Impact of the mediterranean diet on disease progression in pediatric patients with familial mediterranean fever

Aim: Familial Mediterranean fever (FMF) is an autoinflammatory disease characterized by recurrent febrile and serositis attacks. Inflammatory markers increase during attacks, and subclinical inflammation can persist between attacks. Chronic/subclinical inflammation in FMF patients constitutes the primary cause of the life-threatening complication amyloidosis. The Mediterranean diet modulates molecular parameters related to inflammation, exhibiting an anti-inflammatory effect that positively impacts inflammatory diseases. The aim of this study is to investigate the effect of the Mediterranean diet on the frequency of attacks and disease course in children with FMF. Patients and Methods: Children aged 7-18 years diagnosed with FMF who presented to the Department of Pediatric Rheumatology, Dokuz Eylül University of Medicine, between March 2022 and February 2023, were included in the study. Nutritional questionnaires were administered to patients during outpatient visits. 95 patients were screened, of which 91 were included in the analysis. The data obtained in the study were analyzed using SPSS version 24.0. A significance level of p<0.05 was sought in all tests performed. Results: According to the nutritional behavior scale, there was a significant difference between the group with poor and good nutritional behavior in terms of body mass index and exercise-induced leg pain frequency (p=0.016, p=0.036). The leukocyte count in the group with very low-quality Mediterranean diet was significantly higher compared to the group with optimal diet quality (p=0.043). In terms of FMF severity score, patients with higher scores had a significantly higher frequency of M694V homozygous mutation compared to those with lower scores (p<0.001). Conclusion: In familial Mediterranean fever, numerous epigenetic and environmental factors play a role in triggering attacks and influencing disease course. Therefore, potential risk factors should be identified, and complications that may arise from attacks should be minimized through appropriate dietary habits. Keywords: Familial Mediterranean fever, Mediterranean diet