An update on diet and nutritional factors in systemic lupus erythematosus management

Abstract

Systemic lupus erythematosus (SLE) is a chronic inflammatory and autoimmune disease characterised by multiple organ involvement and a large number of complications. SLE management remains complicated owing to the biological heterogeneity between patients and the lack of safe and specific targeted therapies. There is evidence that dietary factors can contribute to the geoepidemiology of autoimmune diseases such as SLE. Thus, diet therapy could be a promising approach in SLE owing to both its potential prophylactic effects, without the side effects of classical pharmacology, and its contribution to reducing co-morbidities and improving quality of life in patients with SLE. However, the question arises as to whether nutrients could ameliorate or exacerbate SLE and how they could modulate inflammation and immune function at a molecular level. The present review summarises preclinical and clinical experiences to provide the reader with an update of the positive and negative aspects of macro- and micronutrients and other nutritional factors, including dietary phenols, on SLE, focusing on the mechanisms of action involved.

Dietary Intake of Free Sugars is Associated with Disease Activity and Dyslipidemia in Systemic Lupus Erythematosus Patients

“…Moreover, in agreement with our results, recently published research concluded that, in patients with SLE, a good diet can contribute to increasing the period of remission, preventing the adverse effects of medications, and improving the physical and mental well-being of patients [7]. Thus, dietary therapy has now been recognised as a promising approach to treating SLE, owing to both its potential prophylactic effects and its contribution to reducing co-morbidities and improving quality of life in these individuals [33].…”

Relationship of the Inflammatory Diet Status and Dietary Intake with Antimalarial Treatment in Systemic Lupus Rrythematosus: A Cross-Sectional Study

“…Regarding this, there are no studies in the literature evaluating the relationship of antimalarial pharmacotherapy with nutritional status and nutrient intake, which will be necessary in order to make an appropriate comparison with other SLE populations with a similar antimalarial treatment. Nevertheless, several studies have linked the presence of nutritional de cits with immune pro-in ammatory imbalances [12], SLE patients in the present study were de cient in the intake of the nutrients evaluated and few patients reached the daily DRI for these nutrients, which is indicative of a poor nutritional adequacy of the diet consumed by these patients.…”

“…Furthermore, diet highlights as a key factor that could modify in ammatory mediators and lipids serum levels, because several nutrients such as vitamins have been related to play a fundamental role in the in ammatory processes modulation [10,11]. A moderate intake of calories and nutrients, physical activity and reduction in body fat, contribute to decrease in ammatory activity and comorbidities in SLE [12]. In contrast, an excessive intake of calories, proteins, simple carbohydrates, saturated and trans fats, have been linked with dyslipidemia, high levels of acute-phase reactants, and in ammatory cytokines such as TNF-α in SLE [12,13].…”

“…A moderate intake of calories and nutrients, physical activity and reduction in body fat, contribute to decrease in ammatory activity and comorbidities in SLE [12]. In contrast, an excessive intake of calories, proteins, simple carbohydrates, saturated and trans fats, have been linked with dyslipidemia, high levels of acute-phase reactants, and in ammatory cytokines such as TNF-α in SLE [12,13].…”

Diet and lupus: what do the patients think?

“…We also identified that there is a lack of knowledge and education about diet in the responders and that most patients had not talked to their doctors about diet. Many patients had tried various diets but very few controlled trials have been performed to inform patient choices (34). This survey Types of fat relating to carbohydrates, dairy and also meat vs healthy natural fats with the understanding of the link to medication that lupus patients are on, like steroids and the difficulty that brings.…”