Nutrients, foods and dietary patterns in the management of autoimmune rheumatic diseases

Summary: Background: Rheumatic disease (RD) represents a broad spectrum of systemic conditions characterized by inflammation and pain in muscles or joints with a significant burden on quality of life. Increasing evidence suggests that diet could play a modulatory role in RD by influencing cardiovascular diseases (CVD) risk factors frequently present in these patients as well as inflammation and antioxidant defence. Objectives: This review aims to summarize the available evidence on the effect of nutrients, foods and dietary patterns on the most common autoimmune inflammatory RD including rheumatoid arthritis, Sjogren's syndrome, systemic lupus erythematosus and systemic sclerosis. Results: We documented that MUFAs and PUFAs seem to have positive effects in modulating the inflammatory process. Regarding the dietary interventions, low-calorie diets, Mediterranean diet and fasting appear to be effective in reducing the symptoms of the most common RD. Positive results were also obtained in some cases with gluten-free, low-fat, vegan, elimination or anti-inflammatory diets. Conclusion: Although further and specific studies are needed, the fact that people obtained an improvement in clinical outcomes after almost all these dietary patterns suggests that a healthy diet could play a pivotal role in the RD management.