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Glucocorticoid (GC) therapy is a common treatment employed in rheumatic and autoimmune diseases due to its anti-inflammatory and immunosuppressive effects. However, GC therapy can also induce a number of adverse effects, including muscle and bone loss, hypertension, metabolic perturbations and increased visceral adiposity. We reviewed available evidence in this area and provide nutritional recommendations that may ameliorate these adverse effects. Briefly, optimizing calcium, vitamin D, sodium and protein intake and increasing consumption of unprocessed and minimally processed foods, while decreasing the consumption of ultra-processed foods, may counteract some of the specific challenges faced by these patients. Importantly, we identified a dearth of empirical data of how nutritional intervention may impact health-related outcomes in this population and further research is required to investigate the clinical and therapeutic efficacy of these theory-based recommendations.

Key points  Rheumatoid arthritis (RA) patients present exacerbated blood pressure responses to exercise, but little is known regarding the underlying mechanisms involved.  This study assessed autonomic and haemodynamic responses to exercise and to the isolated activation of muscle metaboreflex in post‐menopausal women with RA.  Participants with RA showed augmented pressor and sympathetic responses to exercise and to the activation of muscle metaboreflex. These responses were associated with multiple pro‐ and anti‐inflammatory cytokines and with pain.  The results of the present study support the suggestion that an abnormal reflex control of circulation is an important mechanism underlying the exacerbated cardiovascular response to exercise and increased cardiovascular risk in RA. Abstract Studies have reported abnormal cardiovascular responses to exercise in rheumatoid arthritis (RA) patients, but little is known regarding the underlying mechanisms involved. This study assessed haemodynamic and sympathetic responses to exercise and to the isolated activation of muscle metaboreflex in women diagnosed with RA. Thirty‐three post‐menopausal women diagnosed with RA and 10 matched controls (CON) participated in this study. Mean arterial pressure (MAP), heart rate (HR) and muscle sympathetic nerve activity (MSNA frequency and incidence) were measured during a protocol of isometric knee extension exercise (3 min, 30% of maximal voluntary contraction), followed by post‐exercise ischaemia (PEI). Participants with RA showed greater increases in MAP and MSNA during exercise and PEI than CON (ΔMAPexercise = 16 ± 11 vs. 9 ± 6 mmHg, P = 0.03; ΔMAPPEI = 15 ± 10 vs. 5 ± 5 mmHg, P = 0.001; ΔMSNAexercise = 17 ± 14 vs. 7 ± 9 bursts min–1, P = 0.04; ΔMSNAPEI = 14 ± 10 vs. 6 ± 4 bursts min–1, P = 0.04). Autonomic responses to exercise showed significant (P < 0.05) association with pro‐ (i.e. IFN‐γ, IL‐8, MCP‐1 and TNFα) and anti‐inflammatory (i.e. IL‐1ra and IL‐10) cytokines and with pain. In conclusion, post‐menopausal women with RA showed augmented pressor and sympathetic responses to exercise and to the activation of muscle metaboreflex. These findings provide mechanistic insights that may explain the abnormal cardiovascular responses to exercise in RA.

Changes in emotional state due to the COVID-19 pandemic may potentially modify eating habits, which may differ as a function of body mass index (BMI). Using a self-reported, questionnaire-based survey we evaluated Brazilian women during the pandemic for: (i) the influence of BMI on changes in eating habits, food choice determinants, and psychological symptoms; (ii) associations between eating habits, food choice determinants and psychological symptoms. General characteristics, anthropometric data, eating habits before and during the pandemic, food choice determinants and psychological symptoms during the pandemic were collected between June and September, 2020. Participants (n = 1,183) were normal weight (60.4%), overweight (26.2%) and obese (13.4%). A higher frequency of “cooking” (72.3–77.6%, p = 0.004) and “use of delivery service” (29.8–48.8%, p &lt; 0.001) was reported during, in comparison to before the pandemic. Additionally, a higher prevalence of “snacking” (57.1–63.8%, p = 0.005) and “eating at table” (78.5–82.7%, p &lt; 0.001) was reported during the pandemic, while the number of participants reporting “dieting” decreased (28.7–20.4%, p &lt; 0.001). “Health”, “natural concerns” and “need and hunger” were less important determinants for participants with overweight/obesity compared to normal weight. Regression analysis indicated that (i) “health”, “natural concerns” and “affect regulation”; (ii) “health”, “pleasure”, “convenience”, and “natural concerns”; and (iii) “visual appeal” and “pleasure” were the food choice determinants more associated with eating habits among women with normal weight, overweight, and obesity, respectively. In conclusion, eating habits were modified during the pandemic despite BMI, whereas food choice determinants differed between overweight/obesity and normal weight women.

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