Early-life dietary patterns and the risk of juvenile-onset ankylosing spondylitis: a nationwide cohort study in South Korea.

OBJECTIVES

Emerging evidence suggests that early-life exposures may influence the development of inflammatory joint diseases. This study investigated the association between early-life exposures and the incidence of juvenile-onset ankylosing spondylitis (JAS) in a nationwide South Korean cohort.

METHODS

This study included 1 242 257 infants from the South Korean National Health Insurance Service. The association between early-life exposures-such as food diversity, frequency of solid food intake, antibiotic use, and breastfeeding status-and the development of JAS, was examined. Food diversity and frequency of solid food intake were assessed at the 9-12 month screening visit, breastfeeding status was assessed at the 4-6 month and 9-12 month screening visit, and antibiotic use was based on prescription records within the first year after birth. Subgroup analyses were conducted according to food diversity levels. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazards models.

RESULTS

Food diversity and breastfeeding alone were not associated with JAS. However, breastfeeding in infants with high food diversity was linked to a reduced risk of JAS (aHR 0.53, 95% CI 0.31-0.90, P = 0.0195).

CONCLUSION

Paediatrics with high food diversity who were breastfed showed reduced vulnerability to JAS. These findings suggest that maintaining a consistent and appropriate dietary pattern may play an important role in the prevention of JAS.