Diet and Systemic Lupus Erythematosus (SLE): From Supplementation to Intervention

Abstract

Background: Systemic lupus erythematosus (SLE) is a chronic autoimmune inflammatory disease characterised by immune dysregulation affecting multiple organs. Current anti-inflammatory treatments used in SLE are associated with unwanted side-effects. Dietary supplementation has been suggested as a safe and effective addition to conventional treatment, but evidence of efficacy in SLE or preventing associated comorbidities is uncertain. Methods: We identified literature on clinical trials focused on nutritional interventions in SLE aiming to improve inflammation and comorbidities. A systematic-type search on Embase, Medline, and the Cochrane Library, was conducted to identify nutritional interventions among SLE patients in the past 15 years that met our inclusion criteria. Results: We identified 2754 articles, of which 14 were eligible for inclusion based on our set criteria and were subsequently quality assessed. Vitamin D or E supplementation was associated with respective improvement of inflammatory markers or antibody production, but not disease activity scores in most studies. Despite their expected synergistic actions, the addition of curcumin on vitamin D supplementation had no additional effects on disease activity or inflammatory markers. Trials of omega-3 fatty acid supplementation presented significant reductions in ESR, CRP, disease activity, inflammatory markers, and oxidative stress, and improved lipid levels and endothelial function, while a low glycaemic index (GI) diet showed evidence of reduced weight and improved fatigue in patients. Conclusions: Different dietary guidelines can therefore be implicated to target specific SLE symptoms or therapeutic side-effects. This systematic review highlights the scarcity of larger and longer in duration trials with homogenous methodologies and verifiable outcomes to assess disease progression.

The dietary inflammatory index and its association with the prevalence of hypertension: A cross-sectional study

“…Although DII has been validated that it can reflect the dietary inflammation potential and systemic inflammation level, it is not designed for predicting hypertension ( 42 , 43 ). We aimed at screening dietary factors most related to the risk of hypertension.…”

Case series: raw, whole, plant-based nutrition protocol rapidly reverses symptoms in three women with systemic lupus erythematosus and Sjögren’s syndrome

“…One study in autoimmune, Lupus-prone mice suggested that fish oil (omega 3) inhibited production of pro-inflammatory cytokines and improved kidney injury ( 28 ), and omega-3 intake has been linked to improved outcomes in SLE patients, including reduced inflammation, disease activity, and oxidative stress ( 22 ). Other published work has shown that supplementation, such as with omega-3, can help reduce SLE-related sequelae ( 22 , 29 ) and disease activity ( 30 , 31 ) and that omega 3 may reduce the production of inflammatory markers, cytokines and CRP to improve inflammation ( 32–34 ). Finally, PUFA supplements, in particular omega-3, may be an effective treatment for non-specific dry eye disease ( 35 , 36 ).…”

Lúpus Eritematoso Sistêmico - uma revisão abrangente sobre as manifestações clínicas, diagnóstico, manejo terapêutico, complicações e prognóstico

“…Além dos exercícios físicos, mudanças no estilo de vida, como cessação do tabagismo e controle de peso, são importantes para o controle de fatores de risco cardiovasculares (MONTHIDA FANGTHAM et al, 2019). Outro importante adjuvante são os fatores dietéticos, como a restrição de gorduras, para melhor manutenção do peso e melhora na fadiga; o uso de vitaminas, como a vitamina D, que pode reduzir a inflamação e melhorar a saúde óssea; vitamina E, que pode regular a produção de anticorpos; e a suplementação de ômega-3, que reduz a atividade da doença, a inflamação e o estresse oxidativo (JIAO et al, 2022).…”