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The Role of Nutrition and Physical Activity in Autoimmune Diseases

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A special issue of Nutrients (ISSN 2072-6643). This special issue belongs to the section "Nutritional Immunology".

Deadline for manuscript submissions: closed (20 August 2023) | Viewed by 24612

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Prof. Dr. Grazyna Rydzewska

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Guest Editor

Central Clinica Hospital of Ministry of Interior and Adminstration, Warsaw, Jan Kochanowski University, Kielce, Kielce, Poland
Interests: clinical research; inflammatory bowel diseases; acute pancreatitis; chronic pancreatitis; pancreatic cancer; autoimmune pancreatitis; irritable bowel syndrome

Special Issue Information

Dear Colleagues,

Autoimmune diseases are a diverse group of diseases affecting almost all organs and systems and characterized by an abnormal immune response to their own tissues and organs. Concerningly, autoimmune disease incidence is increasing, especially in developed countries. Over 100 different autoimmune diseases have been described, affecting from 3% to 5% of the population. The etiology of autoimmune diseases is unclear in most cases, although both genetic and environmental factors are taken into account. Among the latter, nutritional factors appear to be of increasing importance. Celiac disease causes gluten sensitivity, the best-known effect of nutritional factors in autoimmune disease. Increasingly, studies also indicate the role of nutrition in IBD and the influence of nutrition through not only typical autoimmune mechanisms but also highly processed foods. Consumption of processed foods may increase the risk for other autoimmune diseases. Diet as a modifiable factor also has the potential to improve clinical outcomes for several major autoimmune diseases.

Along with nutrition, physical activity is an essential component of a healthy lifestyle, impacting energy balance, promoting the functional ability of various systems, and improving immunity. Both may influence lifelong health by improving body composition, musculoskeletal health, and physical and cognitive performance. Physical activity can replace many drugs, but nothing can replace physical activity—this slogan is important not only in terms of maintaining a healthy body weight or preventing metabolic disorders, but also regarding autoimmune disorders.

This Special Issue on nutrition and physical activity in autoimmune diseases will include current research on the role of these factors in autoimmune diseases, both in the gastrointestinal tract and beyond. Manuscripts presenting basic and clinical research, observational and meta-analysis studies, and analytical reviews are encouraged in this Special Issue.

Prof. Dr. Grazyna Rydzewska
Guest Editor

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Keywords

autoimmune diseases
nutrition
celiac disease
gluten sensitivity
inflammatory bowel disease
processed food
physical activity

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Published Papers (8 papers)

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Research

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14 pages, 811 KiB

Open AccessFeature PaperArticle

Lifestyle Can Exert a Significant Impact on the Development of Metabolic Complications and Quality Life in Patients with Inflammatory Bowel Disease

by Sandra García-Mateo, Samuel J. Martínez-Domínguez, Carla Jerusalén Gargallo-Puyuelo, María Teresa Arroyo Villarino, Viviana Laredo De La Torre, Beatriz Gallego, Erika Alfambra and Fernando Gomollón

Nutrients 2023, 15(18), 3983; https://doi.org/10.3390/nu15183983 - 14 Sep 2023

Cited by 7 | Viewed by 2606

Abstract

Inflammatory bowel diseases (IBDs) are associated with an increased risk of metabolic comorbidities. There is a lack of data regarding the relationship between lifestyle and metabolic diseases in IBD patients. A cross-sectional study on consecutive IBD outpatients was conducted. Adherence to the Mediterranean diet (MD) was assessed using a 14-item questionnaire from the PREDIMED study, and physical activity was evaluated using the GODIN-Leisure score. Body composition was studied based on body mass index and waist–hip ratio (WHR), while quality of life was assessed using a nine-item short questionnaire. Among the 688 evaluated IBD patients, 66% were overweight or obese, 72.7% did not lead an active lifestyle and 70.1% did not adhere to the MD. Metabolic syndrome was associated with age (OR = 1.07, p = 0.019), overweight/obesity (OR = 12.987, p < 0.001) and the inflammatory behavior of Crohn’s disease (OR = 6.172, p = 0.001). Type 2 diabetes mellitus or prediabetes was associated with age (OR = 1.063 p = 0.016), overweight/obesity (OR = 3.861, p < 0.001) and the inflammatory behavior of Crohn’s disease (OR = 4.716, p = 0.001). Overweight /obesity (OR = 5.494, p < 0.001), a high WHR (OR = 2.564, p = 0.005) and a non-active lifestyle (OR = 2.202, p = 0.0003) were associated with metabolic dysfunction-associated steatotic liver disease. Lifestyle, body composition and not solely systemic inflammation might exert a significant influence on the emergence of metabolic comorbidities such as MASLD, type 2 diabetes mellitus and metabolic syndrome in patients with IBD. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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17 pages, 2711 KiB

Open AccessArticle

Maternal Obesity and Kawasaki Disease-like Vasculitis: A New Perspective on Cardiovascular Injury and Inflammatory Response in Offspring Male Mice

by Yuanzheng Zheng, Wenji Wang, Yu Huo and Yonghao Gui

Nutrients 2023, 15(17), 3823; https://doi.org/10.3390/nu15173823 - 31 Aug 2023

Cited by 1 | Viewed by 1624

Abstract

Maternal obesity affects the risk of cardiovascular disease and inflammatory response in offspring. However, the impact of maternal obesity on offspring with Kawasaki disease (KD), the leading cause of childhood acquired heart disease, is still an understudied area. This study aimed to elucidate the impact of maternal obesity on offspring in KD-like vasculitis and the underlying mechanisms. Offspring of obese female mice and normal diet dams were randomly divided into two subgroups. The pups were injected intraperitoneally with either Candida albicans water-soluble fraction (CAWS) or phosphate buffered saline (PBS) to establish the obesity (OB)-CAWS group, OB group, wild type (WT)-CAWS group, and WT group. Their weight was monitored during the study. After four weeks, echocardiography was applied to obtain the alternation of cardiac structures. Mouse cytokine panel, Hematoxylin-Eosin (HE) staining, western blot, and real-time qPCR were used to study the pathological changes and protein and RNA expression alternations. Based on the study of pathology, serology and molecular biology, maternal obesity lead to more severe vasculitis and induced altered cardiac structure in the offspring mice and promoted the expression of pro-inflammatory cytokines through activating the NF-κB signaling pathway. Maternal obesity aggravated the inflammatory response of offspring mice in KD-like vasculitis. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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16 pages, 2465 KiB

Open AccessArticle

IgE-Dependent Food Sensitisation and Its Role in Clinical and Laboratory Presentation of Paediatric Inflammatory Bowel Disease

by Anna Buczyńska, Urszula Grzybowska-Chlebowczyk and Krzysztof Pawlicki

Nutrients 2023, 15(8), 1804; https://doi.org/10.3390/nu15081804 - 7 Apr 2023

Cited by 1 | Viewed by 2100

Abstract

The rising prevalence of inflammatory bowel disease (IBD) and food allergies and their partially overlapping mechanisms such as microbiome diversity reduction raise questions about the role of allergies in IBD. While data on their comorbidity are available, analysis of IgE-sensitization’s influence on the clinical presentation of IBD is lacking and is the aim of this study. Histories of 292 children with newly diagnosed IBD (173 cases of ulcerative colitis, 119 cases of Crohn’s disease) were analyzed. Disease age of onset, activity, location, behaviour, and anthropometric and laboratory parameters were tested for its dependence on the presence of chosen IgE sensitization markers. A.o. Chi2, OR and phi coefficient were assessed. In Crohn’s disease (CD), elevated total IgE (tIgE) correlated with weight loss, rectal bleeding, ASCA IgG positivity (φ = 0.19 for all) and negatively correlated with complicated disease behaviour (φ = −0.19). TIgE > 5 × reference range correlated with being underweight (φ = 0.2), ASCA IgG positivity (φ = 0.3), ASCA double (IgA and IgG) positivity (φ = 0.25) and elevated total IgG (φ = 0.18). The presence of specific IgEs (sIgE) correlated with extraintestinal manifestations of IBD (φ = 0.19): Egg white sIgE correlated with upper GI involvement (L4b) (φ = 0.26), severe growth impairment (φ = 0.23) and colonic mucosal eosinophilia (φ = 0.19). In ulcerative colitis, decreased IgA correlated with egg white sIgE (φ = 0.3), as well as the presence of any (φ = 0.25) or multiple sIgEs (φ = 0.2); the latter correlated also with elevated IgG (φ = 0.22), fever (φ = 0.18), abdominal pain (φ = 0.16) and being underweight (φ = 0.15). Cow’s milk sIgE correlated positively with growth impairment (φ = 0.15) and elevated IgG (φ = 0.17) and negatively with extensive colitis (φ = −0.15). Pancolitis correlated negatively with sIgE presence (φ = −0.15). In summary, single moderate and numerous weak but interesting relationships were observed. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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13 pages, 611 KiB

Open AccessArticle

Risk Factors for Osteoporosis among Patients with Inflammatory Bowel Disease—Do We Already Know Everything?

by Konrad Lewandowski, Magdalena Kaniewska, Martyna Więcek, Paulina Szwarc, Paulina Panufnik, Edyta Tulewicz-Marti, Magdalena Walicka, Edward Franek and Grażyna Rydzewska

Nutrients 2023, 15(5), 1151; https://doi.org/10.3390/nu15051151 - 24 Feb 2023

Cited by 13 | Viewed by 2851

Abstract

Introduction: There are many known risk factors for osteoporosis (OST) among patients with inflammatory bowel disease (IBD), one of which is physical activity. Material and methods: The aim of the study is to assess the frequency and risk factors of OST among 232 patients with IBD compared to a group of 199 patients without IBD. The participants underwent dual-energy X-ray absorptiometry, laboratory tests, and completed a questionnaire about their physical activity. Results: It was found that 7.3% of IBD patients suffered from OST. Male gender, ulcerative colitis, extensive inflammation in the intestine, exacerbation of disease, rare physical activity, other forms of physical activity, past fractures, lower levels of osteocalcin, and higher levels of C-terminal telopeptide of type 1 collagen were risk factors for OST. As many as 70.6% of OST patients were rarely physically active. Conclusions: OST is a common problem in IBD patients. OST risk factors differ significantly between the general population and those with IBD. Modifiable factors can be influenced by patients and by physicians. The key to OST prophylaxis may be regular physical activity, which should be recommended in clinical remission. It may also prove valuable to use markers of bone turnover in diagnostics, which may enable decisions regarding therapy. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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14 pages, 288 KiB

Open AccessArticle

Nutritional Imbalances in Polish Children with Coeliac Disease on a Strict Gluten-Free Diet

by Anna Szaflarska-Popławska, Aleksandra Dolińska and Magdalena Kuśmierek

Nutrients 2022, 14(19), 3969; https://doi.org/10.3390/nu14193969 - 24 Sep 2022

Cited by 4 | Viewed by 2022

Abstract

Currently, the only treatment for coeliac disease (CD) is a strict, lifelong gluten-free diet (GFD); however, their completeness with regard to energy and macro- and micronutrients remains poorly understood. Paediatric studies are often limited by a low quality and a lack of controls, and their findings should be interpreted with caution. The aim of the present study was to evaluate nutritional imbalances in children with CD on a strict GFD. Methods: A single-centre prospective cohort study was conducted. A total of 48 children with CD (33 girls, mean age 11.8 ± 3.68 years) on a strict GFD (mean duration 5.02 ± 3.87 years) were compared with 50 non-coeliac subjects (26 girls, mean age 10.2 ± 3.97 years). In both groups, anthropometric measurements (body height, weight and BMI) and laboratory tests (haemoglobin level, calcium and magnesium serum concentration, folic acid, vitamin B₁, B₂, B₆ and B₁₂ level) were checked. Additionally, in coeliac subjects, a 3-day food record for energy and macro- and micronutrient intake assessment were determined, and the values were compared to those in non-CD participants and the dietary reference intake (DRI) standards. Results: The CD children were more likely to demonstrate significantly lower serum vitamin B₁ and folic acid levels compared to controls (p = 0.01 and p = 0.002, respectively). Although mean serum calcium values were within normal ranges, they were significantly lower in CD subjects than controls (p = 0.01). Mean calcium, folic acid and vitamin D intake was below the dietary recommendations in the CD group (69.9%, 71.2% and 68.9% DRI, respectively) but did not differ significantly between CD and non-coeliac subjects. In turn, the mean supply of proteins and carbohydrates in the CD group substantially exceeded the recommended levels (190.3% and 189.4% DRI, respectively) but was similar to controls. A significantly higher number of CD children were classified as underweight, and a significantly lower number as overweight or obese, compared with controls (p < 0.001). Conclusion: Although children with CD receive nutritional education at diagnosis, a GFD often does not provide a balanced set of macro- and micronutrients. This is mainly due to unhealthy dietary habits, as commonly observed in the general population. Children with CD should be informed that while their diet should be free of gluten, it should nevertheless cover all their nutrition requirements in the long term. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

Review

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23 pages, 963 KiB

Open AccessEditor’s ChoiceReview

Nutritional Status and Its Detection in Patients with Inflammatory Bowel Diseases

by Beata Jabłońska and Sławomir Mrowiec

Nutrients 2023, 15(8), 1991; https://doi.org/10.3390/nu15081991 - 20 Apr 2023

Cited by 26 | Viewed by 5222

Abstract

Malnutrition is an important issue in patients with inflammatory bowel diseases (IBDs) including Crohn’s disease (CD) and ulcerative colitis (UC). It is caused by altered digestion and absorption within the small bowel, inadequate food intake, and drug–nutrient interactions in patients. Malnutrition is an essential problem because it is related to an increased risk of infections and poor prognosis in patients. It is known that malnutrition is also related to an increased risk of postsurgery complications in IBD patients. Basic nutritional screening involves anthropometric parameters with body mass index (BMI) and others (fat mass, waist-to-hip ratio, muscle strength), medical history concerning weight loss, and biochemical parameters (including the Prognostic Nutritional Index). Besides standard nutritional screening tools, including the Subjective Global Assessment (SGA), Nutritional Risk Score 2002 (NRS 2002), and Malnutrition Universal Screening Tool (MUST), specific nutritional screening tools are used in IBD patients, such as the Saskatchewan Inflammatory Bowel Disease–Nutrition Risk Tool (SaskIBD-NR Tool and IBD-specific Nutritional Screening Tool). There is a higher risk of nutrient deficiencies (including iron, zinc, magnesium) and vitamin deficiencies (including folic acid, vitamin B12 and D) in IBD patients. Therefore, regular evaluation of nutritional status is important in IBD patients because many of them are undernourished. An association between plasma ghrelin and leptin and nutritional status in IBD patients has been observed. According to some authors, anti-tumor necrosis factor (anti-TNFα) therapy (infliximab) can improve nutritional status in IBD patients. On the other hand, improvement in nutritional status may increase the response rate to infliximab therapy in CD patients. Optimization of nutritional parameters is necessary to improve results of conservative and surgical treatment and to prevent postoperative complications in patients with IBDs. This review presents basic nutritional screening tools, anthropometric and laboratory parameters, dietary risk factors for IBDs, common nutrient deficiencies, associations between anti-TNFα therapy and nutritional status, selected features regarding the influence of nutritional status, and surgical outcome in IBD patients. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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29 pages, 1189 KiB

Open AccessReview

Selected Aspects of the Intricate Background of Immune-Related Cholangiopathies—A Critical Overview

by Beata Kasztelan-Szczerbinska, Anna Rycyk-Bojarzynska, Agnieszka Szczerbinska and Halina Cichoz-Lach

Nutrients 2023, 15(3), 760; https://doi.org/10.3390/nu15030760 - 2 Feb 2023

Cited by 2 | Viewed by 2988

Abstract

Primary biliary cholangitis (PBC), and primary sclerosing cholangitis (PSC) are rare immune-related cholangiopathies with still poorly explained pathogenesis. Although triggers of chronic inflammation with subsequent fibrosis that affect cholangiocytes leading to obliteration of bile ducts and conversion to liver cirrhosis are unclear, both disorders are regarded to be multifactorial. Different factors can contribute to the development of hepatocellular injury in the course of progressive cholestasis, including (1) body accumulation of bile acids and their toxicity, (2) decreased food intake and nutrient absorption, (3) gut microbiota transformation, and (4) reorganized host metabolism. Growing evidence suggests that intestinal microbiome composition not only can be altered by liver dysfunction, but in turn, it actively impacts hepatic conditions. In this review, we highlight the role of key factors such as the gut–liver axis, intestinal barrier integrity, bile acid synthesis and circulation, and microbiome composition, which seem to be strongly related to PBC and PSC outcome. Emerging treatments and future therapeutic strategies are also presented. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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15 pages, 596 KiB

Open AccessReview

Selected Aspects of Nutrition in the Prevention and Treatment of Inflammatory Bowel Disease

by Paulina Panufnik, Martyna Więcek, Magdalena Kaniewska, Konrad Lewandowski, Paulina Szwarc and Grażyna Rydzewska

Nutrients 2022, 14(23), 4965; https://doi.org/10.3390/nu14234965 - 23 Nov 2022

Cited by 1 | Viewed by 2737

Abstract

Inflammatory bowel disease has become a global health problem at the turn of the 21st century. The pathogenesis of this disorder has not been fully explained. In addition to non-modifiable genetic factors, a number of modifiable factors such as diet or gut microbiota have been identified. In this paper, the authors focus on the role of nutrition in the prevention of inflammatory bowel disease as well as on the available options to induce disease remission by means of dietary interventions such as exclusive and partial enteral nutrition in Crohn’s disease, the efficacy of which is reported to be comparable to that of steroid therapy. Diet is also important in patients with inflammatory bowel disease in the remission stage, during which some patients report irritable bowel disease-like symptoms. In these patients, the effectiveness of diets restricting the intake of oligo-, di-, monosaccharides, and polyols is reported. Full article

(This article belongs to the Special Issue The Role of Nutrition and Physical Activity in Autoimmune Diseases)

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