Dietary modulation in systemic lupus erythematosus: the role of the dietitian nutritionist
Keywords:
Gastric protectors, variability in safety profile, outpatient consultation, gastroenterological perspectiveAbstract
Introduction: A large body of evidence has documented the antioxidant, anti-inflammatory, and immunomodulatory effects of proper nutrition on immunoinflammatory diseases such as SLE. Therefore full integration of the dietitian nutritionist within the multidisciplinary team is essential for designing, implementing, and monitoring personalized nutritional strategies. Their training and expertise allow interventions to be tailored to the individual needs of the patient, considering factors such as their immunological status, comorbidities, drug therapy, and cultural and socioeconomic preferences.
Objective: to contribute to disseminating knowledge that promotes understanding of the role of the dietitian nutritionist in dietary modulation in systemic lupus erythematosus.
Development: in autoimmune diseases such as SLE, where metabolic risks, immunological alterations, and multi-organ involvement coexist, the role of the clinical nutritionist is essential to assess the feasibility, potential benefits, and limitations of this type of intervention.
Conclusions: this comprehensive approach not only optimizes disease control and quality of life, but also prevents associated complications and promotes long-term adherence. Recognizing and strengthening the role of the dietitian nutritionist in the management of SLE is, therefore, an essential step toward more comprehensive, effective, and safe care.
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1.Andrade-Ortega L, Xibillé-Friedmann D, Galarza-Delgado DA, Saavedra MÁ, Alvarez-Nemegyei J, Amigo-Castañeda MC, Barile-Fabris LA. Guías de Práctica Clínica para el tratamiento del lupus eritematoso sistémico del Colegio Mexicano de Reumatología. Actualización 2024. Reumatología Clínica. [Internet]. 2024 [citado 2 de junio de 2025]; 20(9):490-510. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S1699258X24000846
2.Xibillé-Friedmann D, Pérez-Rodríguez M, Carrillo-Vázquez S, Álvarez-Hernández E, Aceves FJ, Ocampo-Torres MC, Barile-Fabris LA. Clinical practice guidelines for the treatment of systemic lupus erythematosus by the Mexican College of Rheumatology. Reumatología Clínica (English Edition) . [Internet]. 2019 [citado 2 de junio de 2025];15(1):3-20. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S2173574318301813
3.Martínez Larrarte JP, Pozo Abreu SM, Urquiza Portilla L, Sánchez Sánchez R, López Mantecón AM, Barrios Lamoth E. Índice neutrófilo/linfocitos como predictor de gravedad en pacientes con lupus eritematoso sistémico: presentación de caso. Revista Cubana de Reumatología. [Internet]. 2024 [citado 2 de junio de 2025];26:1156. Disponible en: https://revreumatologia.sld.cu/index.php/reumatologia/article/view/1156
4.Vásquez Duque GM. Diet and lupus. Revista Colombiana de Reumatología. [Internet]. 2019 [citado 2 de junio de 2025]; 26(2):81-82. Disponible en: http://www.scielo.org.co/scielo.php?pid=S0121-81232019000200081&script=sci_arttext&tlng=en
5.Matthias T, Wusterhausen P, Gitsioudis P. Lupus and nutrition-the first step to control your flares?. The Journal of Rheumatology [Internet]. 2025 [citado 2 de junio de 2025];52, Suppl 1:252-253. Disponible en: https://www.jrheum.org/content/52/Suppl_1/252.2.abstract
6.Bernad Serra M. Intervenciones nutricionales en el manejo del Lupus etritematoso sistémico (LES): enfoque en el riesgo cardiovascular de LES. Tesis de Maestría. Universitat Rovira i Virgili, 2024. Disponible en: https://repositori.urv.cat/estatic/TFM0011/en_TFM1953.html
7.Meyer O. Lupus eritematoso sistémico. EMC-Aparato Locomotor 2004;38(1):1-24.
8.Karnal EM, Fabian J, Carlesso LC, Gelinski JMLN. Primary Nutritional Guidance at Systemic Lupus Erythematosus. J Sci Res Rep. 2020; 26, 10-9.
9.Olvera MS. Sobre la intervención nutricional y alimentaria en la diabetes mellitus. Revista Cubana de Alimentación y Nutrición. [Internet]. 2022 [citado 2 de junio de 2025];30(2):17. Disponible en: https://revalnutricion.sld.cu/index.php/rcan/article/view/1206
10.Osuna-Padilla IA, González-Guzmán S, Rodríguez-Moguel NC. El nutricionista-dietista como agente de cambio en la unidad de cuidados intensivos. Rev Nutr Clín Metab. [Internet]. 2023 [citado 2 de junio de 2025];6(2):3–5. Disponible en: https://pesquisa.bvsalud.org/portal/resource/pt/lil-229121
11.da Mota JC, Martínez-Urbistondo M, Ferreira-Nicolett C. Valor de la nutrición de precisión en el control inflamatorio del lupus eritematoso sistémico. Revista chilena de nutrición . [Internet]. 2024 [citado 2 de junio de 2025]; 51(2):172-176. Disponible en: https://www.scielo.cl/scielo.php?pid=S0717-75182024000200172&script=sci_arttext
12.Calzza JI, Muza LS, Gasparin AA, Xavier RM, Monticielo OA. Nutritional aspects and cardiovascular risk in systemic lupus erythematosus. Revista da Associação Médica Brasileira. [Internet]. 2021 [citado 2 de junio de 2025];67(5):656-660. Disponible en: https://www.scielo.br/j/ramb/a/sWTSq7bFNMrnwqc9BzShptR/
13.del Olmo Romero S. Influencia de componentes de la dieta Mediterránea en pacientes con lupus eritematoso sistémico (Doctoral dissertation), Universidad de Granada, España, 2024. Disponible en: https://dialnet.unirioja.es/servlet/tesis?codigo=342400
14.Onfray-Centonzio P, Correa-Yáñez MJ, Gamboa-Menai SA, Cancino-López V, Durán-Agüero S. Evaluación del nivel de participación del nutricionista en la prescripción dietética en hospitales públicos y privados de Chile. Perspectivas en Nutrición Humana. [Internet]. 2019 [citado 2 de junio de 2025];21(1):71-79. Disponible en: http://www.scielo.org.co/scielo.php?pid=S0124-41082019000100071&script=sci_arttext
15.Solis Cartas U, Valdés González JL, Vásconez Andrade WP, Tinajero Novillo LC. La nutrición como herramienta terapéutica para el control de enfermedades reumáticas. Rev. cuba. de Reumatol. [Internet]. 2024 [citado 2 de junio de 2025];26:e1274. Disponible en: https://revreumatologia.sld.cu/index.php/reumatologia/article/view/1274
16.Teng X, Brown J, Choi SC, Li W, Morel L. Metabolic determinants of lupus pathogenesis. Immunol Rev. [Internet].2020 [citado 2 de junio de 2025];295:167-86. Disponible en: doi: 10.1111/imr.12847
17.Islam MA, Khandker SS, Kotyla PJ, Hassan R. Immunomodulatory effects of diet and nutrients in systemic lupus erythematosus (SLE): a systematic review. Frontiers in immunology. [Internet]. 2020 [citado 2 de junio de 2025];11:1477. Disponible en: https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2020.01477/full
18.Bradyanova S, Manoylov I, Boneva G, Kechidzhieva L, Tchorbanov A, Nikolova‐Ganeva K. Methyl‐supplemented nutrition delays the development of autoimmune disease in pristane‐induced murine lupus. Immunology. [Internet]. 2024 [citado 2 de junio de 2025];172(2):269-278. Disponible en: https://onlinelibrary.wiley.com/doi/full/10.1111/imm.13774
19.Brañas F, Azcoaga A, Ontiveros MG, Antela A. Cronicidad, envejecimiento y multimorbilidad. Enfermedades Infecciosas y Microbiología Clínica 2018;36:15-18.
20.Salas IF, Hernández CP, Ortega JAA. Modulación de la respuesta inflamatoria a través del consumo de omega-3 en enfermedades autoinmunes: una revisión de la literatura científica. South Florida Journal of Health. [Internet]. 2025 [citado 2 de junio de 2025];6(2):e5122-e5122. Disponible en: https://ojs.southfloridapublishing.com/ojs/index.php/jhea/article/view/5122
21.Ciurtin C, Jury EC, Robinson GA. Comment on: Systemic lupus erythematosus patients have unique changes in serum metabolic profiles across age associated with cardiometabolic risk: reply. Rheumatology 2024;63(12):e343-e344.
22.Pocovi-Gerardino G. Influencia del patrón de alimentación y de factores dietéticos en el lupus eritematoso sistémico (LES) (Doctoral dissertation), Universidad de Granada, España, 2021. Disponible en: https://digibug.ugr.es/handle/10481/66643
23.Chen Y, Lin J, Xiao L, Zhang X, Zhao L, Wang M, Li L. Gut microbiota in systemic lupus erythematosus: A fuse and a solution. Journal of Autoimmunity 2022; 132: 102867.
24.Xiang S, Qu Y, Qian S, Wang R, Wang Y, Jin Y, Ding X.. Association between systemic lupus erythematosus and disruption of gut microbiota: a meta-analysis. Lupus science & medicine. [Internet]. 2022 [citado 2 de junio de 2025];9(1): e000599. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8961174/
25.Imoto AM, Gottems LB, Salomon A., Silva HECE, Júnior IL, Peccin MS, Santana LA. The impact of a low-calorie, low-glycemic diet on systemic lupus erythematosus: a systematic review. Advances in Rheumatology. [Internet]. 2021 [citado 2 de junio de 2025]; 61:1-20. Disponible en: https://link.springer.com/article/10.1186/s42358-021-00224-1
26.Guevara WMM, Sánchez VMZ. Efectos del ayuno intermitente en el estado nutricional ayuno y estado nutricional. Polo del Conocimiento[Internet]. 2025 [citado 2 de junio de 2025];10(2):643-655. Disponible en: https://polodelconocimiento.com/ojs/index.php/es/article/view/8904
27.Canicoba M. Aplicaciones clínicas del ayuno intermitente. Rev Nutr Clínica Metab. [Internet]. 2020 [citado 2 de junio de 2025];3(2):87-94. Disponible en: https://revistanutricionclinicametabolismo.org/index.php/nutricionclinicametabolismo/article/view/174
28.Bottan VM. El secreto está en el intestino: Recupera tu salud intestinal, controla tu peso y previene enfermedades. Tinta Libre Ediciones; 2025.
29.Angulo AA, Rodríguez D, García MA. Estado nutricional y calidad de vida del adulto mayor: revisión sistemática. Revista Gregoriana de Ciencias de la Salud[Internet]. 2024 [citado 2 de junio de 2025];1(2):165-177. Disponible en: https://revistasalud.sangregorio.edu.ec/index.php/salud/article/view/3149
30.Gilaberte Y, Aguilera J, Carrascosa JM, Figueroa FL, de Gabriel JR, Nagore E. La vitamina D: evidencias y controversias. Actas dermo-sifiliográficas [Internet]. 2011 [citado 2 de junio de 2025];102(8):572-588. Disponible en: https://www.sciencedirect.com/science/article/abs/pii/S0001731011001931
31.Lopera Arango DL, Ramírez Salazar EA, García Vallejo V, Giraldo Zuluaga KM, Ramírez Gil MA. El Nutricionista Dietista, profesional indispensable en el equipo interdisciplinario de Atención Primaria en Salud. Revis Bionatura 2022; 8 (3):77.
32.Mendoza Bone KK, Abril-Merizalde DL, Párraga Acosta J S, Andrade-Trujillo CA. Relación del consumo de calcio con el síndrome metabólico en adultos de la Amazonía Ecuatoriana. Archivos Latinoamericanos de Nutrición. 2023;73(1):1-7.
33.Klack K, Bonfa E, Borba Neto EF. Diet and nutritional aspects in systemic lupus erythematosus. Revista brasileira de reumatologia [Internet]. 2012 [citado 2 de junio de 2025]; 52, 395-408. Disponible en: https://www.scielo.br/j/rbr/a/GdDn9cjL4gLTYghMXYMBjQn/?lang=en&format=html
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