Nutritional interventions as modulators of the disease activity for idiopathic inflammatory myopathies: a scoping review

• Published in: Journal of human nutrition and dietetics 2024-06, Vol.37 (3), p.772-787
• Main Authors: Sánchez‐Rosales, Abril I., Posadas‐Calleja, Juan G., Serralde‐Zúñiga, Aurora E., Quiroz‐Olguín, Gabriela
• Format: Article
• Language: English
• Subjects: Antioxidants; Antioxidants - administration & dosage; Autoimmune diseases; chronic inflammation; Connective tissue; Connective tissue diseases; Connective tissues; Cytokines; Diet; Diet, Mediterranean; dietary patterns; Dietary restrictions; Fatty Acids, Omega-3 - administration & dosage; Female; Health services; Humans; Immune system; immunonutrition; Inflammation; Male; Modulators; Morbidity; Muscles; muscular atrophy; Myositis - diet therapy; Nutrients; Nutrition; Nutritional status; Vitamin D; Vitamin D - administration & dosage; Vitamin deficiency; Weight loss
• ISSN: 0952-3871; 1365-277X
• DOI: 10.1111/jhn.13287

Idiopathic inflammatory myopathies (IIMs) are chronic, autoimmune connective tissue diseases associated with significant morbidity and disability. Nutrients can activate the immune system and contribute to chronic low‐grade inflammation (LGI). Chronic muscle inflammation leads to imbalanced pro‐inflammatory and anti‐inflammatory cytokines, causing inadequate nutrition, weight loss and muscle weakness during a negative cycle. Owing to its potential to modulate LGI in various diseases, the Mediterranean diet (Med Diet) has been extensively studied. This scoping review explores the nutritional implications and recommendations of the Med Diet as a treatment for immune‐mediated diseases, focusing on the gaps in IIM nutritional interventions. A comprehensive literature search of the MEDLINE and EBSCO databases between September 2018 and December 2022 was performed. We identified that the Med Diet and its specific components, such as omega‐3 (nω3) fatty acids, vitamin D and antioxidants, play a role in the dietary treatment of connective tissue‐related autoimmune diseases. Nutritional interventions have demonstrated potential for modulating disease activity and warrant further exploration of IIMs through experimental studies. This review introduces a dietary therapeutic approach using the Med Diet and related compounds to regulate chronic inflammatory processes in IIMs. However, further clinical studies are required to evaluate the efficacy of the Med Diet in patients with IIMs. Emphasising a clinical–nutritional approach, this study encourages future research on the anti‐inflammatory effects of the Med Diet on IIMs. This review highlights potential insights for managing and treating these conditions using a holistic approach. Chronic inflammation in idiopathic inflammatory myopathies produces muscle damage. Activation of pro‐inflammatory pathways results in insulin resistance and chronic inflammation of skeletal muscle. Pro‐inflammatory cytokines impair the nutritional status. There is a potential role for nutrition intervention in the regulation of inflammation. Food bioactive compounds present in the Mediterranean diet have been widely studied for their antioxidant and inflammation‐modulating properties. Highlights Inflammatory myopathies cause the induction of chronic muscle inflammation. Production of pro‐inflammatory cytokines mediates low‐grade inflammation. Pro‐inflammatory cytokines cause deterioration in nutritional status. Modulation of inflammation th