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Dietary factors in rheumatic autoimmune diseases: a recipe for therapy?

Key Points

  • Dietary habits have long been known to have a crucial influence on human health and diseases

  • Novel roles of dietary factors in the complex interaction of different environmental factors in the pathogenesis of rheumatic autoimmune disease, as part of the 'mosaic of autoimmunity' concept, are now increasingly appreciated

  • Whereas salt seems to promote inflammation via various mechanisms, consumption of curcumin, spicy food (capsaicin), chocolate and red wine (resveratrol) might attenuate immune hyperactivity; consumption of fatty acids and coffee seems to have ambivalent effects on autoimmunity

  • The human gut microbiome is emerging as a key contributor to and a common denominator of the effects of these dietary compounds on the immune system and the development of immune-mediated diseases

Abstract

Today, we are facing a new era of digitization in the health care system, and with increased access to health care information has come a growing demand for safe, cost-effective and easy to administer therapies. Dietary habits have a crucial influence on human health, affecting an individual's risk for hypertension, heart disease and stroke, as well as influencing the risk of developing of cancer. Moreover, an individual's lifestyle choices can greatly influence the progression and manifestation of chronic autoimmune rheumatic diseases. In light of these effects, it makes sense that the search for additional therapies to attenuate such diseases would include investigations into lifestyle modifications. When considering the complex web of factors that influence autoimmunity, it is not surprising to find that several dietary elements are involved in disease progression or prevention. In this Review, several common nutritional components of the human diet are presented, and the evidence for their effects on rheumatic diseases is discussed.

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Figure 1: Dietary factors associated with autoimmunity.
Figure 2: The role of diet in shaping the gut microbiome.
Figure 3: Molecular mechanisms linking a high-salt diet to an inflammatory response.

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All authors researched the data for the article, provided substantial contributions to discussions of its content, wrote the article and undertook review and/or editing of the manuscript before submission. S.D. and Y. Segal share lead authorship.

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Dahan, S., Segal, Y. & Shoenfeld, Y. Dietary factors in rheumatic autoimmune diseases: a recipe for therapy?. Nat Rev Rheumatol 13, 348–358 (2017). https://doi.org/10.1038/nrrheum.2017.42

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