Original Communication

European Journal of Clinical Nutrition (2003) 57, 328–334. doi:10.1038/sj.ejcn.1601543

Nutrient intake in women with primary and secondary Sjögren's syndrome

J M Cermak1,2,3,, A S Papas4,, R M Sullivan1,, M R Dana1,2,3, and D A Sullivan1,3,*,

  1. 1Schepens Eye Research Institute, Boston, Massachusetts, USA
  2. 2Brigham and Women's Hospital, Boston, Massachusetts, USA
  3. 3Harvard Medical School, Boston, Massachusetts, USA
  4. 4Tufts University School of Dental Medicine, Boston, Massachusetts, USA

Correspondence: D A Sullivan, Schepens Eye Research Institute, 20 Staniford Street, Boston, MA 02114, USA. E-mail: sullivan@vision.eri.harvard.edu

*Guarantor: DA Sullivan.

Contributors: JMC coordinated the study and contributed to the study design, compilation of data, statistical analyses, interpretation of data and writing of the initial draft of the paper. ASP, RMS and MRD contributed to the recruitment of patients, conduct of the study, compilation of data or critical evaluation of the paper. DAS was responsible for the study, oversaw its conduct, performed the statistical analyses, interpreted the data and wrote the paper.

Received 24 August 2001; Revised 27 May 2002; Accepted 28 May 2002.



Objective: Recently, it has been proposed that dietary factors may contribute to the etiology and progression of Sjögren's syndrome, and that nutritional intervention may modify the severity of pathological abnormalities. The objective of this study was to determine whether the nutrient intake of women with primary (1°SS) or secondary (2°SS; ie with systemic lupus erythematosus (2°SS/SLE) or rheumatoid arthritis (2°SS/RA) Sjögren's syndrome is significantly different than that of age- and gender-matched controls.

Design: Women with Sjögren's syndrome were asked to complete the 97 General Purpose Semi-Quantitative Food Frequency Questionnaire, which consists of a list of 147 separate food items that represent the major sources of multiple nutrients. Nutritional data were evaluated in terms of absolute and energy-adjusted nutrient amounts and analyzed by ANOVA.

Results: Our results showed: (a) greater intake of energy, glutamate, carbohydrates, lactose, phosphorus, caffeine and unsupplemental thiamin and riboflavin in 1°SS, as well as supplemental calcium in 2°SS/SLE, compared with controls; (b) greater nutrient intake of energy, protein, glutamate, methionine, tryptophan, carbohydrates, lactose, supplemental calcium and phosphorus, sodium, caffeine and unsupplemental calcium, riboflavin and thiamin in 2°SS/RA, relative to 1°SS and/or 2°SS/SLE; (c) higher energy-adjusted values for supplemental calcium in 2°SS/SLE, and for vitamin A and supplemental iron and zinc in 2°SS/RA, compared with other groups; and (d) higher energy-adjusted intake of supplemental calcium, and a lower energy-adjusted intake of unsupplemental vitamin C, polyunsaturated fat, linoleic acid, omega-3 fatty acid, and specific other unsaturated fatty acids, in the Sjögren's syndrome group as a whole, relative to controls.

Conclusions: Our findings demonstrate that nutrient intake is altered in Sjögren's syndrome.

Sponsorship: This research was supported by a grant from Allergan Inc.


nutrient, nutrition survey, Sjögren's syndrome, systemic lupus erythematosus, rheumatoid arthritis

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