Nutritional recommendations for patients undergoing prolonged glucocorticoid therapy

Area of Science:

• Rheumatology
• Immunology
• Nutrition Science

Background:

• Glucocorticoids (GCs) are vital for managing rheumatic and autoimmune diseases due to their anti-inflammatory and immunosuppressive properties.
• However, GC therapy is associated with significant adverse effects, including myopathy, bone loss, hypertension, metabolic dysfunction, and increased visceral fat.
• These side effects can negatively impact patient quality of life and treatment adherence.

Purpose of the Study:

• To review existing evidence on the adverse effects of Glucocorticoid (GC) therapy.
• To provide evidence-based nutritional recommendations for ameliorating GC-induced side effects.
• To identify gaps in current research regarding nutritional interventions in patients on GC therapy.

Main Methods:

• Systematic review of available literature on Glucocorticoid (GC) therapy and its associated adverse effects.
• Analysis of nutritional factors that may influence or counteract these adverse effects.
• Synthesis of findings to formulate practical nutritional recommendations.

Main Results:

• Glucocorticoid (GC) therapy is linked to muscle and bone loss, hypertension, metabolic disturbances, and increased visceral adiposity.
• Optimizing intake of calcium, vitamin D, sodium, and protein is recommended.
• Reducing consumption of ultra-processed foods and increasing intake of unprocessed foods may help counteract adverse effects.

Conclusions:

• Nutritional interventions, focusing on specific micronutrients and food processing levels, show theoretical promise in managing Glucocorticoid (GC) therapy side effects.
• There is a significant lack of empirical data to support the clinical efficacy of these nutritional recommendations.
• Further research is crucial to validate the therapeutic benefits of nutritional strategies in patients undergoing Glucocorticoid (GC) treatment.