SP22 689 Weekly Wall 3 by Sara Police

Increased Cardiovascular Risk in Rheumatoid Arthritis

ccci222 — 2022-01-27 17:02:26 UTC

The paper I chose for this week's post focuses on rheumatoid arthritis(RA) related factors contributing to cardiovascular risk. As we just learned in this week's module, rheumatoid arthritis is an autoimmune systemic inflammatory disorder mostly affecting the destruction of the joints. Interestingly enough, while RA affects the joints, the largest proportion of excess mortality in rheumatoid arthritis patients is Cardiovascular disease, accounting for 39.6% of deaths. This can be explained by the increased TNF-α and IL-18 expression, as well as increased IL-33 and IL-33 ligand expression in RA patients. This finding suggests that this pro-inflammatory environment fosters atherogenesis; the process of plaque formation leading to coronary heart disease. This is important to understand because RA patients are at increased risk of cardiovascular disease. Several mechanisms beyond traditional cardiovascular risk factors confer this risk. Clinical treatment of RA patients needs to be aggressive against cardiovascular disease and continuous monitoring of risk factors is essential to reduce the substantial burden posed by this common comorbidity.

England, B. R., Thiele, G. M., Anderson, D. R., & Mikuls, T. R. (2018). Increased cardiovascular risk in rheumatoid arthritis: mechanisms and implications. BMJ (Clinical research ed.), 361, k1036. https://doi.org/10.1136/bmj.k1036

Exercise Prescription for patients with MS- Ashley Wahlman

anwa238 — 2022-01-28 15:57:05 UTC

For the weekly wall discussion, I decided to look at potential treatments for MS. As we know many patients with MS suffer with motor dysfunction due to muscle weakening, fatigue, spasticity and balance issues. As a result of this, many physicians wouldn't recommend any physical activity to newly diagnosed MS patients. However, regular physical activity in these patients has shown to have promising benefits. Such as limiting the deconditioning process and improving the patient back to optimal functioning including physical and mental health. One key finding is that they noticed by strengthening the respiratory muscles this enhanced maximal inspiratory and expiratory pressures. Which is very important because people who suffer with MS typically have a more difficult time breathing due to respiratory muscle weakness. I think this plays into nutritional sciences very easily. I always think that being healthy requires eating a more balanced diet as well as pairing that with exercise to achieve optimal results. Which is how exercise relates to nutritional sciences because eating healthy is one part of the equation and exercise is the other part. This has many implications because for a significant amount of time we wouldn't prescribe exercise to MS patients, but we continuously observed their physical and mental health decline. However, with tailoring exercise programs to each individual patient we have been able to observe the patient get back to a much better physical and mental health. Overall, I believe this is a great therapeutic recommendation it doesn't require the patient to take more medications that could possibly affect their health. Instead they can do something naturally that will have many positive benefits.

Halabchi, F., Alizadeh, Z., Sahraian, M. A., & Abolhasani, M. (2017). Exercise prescription for patients with multiple sclerosis; potential benefits and practical recommendations. BMC neurology, 17(1), 185. https://doi.org/10.1186/s12883-017-0960-9

👍 Mediterranean diet; 👎 Western Diet for Multiple Sclerosis

rwpr222 — 2022-01-28 20:15:25 UTC

The research paper selected for this week is titled: “The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review.”

This research paper is a 2021 review from the neurosciences department of the University of Palermo, Palermo, Italy. They have reviewed the existing evidence on nutritional lifestyle and physical activity from the perspective of the Multiple Sclerosis (MS) management. They have reviewed the diets, macronutrients, oligoelements associated with MS pathogenesis and clinical course.

This study is important because it reviews the nutritional lifestyles with the greatest association with the pathogenesis and improved clinical course for patients with MS. The authors point out that a pro-inflammatory status associated with high-lipid diet, abdominal obesity and/or dysbiosis contribute to MS pathogenesis and severity.

The key findings from this study are that low-carbohydrate, Mediterranean, and fasting-mimicking diets have evidence in animal models and human studies positive effects on MS and have positive patient reported outcomes.

A clinical implication from of this study is that the Western diet is associated with the pathogenesis of MS and that deliberate nutritional lifestyle such as Mediterranean diet improve the clinical course of the disease. ¹

1. Fanara S, Aprile M, Iacono S, et al. The Role of Nutritional Lifestyle and Physical Activity in Multiple Sclerosis Pathogenesis and Management: A Narrative Review. Published online 2021. doi:10.3390/nu13113774

Richard Proudfoot

The role of diet in the treatment of rheumatoid arthritis

colezetter — 2022-01-29 10:19:19 UTC

For this weeks module, I decided to look into a research paper that detailed the role of diet in the treatment of rheumatoid arthritis. I found this study to be very important because it directly relates to this course and this week's content. It gives great detail on what the illness and it's background. How RA is a chronic, inflammatory autoimmune disorder that affects the body's joints. This paper provides background to the disease by how it is characterized by severe inflammation of the synovial lining of the joints and provides key information about cytokines. This brings to light how much pain patient's who are diagnosed with this disease live their lives with.

One key finding to this study would be that some studies investigating the role of different dietary patterns in the treatment of RA have reported improvement in a number of symptoms, but the potential mechanisms of action are still unclear. In this study, they looked at Mediterranean diets, vegetarian diets, and elimination diets.

I would say the clinical implications of this study would be how clinicians could treat patients diagnosed with RA by altering their diet to improve their symptoms. If dietary alteration could be proven to improve conditions, they would be implemented clinically.

O’Connor, Á. “An Overview of the Role of Diet in the Treatment of Rheumatoid Arthritis: Diet and Rheumatoid Arthritis.” Nutrition bulletin 39.1 (2014): 74–88. Web.

Weight loss and improvements in fatigue in systemic lupus erythematosus: a controlled trial of a low glycaemic index diet versus a calorie restricted diet in patients treated with corticosteroids - PubMed (nih.gov)

emaleehaynes — 2022-01-29 15:00:17 UTC

The purpose of this study was to determine if different diets would result in flare ups and weight loss in lupus patients. The participants were all female, had a BMI >25 kg/m2 and had corticosteroid dependent lupus. This study is important because there can be concern amongst lupus patients for ways to lose weight through their diet without causing a flare up. Specifically, this study evaluated low GI and low-calorie diets. A key finding in this study was that both diets caused significant weight loss without flare ups and showed significant reduction in overall fatigue of patients. The clinical implications of this would be for providers to potentially recommend these diets to patients interested. While this study was not a very large group of participants, all of them found weight loss relief without exacerbating their lupus. This study provides options for patients to try with success from other patients which would likely provide some confidence in trying for fellow lupus patients.

Davies RJ, Lomer MC, Yeo SI, Avloniti K, Sangle SR, D'Cruz DP. Weight loss and improvements in fatigue in systemic lupus erythematosus: a controlled trial of a low glycemic index diet versus a calorie restricted diet in patients treated with corticosteroids. Lupus. 2012 May;21(6):649-55. doi: 10.1177/0961203312436854. Epub 2012 Feb 6. PMID: 22311939.

The Impact of Nutrition & Generally Available Products on Rheumatoid Arthritis

lrdu229 — 2022-01-29 21:12:30 UTC

In light of the topics for this week, I wanted to focus on the link between nutrition and Rheumatoid Arthritis (RA). This literature review complied 39 research papers looking into the affects of generally available products on RA. The most common of these products included alcohol, coffee & tea, meat & meat products, and the Mediterranean diet. This review is important because it combines previous information in terms of nutrition and RA and evaluates them to see if certain nutrients can be beneficial to someone with RA. By looking at multiple results at once, it can help to further make sense of them. I also feel that this review is important because it not only acknowledges what is good about the studies, but also where each study falls short.

One key finding of this review is that none of the studies showed a definitive yes or no as to whether or not the nutrients were beneficial to people with RA. This is consistent with many many diseases involving diet. A few of the studies showed that moderate alcohol consumption could lower the risk of RA/modify it's symptoms, but not all of these studies had the same idea of "moderate" (for ex: one study considered one drink as 16 grams, while another study considered a drink to be 500mL and only suggested 15 grams a week).

The clinical implications of this review relate to what we have learned so far this week: while there are suggested dietary intakes, what will work best is specific to each individual. Therefore, individuals should monitor what they eat and how their body reacts to it.

Grygielska, J., Raciborski, F., Kłak, A., & Owoc, J. (2018, May 9). The impact of nutrition and generally available products such as nicotine and alcohol on rheumatoid arthritis - review of the literature. Reumatologia. Retrieved January 29, 2022, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5974635/

Katelyn Spain: An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis

2022-01-30 17:09:28 UTC

The purpose of this study was to determine if the Mediterranean diet opposed to the Western Diet was more effective in suppressing disease symptoms in patients with rheumatoid arthritis. Since the Mediterranean diet can be beneficial to some rheumatoid arthritis patients, this study can support the dietary interventions in treatment of rheumatoid arthritis. It was found in this study that patients with rheumatoid arthritis treated with the Mediterranean diet had a reduction in inflammatory activity, an increase in physical function, and overall improved vitality. The patients that were considered the control, consuming a normal Western diet, had no significant changes in their inflammatory activities, physical functions and vitalities. This study relates to nutritional sciences because it shows how a change in diet can treat an autoimmune disorder. The clinical implications of this study are that physicians can recommend this diet change to their patients with rheumatoid arthritis because of the high consumption of omega-3 fatty acids and anti-inflammatory phytochemicals in the Mediterranean diet, that are not present in the Western diet. These components of the Mediterranean diet decrease inflammation in patients with rheumatoid arthritis.

Esraa Zamzami: A dual effect of ursolic acid to the treatment of multiple sclerosis through both immunomodulation and direct remyelination

ezamzamiez — 2022-01-31 04:32:09 UTC

This study is important because there are many medications for Multiple Sclerosis (MS); however, all of them are immunosuppressive and non are therapeutic. This study provides promising evidence that ursolic acid (UA) has both immunomodulatory to decrease inflammation and therapeutic effects to stimulate and increase remyelination. The main key finding in this study is that UA has the ability to stimulate the maturation of oligodendrocytes and promote the production of myelin basic protein (MBP) to enhance remyelination. This information directly relates to nutrition because UA is a natural triterpene compound found in food, like in rosemary, sage, and especially in the skin of fruits like apple peel and grape skin. The clinical implication is that MS patients increase their fruit consumption and, more importantly, eat them with their skin after washing them properly. UA toxicity is very high and cannot be reached by food consumption, so it is usually safe.

Zhang, Y., Li, X., Ciric, B., Curtis, M. T., Chen, W. J., Rostami, A., & Zhang, G. X. (2020). A dual effect of ursolic acid to the treatment of multiple sclerosis through both immunomodulation and direct remyelination. Proceedings of the National Academy of Sciences of the United States of America, 117(16), 9082–9093. https://doi.org/10.1073/pnas.2000208117

Randomized-controlled trial of a modified Mediterranean dietary program for multiple sclerosis: A pilot study

Cassie_Craig — 2022-01-31 19:50:08 UTC

This article focused on a pilot study of female multiple sclerosis patients that were prescribed to follow a Mediterranean diet while receiving an educational background on the diet in a clinical setting. The purpose of the educational sessions was to increase adherence to the diet plan, therefore increasing the diets effectiveness. There were significant results indicating a reduction in patient fatigue, severity of symptoms and expanded disability status in patients that were a part of the diet intervention group. This relates to nutritional studies because a Mediterranean diet is being implemented in these patients’ treatment plans. The clinical implications of this study can be seen in the increased effectiveness due to the monthly sessions and attendance to educational sessions. Further studies can be done with the implementation of the dietary intervention group’s guidelines to test the impact of potential dietary treatments. I believe that providing an engaging educational atmosphere for the patients increased their likelihood to follow the diet, and therefore they saw better results.

Dietary habits, serum concentration of copper, zinc, and Cu-to-Zn ratio, and ability status of patients with relapsing-remitting MS

MitchellWatts — 2022-02-01 02:17:03 UTC

The aim of this study was to determine the influence of diet on the serum concentrations of copper (Cu), zinc (Zn) and the effect of Cu-Zn ratio on ability status (using the Expanded Disability Status Scale) for patients with relapsing-remitting multiple sclerosis (MS). The authors found that serum Zn was significantly lower in MS individuals compared to healthy individuals (control), and that the ratio of Cu to Zn was higher in MS patients. Lower ability status was found in patients with this imbalanced ratio of Cu to Zn.

A high level of Cu can be detrimental as seen in the Fenton reaction, where Cu is involved in the formation of oxygen free radicals generating oxidative stress. A high level of serum Cu could contribute to the low absorption of Zn. A Zn deficiency increases the generation of inflammatory cytokines and oxidative stress and induces endothelial cell dysfunction, which is involved in the pathogenesis of MS. The level of Zn depends on the levels of Cu because this element competes with Zn for binding to metallothionein, which would reduce absorption. This ratio of Cu to Zn is potentially a marker of oxidative stress.

Including foods sources of dietary zinc could improve the clinical condition of individuals with MS. Bioavailability of Zn is relatively high in meat, eggs, and seafood. Many foods have both zinc and copper, which is important to maintain a balanced ratio.

Socha, K., Karpińska, E., Kochanowicz, J., Soroczyńska, J., Jakoniuk, M., Wilkiel, M., Mariak, Z. D., & Borawska, M. H. (2017). Dietary habits; concentration of copper, zinc, and Cu-to-Zn ratio in serum and ability status of patients with relapsing-remitting multiple sclerosis. Nutrition, 39-40, 76–81. https://doi.org/10.1016/j.nut.2017.03.009

Seonwook Kim: Beneficial effect of Mediterranean diet on disease activity and cardiovascular risk in systemic lupus erythematosus patients: a cross-sectional study

ski224 — 2022-02-01 04:48:24 UTC

My selected article is about Mediterranean diet (Med Diet) on disease activity and cardiovascular risk in systemic lupus erythematosus (SLE) patients. The study was a cross-sectional study on 280 patients with SLE. It is important because this study assessed, for the first time, the association between adherence to the Med Diet and SLE activity, damage accrual, and Cardiovascular risk markers. One of the key findings is that SLE patients with higher Med Diet adherence had better anthropometric profiles and serum levels of cardiovascular risk and inflammatory markers. The Med Diet group ate nutritionally balanced meals that contain olive oil, fruits, vegetables, legumes, fish, and nuts, as well as abstaining from red meats, meat products, sugary foods, and pastries. And this method could lower overall disease activity. Clinically, this Med Diet style can help the disease state by changes in the immune system, inflammatory markers, and other cardiovascular risk factors. Med Diet is not only ameliorating SLE activity but also downregulating cardiovascular risk factors. Therefore this can be used as combinational therapy with medication to improve the disease.

Pocovi-Gerardino G, Correa-Rodríguez M, Callejas-Rubio JL, Ríos-Fernández R, Martín-Amada M, Cruz-Caparros MG, Rueda-Medina B, Ortego-Centeno N. Beneficial effect of Mediterranean diet on disease activity and cardiovascular risk in systemic lupus erythematosus patients: a cross-sectional study. Rheumatology (Oxford). 2021 Jan 5;60(1):160-169. doi: 10.1093/rheumatology/keaa210. PMID: 32594173.

Rhoda Inimgba: Nutrient Composition Comparison betweena Modified Paleolithic Diet for Multiple Sclerosis andthe Recommended Healthy U.S.-Style Eating Pattern.

inimgbamiebi2000 — 2022-02-01 16:46:52 UTC

The purpose of this study was to compare the nutritional intake of the WahlsElim diet and the Dietary Reference Intakes in people with multiple sclerosis. This is important because having a report on the WahlsElim diet and how it supplements the different nutrition missing in people with multiple sclerois will provide them with more dietary guidelines to improve their health.
The paleolithic WahlsElim diet does not include grains and dairy but encourages at least 9 cups of fruits and vegetables and also saturated fat for cooking. The menu also showed low added sugar and glycemic index. A major finding was that the WahlsElim diet met the vitamin E and vitamin D requirement while The US Healthy Eating pattern did not. This relates to nutritional sciences because it shows that this modified paleolithic diet can supplement for the vitamins missing in people with multiple sclerosis though food still needs to be selected carefully to be able to reduce saurated fat and sodium.
Clinically, this study has shown that there are ways that the diet of patients with multiple sclerosis can be modified to supplement for the nutrition they are missing and also provide them with more dietary guidelines to improve their nutrition and overall health. Therefore, combining this diet and mindful watching the food they eat and their medications can improve their health.
Chenard, C., Rubenstein, L., Snetselaar, L., & Wahls, T. (2019). Nutrient composition comparison between a modified paleolithic diet for multiple sclerosis and the recommended healthy u.s.-style eating pattern. Nutrients, 11(3), 537. https://doi.org/10.3390/nu11030537 .

Diet and lupus: what do the patients think?

richardadefioye — 2022-02-01 18:13:10 UTC

For this week's assignment I decided to go with this paper that examined the experiences of lupus erythematosus patients with their diet.

As we learnt in this week's module, there are currently no established dietary regimens for the treatment of Lupus. However, methods such as vitamin D supplementation and the consumption of anti-inflammatory nutrients have been proposed to help.

For this study, the researchers conducted an online survey using a 15-point questionnaire, which attracted 284 lupus patients. The goal of the questionnaire was to get the patient's perspective about dietary choices as it relates to lupus.

The striking results of this study for me was that 76% of the patients said they had never received any sort of dietary advice to manage the condition and 100% of the respondents said that they were willing to change their dietary choices if it would help their symptoms.

For me, I don't find it surprising that the patients received little to no advice regarding a dietary plan for lupus management because a lot of scientifically-proven information is yet unavailable regarding dietary intervention.

This further reiterates the need for more nutritional research targeted at the management of auto-immune diseases like lupus.

Robinson GA, Mcdonnell T, Wincup C, Martin-Gutierrez L, Wilton J, Kalea AZ, Ciurtin C, Pineda-Torra I, Jury EC. Diet and lupus: what do the patients think? Lupus. 2019 May;28(6):755-763. doi: 10.1177/0961203319845473. Epub 2019 Apr 26. PMID: 31027464.

Andrea Ballinger: Effect of nutrient intake on fatigue in MS Patients

2022-02-01 18:32:31 UTC

The above study surveys the role nutrient intake make have on fatigue levels in relapse-remitting MS patients. This is important as chronic fatigue is a common indicator and symptom of MS. If fatigue can be managed with appropriate nutrient supplementation, then this could greatly benefit MS patients.

The present study follows the prevalence rates of MS as the study included 25 male subjects and 76 female subjects. To measure fatigue levels of participants, the study utilized the Modified Fatigue Impact Scale, which measures physical, cognitive, and psychosocial fatigue levels. Dietary intake was measured using a food log and compared to dietary reference intake values. Overall, the study observed a significantly lower dietary intake of magnesium and folate in MS patients which correlated with higher fatigue levels. This is important clinically, as folate plays a large role in neurodegenerative diseases. Low serum and cerebrospinal fluid folate levels can impair brain function, contributing to the cognitive fatigue measured by the MFIS. Additionally, magnesium deficiency can induce inflammatory cytokinesis production. Identifying a folate and magnesium deficiency in MS patients can be clinically useful in the management of symptoms and disease progression.

The role of diet in rheumatoid arthritis

jaidag99 — 2022-02-01 18:35:44 UTC

I decided on this article because a lot of patients are not aware of the most relevant diet they should uphold. The importance of this article is to further challenge clinicians in specifying diets that will aid in importance to their particular patient. A key finding in this research is that the role of obesity and high-fat diets in RA negatively affects the progression of this disease. In almost all western countries it has become the biggest problem that continues to grow. This implies that RA is the most prevalent here in which diet becomes a huge part of preventing exponential growth. Targeting fat loss as well as low-fat diets in individuals will also help with the harsh forthcomings of this disease. It is found that most patients won’t comply with dietary recommendations, however, it is important for clinicians to have multiple ways a patient can realistically incorporate it into their life. This is why education in disease and nutrition to one’s patient is critical for their health.

Skoczyńska, M., & Świerkot, J. (2018). The role of diet in rheumatoid arthritis. Reumatologia, 56(4), 259–267. https://doi.org/10.5114/reum.2018.77979

Sidney Harm: Low-fat plant based diets impacts on Multiple Sclerosis

sidneyharm — 2022-02-01 20:24:37 UTC

This randomized-controlled study looked into a low-fat and plant based diet intervention and the impact on multiple sclerosis symptoms and progression. This was a year long study with 61 participants, separated into a control group and a diet intervention group. Between the two groups there was no observed difference between brain MRI, MS relapses or disability within 12 months from individuals in the control and diet group. It was found that the diet group did have improvements within bio markers such as LDL cholesterol, total cholesterol, insulin and a reduction in BMI.

While there wasn’t a significant difference in brain MRI activity between the two groups, seeing that the diet group had improvements in their labs and in a self reported fatigue scale is a promising sign to diet could have an impact on progression of this disease. If an individual can adhere to a low-fat plant based diet this could improve their quality of life, a larger and longer study should be done to see what the long term effects of good adherence of a low-fat plant based diet has. There could’ve been a possibility that there was not any observed difference between the groups brain MRI’s due to the time frame the study was conducted. I would be interested to see what other diets have been looked at, specifically thinking on how the Mediterranean diet would impact a individual with MS.

Yadav, V., Marracci, G., Kim, E., Spain, R., Cameron, M., Overs, S., Riddehough, A., Li, D. K., McDougall, J., Lovera, J., Murchison, C., & Bourdette, D. (2016). Low-fat, plant-based diet in multiple sclerosis: A randomized controlled trial. Multiple sclerosis and related disorders, 9, 80–90. https://doi.org/10.1016/j.msard.2016.07.001

The Therapeutic Effect of the Ketogenic Diet in Treating Progressive Multiple Sclerosis

tonyeinimgba99 — 2022-02-01 21:10:58 UTC

The purpose of the article was to explore the therapeutic effect of a ketogenic diet in treating progressive multiple sclerosis by possibly improving mitochondrial function. Mitochondrial dysfunction is a critical and common step seen in a lot of neurodegenerative diseases which makes it a viable therapeutic target. The neurodegeneration seen in progressive MS patients was suggested to have a possible correlation with glucose hypometabolism, as a study showed lower glucose uptake in the brain of MS patients in comparison to healthy controls, which creates a potential area for therapy using ketone metabolism to increase energy supply. There were various studies performed in mice that showed that the ketogenic diet had anti-inflammatory effect, increase in mitochondrial biogenesis, as well as other neuroprotective properties. However, a key finding in human studies was an improvement in MS patients with a dysfunctional glucose transporter when on a ketogenic diet. This relates to nutritional sciences as it shows a modification in diet such as switching to a ketogenic diet could have such massive effect on the neurodegenerative aspect of progressive MS and provide a possible therapeutic area to explore for treatment of other neurodegenerative diseases. The clinical implication of the study was to identify an alternative source of fuel that may reduce the rate of neurodegeneration in MS patients.

Storoni, & Plant, G. T. (2015). The Therapeutic Potential of the Ketogenic Diet in Treating Progressive Multiple Sclerosis. Multiple Sclerosis International, 2015, 681289–9. https://doi.org/10.1155/2015/681289

Diet, Gut Microbiota, and Vitamins D + A in Multiple Sclerosis

tccjrr — 2022-02-01 21:21:45 UTC

This review paper compares how the differences in the western and vegetarian diets affect gut microbiome composition and how these bacteria can affect the efficiency of vitamin D in the body. Sites of inflammation are a primary target in MS progression. Reducing low grade inflammation may slow the progression of the disease. The western diet is higher in calories and low in fiber. It is also considered proinflammatory as there is an increase in TNF, IL-6, and IL-17 in the gut which then travels through the body. The presence of these cytokines increases permeability of the gut and blood brain barrier. The gut microflora of those following this diet have reduced microbial diversity. Conversely, the vegetarian diet has more microbial diversity and the gut microbiome releases higher levels of anti-inflammatory molecules.
Despite high levels of sunlight exposure, MS patients may still have low levels of vitamin D. The researchers determined that high levels of supplemental vitamin D in the form of cholecalciferol were needed to increase levels in normal levels. The reason behind this is unclear but may be related to the enzymes that convert vitamin D into its active form or a shortage of available vitamin D receptors (VDR). The western diet leads to an increase in bile salts which are a ligand for VDRs . If these receptors are bound to bile salts, vitamin D is unable to maintain the gut barrier leading to the increased permeability seen. The anti-inflammatory effects seen in the gut are the result of co-activation of the VDR by both vitamins D and A.

Habitual fish intake negatively correlates with prevalence of frailty among patients with rheumatoid arthritis

Ellen_Reusch — 2022-02-02 00:24:43 UTC

Ellen Reusch
To supplement this week's readings, I found this really interesting article about a research study done to evaluate the impact fish consumption has on the frailty of patients diagnosed with rheumatoid arthritis. Frailty is characterized by metabolic imbalances and multisystem dysregulation, which leads to worse health outcomes in geriatric patients. The study focused on 306 female RA patients. They were asked to answer questions based on their dietary habits, and were also assessed for frailty status using the Study of Osteoporotic Fractures (SOF) criteria. Results of this study showed that habitual fish intake was negatively correlated with frailty status - meaning that patients who habitually consumed fish showed less chance of being classified in the frail category. The RA patients consuming fish more than two times a week had lower prevalence of frailty than those who consumed fish less than two times per week. Additional analyses of the data collected for this study showed that five foods (fish, meat, milk, vegetables, and fruit) were inversely correlated with increased frailty (with fish being the most significant). While this study gives limited information related to the mechanism by which fish intake improves frailty status, it does provide evidence that habitual fish intake may be beneficial for patients wishing to slow the progression of frailty due to rheumatoid arthritis. Clinically, this information could be crucial to patients trying to maintain their health and avoid potential comorbidities caused by rheumatoid arthritis. Additionally, this study could lead to improved nutritional counseling guidelines given to patients with inflammatory conditions, as it is well known that nutrition plays a key role in these types of disease states.

Minamino et. al. (2021), Habitual fish intake negatively correlates with prevalence of frailty among patients with rheumatoid arthritis. Nature. Retrieved February 02, 2022, from: https://www.nature.com/articles/s41598-021-84479-0.pdf

Nutritional Recommendations for Patients with Multiple Sclerosis - Kate Mashburn

katecmashburn — 2022-02-02 01:27:04 UTC

https://pubmed.ncbi.nlm.nih.gov/27645350/

There are very few studies researching how diet changes impact symptoms and overall quality of life for patients with multiple sclerosis. However, even with limited research in this area, it has been shown that changes in the diet really do positively impact patients with MS. In this study, a low fat and purely plant-based diet and how that affects symptoms of those living with multiple sclerosis is explored. The specific symptom that is highlighted in this study is fatigue. Once completed, the results showed no improvement in disability or brain MRI. However, BMI and patient’s measures on fatigue significantly improved. It is important to note that the measure of fatigue was self-reported and cannot be scientifically measured. However, any improvements, self-reported or not, is very important for these patients and future patients that are diagnosed with MS. The improvement of BMI can eventually lead to improved vascular health, but a separate, long term study would need to be conducted to conclude that.

Joe Devine: Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations?

2022-02-02 02:41:40 UTC

Rheumatoid Arthritis is classified by its pro-inflammatory cytokines and symmetrical poly arthritis. Certain diets can exasperate this pro-inflammatory response, and one fo those diets is the western diet. The western diet is a calorically excessive diet that is rich in red meat and salts. These dietary choices can Shape the gut microbiota as well as body composition influencing the effects of Rheumatoid Arthritis. One theory presented in this study was that a high oral iron load from increased red meat could lead to the onset of RA symptoms and increased synovial membrane activity, however, they presented a study that showed no significant difference between the two groups intake of red meat. The group that did present with RA symptoms did have lower incidence of eating fish. One interesting hypothesis the researches presented for future studies was a potential synergistic effect of smoking and salt intake that increased Th17 lymphocyte differentiation and enhanced autoimmunity.

Gioia, C., Lucchino, B., Tarsitano, M. G., Iannuccelli, C., & Di Franco, M. (2020). Dietary habits and nutrition in rheumatoid arthritis: Can diet influence disease development and clinical manifestations? Nutrients, 12(5), 1456. https://doi.org/10.3390/nu12051456

Epigenetic regulation by diet in SLE

2022-02-02 02:58:47 UTC

--Ivana Djuricic--

Montoya, T., Castejón, M., Muñoz-García, R., & Alarcón-de-la-Lastra, C. (2021). Epigenetic linkage of systemic lupus erythematosus and nutrition. Nutrition Research Reviews, 1-21. doi:10.1017/S0954422421000287

I thought this review was important and interesting because a lot of the time we look for nutritional plans that will alleviate the symptoms of a disease in a big picture approach, but I haven’t really given thought to how nutrients have the ability to epigenetically effect the prevalence and severity of diseases on a smaller, molecular scale. It was interesting how this review approached lupus and nutrition, although it does note that further clinical studies about dietary bioactive compounds are needed for SLE because they have been mostly studied in cancer thus far, it did bring up interesting correlations between epigenetic changes caused by some nutrients and decreases in transcription of genes responsible for downstream inflammatory mediators.

One key finding is that I enjoyed reading about was an animal and subsequent clinical study on curcumin (a polyphenol in turmeric). In the animal studies, a diet supplemented with curcumin improved renal damage and was able to control autoantibody and cytokine production at the onset of lupus. In the clinical trial, a curcumin supplemented diet or curcumin treated T cells from SLE patients regulated the Th17 vs Treg balance of the CD4+ T cells (Th17 will cause a proinflammatory immune response while Tregs work to dampen the immune response against our own cells). Curcumin is known to decrease HAT activity (HAT enzymes work in the process of histone acetylation by transferring an acetyl group to lysine residue on the N terminal tail) in an IL6 promoter and this decrease in activity inhibits the release of IL6 and TNFa (pro-inflammatory cytokines). The study on curcumin also found that daily intake decreases miR21 (miRNAs regulate 60% of mRNA and this is one that is overexpressed in CD4 T cells in SLE patients as compared to controls and correlated to disease activity) and miR155 (regulates B cell activation and survival) levels.

I think this highlights the importance of micronutrients when making a diet plan for SLE patients and makes me realize how powerful our nutrition can be for health. The things we eat can impact and change our genes to make us more or less susceptible to autoimmune disease on a genetic level, which is not something that I realized about nutritional science before this paper.

Clinically, we should look into dietary changes for the SLE patients to see if/how symptoms improve to any degree. Curcumin is just one nutrient listed in this review, so taken together with others mentioned, it is feasible that the addition of certain micronutrients in their diets, based on current data, would improve clinical outcomes for SLE patients. Although as the review mentioned, there is more work that needs to be done to specifically study the effects of these micronutrients on the course of SLE.

Immune response to SARS-CoV2 vaccines in multiple sclerosis and healthy controls

smayer2247 — 2022-02-02 03:51:06 UTC

These past two years have been scary for many around the world and many are left wondering DO I EVEN HAVE THE ANTIBODIES, well the answer is yes, yes you do! After waiting hopelessly for months with no end in sight during the start of 2020, the COVID-19 vaccine was released and many became hopeful. Those who were less hopeful were those living with auto-immune diseases or those who take immunosuppressants for many different reasons. Personally, I was worried for my mother who lives with Multiple Sclerosis because vaccine protection was a major question for her.

I present this article today to highlight good news on the COVID-19 vaccine and those living with MS. Compared to 97.4% in Healthy Control, seroconversion occurred in 96.7% (88/91) untreated pwMS, 97.1% (135/139) on immunomodulatory (IM-DMT) and 61.1% (138/226, p<0.001) on immunosuppressive DMT (IS-DMT). These results were determined by quantitating SARS-CoV-2-IgG response 3 months post-injection of the initial COVID-19 vaccine. Notice a decrease in response on those who take immunosuppressants (duh, we expect this because the vaccine needs a comprehensive immune response). Still a 61% seroconversion is still good enough and much better than 0! This is great news as we continue researching and understanding immune response and how COVID-19 affects us.

Bsteh, G., Hegen, H., Traxler, G., Krajnc, N., Leutmezer, F., Di Pauli, F., Kornek, B., Rommer, P., Zulehner, G., Dürauer, S., Bauer, A., Kratzwald, S., Klotz, S., Winklehner, M., Deisenhammer, F., Guger, M., Höftberger, R., & Berger, T. (2022). Comparing humoral immune response to SARS-CoV2 vaccines in multiple sclerosis and healthy controls: an Austrian prospective multi-center cohort study. European journal of neurology, 10.1111/ene.15265. Advance online publication. https://doi.org/10.1111/ene.15265

Seafood, fatty acid biosynthesis genes, and multiple sclerosis susceptibility.

clwi230 — 2022-02-02 04:28:54 UTC

Clarisa Williams:

Langer-Gould, A., Black, L. J., Waubant, E., Smith, J. B., Wu, J., Gonzales, E. G., Shao, X., Koebnick, C., Lucas, R. M., Xiang, A., & Barcellos, L. F. (2020). Seafood, fatty acid biosynthesis genes, and multiple sclerosis susceptibility. Multiple Sclerosis Journal, 26(12), 1476–1485.

This week I chose gather more information regarding the consumption of Omega-3 as it relates to Multiple Sclerosis. There have been several implications towards a healthier and overall improvement in quality of life for those who consume a Mediterranean diet for individuals with Multiple Sclerosis. This analysis was conducted to determine the impact of changing a modifiable risk factor on the risk of Multiple Sclerosis. Including a higher fish or omega-3 consumption. There are health benefits to increasing the consumption of omega 3 through a greater intake in seafood and fish. Individuals that consumed fish or seafood at least once a week were associated with 44% lower odds of Multiple Sclerosis compared to those that did not consume fish oil, seafood, or fish. Omega-3 consumption is associated with lower risk of metabolic syndrome. Omega-3s are present in foods we regularly have access to. Drawing a connection between omega-3s and Multiple Sclerosis can provide a clearer explanation to supporting a diet such as the Mediterranean diet. This study found that a diet rich in fish or seafood can reduce the risk of developing Multiple Sclerosis. Making adaptations and adjustments to the diets of those who are at a higher risk of developing Multiple Sclerosis can serve as preventative care and treatment.

Dierra Doaks: Pediatric Lupus in South Africa

2022-02-02 04:30:28 UTC

In the reading on Lupus etiology for this week, I remember reading that patients with systemic lupus erythematosus (SLE) of non-Caucasian and African American descent with early disease onset have the poorest long-term prognosis. I decided to research more about patients outside of the U.S and found an article on pediatric lupus in South Africa. SLE is more common and severe in people of African descent than in Caucasians in North America and Europe. However, this article explains that the epidemiology of SLE in Africa is still unknown. Recent studies have shown that the incidence levels of SLE may be higher in Africa than previously thought. Children with SLE usually present with higher SLE activity and can require more therapy than adult-onset patients. Children can also experience more organ damage than adult-onset patients. This research article included the first registry of high risk pediatric SLE patients in South Africa to solve the lack of research for this population. They conducted a cross sectional analysis of 72 patients. The cohort study concluded that the children presented with high disease activity and progress to end organ damage at higher rates than pediatric SLE cohort studies completed in North America.

Dierra Doaks

Lewandowski, Laura Beth. “Pediatric Lupus in South Africa.” ProQuest Dissertations Publishing, 2015. Print.