ArticleClinical rheumatology2026
Fruit and vegetable intake as a mediator in the association between ultra-processed food and disease activity in ankylosing spondylitis.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThe aim of this study was to examine the potential mediating role of fruit and vegetable intake frequency in the association between ultra-processed food consumption and disease activity in patients with ankylosing spondylitis (AS).
methodsThis study was conducted with 104 patients with AS who presented to a public hospital in Türkiye. Study data were collected through face-to-face interviews using a structured questionnaire. The questionnaire included participants' general characteristics, dietary habits, the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), and the Short Screening Questionnaire for Processed Food Consumption. In addition, selected biochemical and hematological parameters of the participants were assessed.
resultsMediation analyses demonstrated that fruit and vegetable intake frequency partially explained the association between ultra-processed food consumption and disease activity in AS. Ultra-processed food consumption was associated with higher disease activity, both through direct associations (βfruit = 0.430, p < 0.001; βvegetable = 0.338, p < 0.001) and indirectly through its association with reduced fruit (β = - 0.23, p = 0.016) and vegetable (β = - 0.396, p < 0.001) intake frequency (IEfruit = 0.084, IEvegetable = 0.180; p < 0.05).
conclusionOverall, this study found that ultra-processed food consumption was associated with higher disease activity, both directly and through its association with lower fruit and vegetable intake frequency. These findings suggest that limiting ultra-processed food consumption and increasing fruit and vegetable intake may be beneficial for symptom management in patients with AS. Key Points • Higher consumption of ultra-processed foods is associated with increased disease activity in patients with ankylosing spondylitis • Increased fruit and vegetable intake frequencies are independently associated with lower disease activity • Fruit and vegetable consumption partially explains the association between ultra-processed food intake and disease activity • Dietary modifications focusing on plant-based foods may help manage disease severity in ankylosing spondylitis.
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