Research and Assistance to Rheumatism (AMRAR) in collaboration with the Moroccan Association of Polyarthritics and Spondyloarthritics (AMPS). By telephone interviews, we collected patients' sociodemographic data, knowledge, attitudes, and practices toward diet, using a structured Google form questionnaire validated by a team of rheumatologists. A univariate and multivariate analysis was performed to assess the factors associated with these elements. Results Two hundred patients participated in the survey (mean age: 48.3 ± 14.2 years, 77% female, 24.5% illiterate). Patients were followed up for rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and non-specified rheumatism in 59.5%, 25.5%, 3%, and 12% of cases, respectively. An assessment of the nutritional knowledge of patients with CIR indicated a general awareness of the role of diet in disease management. Valid response rates for key statements ranged from 53.5% to 79%. However, a substantial number of patients (up to 40.5%) exhibited misconceptions, most notably regarding the consumption of red meat and dairy products. Patients have varying perceptions of the impact of foods on rheumatic symptoms. For example, 36.5% think cow's milk aggravates symptoms, while 40% do not know. White flour is perceived as aggravating by 51.5% of patients, and red meat by 49.5%. On the other hand, foods such as ginger (46.5%) and turmeric (46%) are considered beneficial for symptoms, as are fish, considered to improve symptoms by 55% of patients. Finally, white sugar, soft drinks, and deli meats are thought to aggravate symptoms by 48.5%, 47.5%, and 51.5% of patients, respectively. Among patients with CIR, 38% have modified their eating habits, the most frequent changes being a reduction in sugar, fatty foods, and red meat consumption by 51.4%, 52.7% and 55.5% of patients, respectively. In terms of cooking methods, 79.5% of patients prefer to bake, and 29.5% follow a specific diet, mainly Mediterranean (53%). 3.5% of patients stopped their medication, and 12% reduced their dose after having adopted these dietary modifications. Conclusion This study reveals significant gaps in the nutritional knowledge of patients with CIR. The varied and often incorrect perceptions of the impact of food on symptoms show the need for better nutritional education. To enhance CIR management, it is essential to develop specific dietary guidelines tailored to the Moroccan context.