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May 17, 2026The Journal of Rheumatology0 citations

The Ecological Relationship Between Food Access and Disease Activity in Canadian Children newly diagnosed with Juvenile Idiopathic Arthritis

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AWAlexandra WeltenSZShiran ZhongJGJason Gilliland

Key Points

  • The study aims to explore how food access affects disease activity and weight in children with Juvenile Idiopathic Arthritis (JIA).
  • Clinical data from children newly diagnosed with JIA (2017–2021) in the CAPRI registry were analyzed.
  • Food accessibility measures were linked using postal codes and assessed at baseline and 1-year follow-up.
  • Spearman's rho correlations, Mann–Whitney U test (p < 0.05), and mixed effects linear regression were used for analysis.
  • 21.9% of JIA patients were overweight or obese, with less access to grocery stores (p = 0.02).
  • Healthy-weight and overweight patients had lower disease activity (cJADAS10) compared to those with obesity at baseline (p = 0.02 and p = 0.04, respectively).
  • At 1-year follow-up, higher densities of fast-food restaurants and convenience stores correlated with lower disease activity (r s = –0.14, p = 0.02).

Abstract

Objective A healthy diet may contribute to improved disease activity in JIA. In Canada, access to healthy food is variable. This study examined the relationship between food accessibility, disease activity measures, and weight in children with JIA. Methods Clinical data from children newly diagnosed with JIA (2017–2021) collected in the CAPRI registry were linked to neighborhood-level food accessibility measures using postal codes. Data were analyzed at enrollment and at 1-year follow-up. Associations were assessed using Spearman's rho correlations, Mann–Whitney U test (p 85th percentile) and lived in areas with less access to chain grocery stores (p = 0.02) compared with those with underweight or healthy BMI. At baseline, healthy-weight (p = 0.02) and overweight (p = 0.04) patients had lower disease activity (cJADAS10) than those with obesity; this association was not observed at 1-year follow-up. At baseline, a greater proportion of fast-food restaurants in the neighborhood was linked to fewer active joints (r s = –0.09, p = 0.04). At 1-year, higher densities of fast-food restaurants and convenience stores were associated with lower disease activity (r s = –0.14, p = 0.02). Conclusion Obesity was linked to higher disease activity and reduced access to healthy food in chain grocery stores. However, greater access to both healthy and unhealthy food was associated with lower disease activity, relationships that may reflect general benefits of urban living.

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Cite This Study

Welten et al. (2026) studied this question.

synapsesocial.com/papers/6a095bba7880e6d24efe19c0https://doi.org/10.3899/jrheum.2025-1200
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