Focus on Dietary Pattern: Would this be the Answer to the Rising Prevalence of Autoimmune Diseases? Results of a Systematic Review

Author(s): Eduarda Luckemeyer Banolas,Mikaela Zeni, Catarina Vellinho Busnello, Mariana Graeff Bins Ely, Marilia Oberto da Silva Gobbo, Janine Alessi.

Considering the different mechanisms by which lifestyle habits may influence autoimmunity, dietary patterns emerge as potential mediators of this effect. This study aimed to synthesize the results of experimental studies evaluating the effect of different dietary interventions on the clinical presentation and inflammatory markers of autoimmune diseases with joint involvement, generating important insights for dietary recommendations to patients and future studies to come. A systematic literature review was performed (MEDLINE, Embase and Cochrane Library), using a prespecified search strategy. Inclusion criteria were randomized clinical trials with adults diagnosed with autoimmune diseases with joint involvement, and evaluated any dietary intervention compared to usual diet or western diet. The studies included were fully evaluated for data extraction and, subsequently, were combined based on the type of diet used in the intervention. A total of 12 studies were included in this review. Clinical trials with a Mediterranean diet demonstrated improvement in health-related quality of life and suppression of the activity of the disease in patients with rheumatoid arthritis. Vegan or lactovegetarian diets have shown to promote changes in fatty acid patterns in patients with rheumatoid arthritis and improve their symptoms, especially with a strict diet (vegan, rich in lactobacilli, uncooked). Vegan diet and raw diet had a positive influence on symptoms in patients with rheumatoid arthritis and with fibromyalgia. Finally, fasting was associated with decrease in IL-6 serum levels in patients with rheumatologic diseases, and both fasting and ketogenic diets increase serum dehydroepiandrosterone concentrations.

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