Background/Purpose

Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc) can be both associated with various degrees and types of malnutrition, with different pathogenetic mechanisms.  It’s well known that a balance between nutritional needs, energy intake and nutrients can contribute to the control of the inflammatory processes and can have a beneficial effect on osteoporosis, metabolic syndrome, hypertension, cardiovascular disease and neoplasia. Nutritional therapy is a promising way to approach SLE and SSc, indeed, a diet rich in vitamins, minerals and mono/polyunsaturated fatty acids could promote a beneficial protective effect against inflammatory activity and tissue damage as well as comorbidities. The aim of this study was to assess the nutritional status and food intake of a cohort of SLE and SSc patients in comparison to healthy subjects.

Methods

Twenty patients with SLE and 20 patients with SSc were included in the nutritional assessment. Twenty healthy age and sex matched subjects (H) were used as controls. Food intake was assessed using a Food Frequency Questionnaire, validated in the European Prospective Investigation into Cancer (EPIC) Cohort Study. All individual questionnaires were checked and coded by trained dieticians, computerized and then transformed into estimates of intake for a series of over 30 nutrients. At enrollment, weight, height, waist and hip circumferences were measured for each participant.  

Results

The average age of SLE, SSc patients and controls was 36 ± 10, 40 ± 9 e 35 ± 10 years respectively (p=n.s.). The majority of SLE patients (90%) resulted normal weight: the body index mass (BMI) ranged between 18,5 and 24,99 kg/m². The rest of the group was overweight (25 ≤ BMI ≤ 29,99 kg/m²). No obesity or underweight was observed. No differences in BMI were observed between SLE patients and H.

More than half of the SSc patients (66%) was normal weight; the rest of the group was underweight (89% slightly underweight with 17 ≤ BMI ≤ 18,49 kg/m² and 13% moderately underweight with 16 ≤ BMI ≤ 16,99 kg/m²). SSc patients showed a lower mean value of BMI if compared with both SLE patients and H.

The annual frequency consumption of fruit, leafy vegetables, legumes, vegetables, milk, pasta, meat, and fish was similar in all the groups. On the contrary, the annual energy intake (kcal) was significantly lower in SSc patients if compared to SLE patients and H (p<0.02).

Conclusion

In this study we investigated the nutritional status of patients affected by two systemic autoimmune diseases. Our preliminary data showed an inadequate consumption of nutrients in SSc patients if compared to SLE patients and controls, probably due to a more severe gastro-enteric involvement. These results highlight the importance of an individualized nutrition approach in these patients according to disease-related specificities and pharmacological therapies.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/nutritional-assessment-in-patients-with-systemic-lupus-erythematosus-and-systemic-sclerosis/