On the question of nutrition of children with rheumatic diseases





diet, children, rheumatic diseases


The article presents data from recent studies on the influence of active components of food and diet on the course of rheumatic diseases, it was discussed the main current recommendations for patient nutrition.

It has been shown that nutrition does not have a proven direct effect on the course of rheumatic diseases in children, which is why without standardized drug therapy can not prescribe any diet, but by increasing the variety of foods and their overall harmonization, the doctor's recommended diet reduce the manifestations of comorbid conditions or side effects of treatment. In children with rheumatic pathology who have lesions of the visceral organs (heart, liver, kidneys), the diet should be used in accordance with the guidelines for the treatment of relevant pathological conditions. Similarly, only patients with a proven deficiency of vitamins (including vitamin D) should be prescribed the necessary drugs in accordance with the relevant guidelines. In the case of a combination of such disorders, it is advisable to individualize the diet with the involvement of a professional nutritionist. Pediatric patients with rheumatic diseases and their parents should be informed by a physician about the importance of a healthy diet that meets the age requirements and includes a variety of foods high in grains, fruits and vegetables, low in saturated fat, moderate in sugar, but complete removal of any -what foods from the diet is impractical.

No conflict of interests was declared by the authors.


Alghadir AH, Gabr SA, Al-Eisa ES. (2016). Green tea and exercise interventions as nondrug remedies in geriatric patients with rheumatoid arthritis. J Phys Ther Sci. 28 (10): 2820-2829. https://doi.org/10.1589/jpts.28.2820; PMid:27821943 PMCid:PMC5088134

Alunno A, Nikiphorou Е, Philippou Е, Daien С. (2020). Nutrition in RMDs: is it really food for thought? Focus on rheumatoid arthritis. BMC Rheumatology. 4: 10. https://doi.org/10.1186/s41927-020-0113-4; PMid:32175525 PMCid:PMC7063796

Bruzzese V, Scolieri P, Pepe J. (2021). Efficacy of gluten-free diet in patients with rheumatoid arthritis. Reumatismo. 18; 72 (4): 213-217. https://doi.org/10.4081/reumatismo.2020.1296; PMid:33677948

Caizhen Li, Li Zhu, Yinming Dai et al. (2022). Diet-Induced High Serum Levels of Trimethylamine-N-oxide Enhance the Cellular Inflammatory Response without Exacerbating Acute Intracerebral Hemorrhage Injury in Mice. Oxidative Medicine and Cellular Longevity: 16. Article ID 1599747. https://doi.org/10.1155/2022/1599747; PMid:35242275 PMCid:PMC8886754

Carlberg C. (2014). The physiology of vitamin D-far more than calcium and bone. Front Physiol. 5: 335. https://doi.org/10.3389/fphys.2014.00335

Cerk B, Panush RS. (2021). Food, Diet, Nutrition & Rheumatic Diseases-Are They Really Related? By MD. URL: https://www.the-rheumatologist.org/article/food-diet-nutrition-rheumatic-diseases-are-they-really-related/?singlepage=1.

Charoenngam N. (2021). Vitamin D and Rheumatic Diseases: A Review of Clinical Evidence. Int J Mol Sci. 22 (19): 10659. https://doi.org/10.3390/ijms221910659; PMid:34639000 PMCid:PMC8508879

Daiena C, Czernichowc S, Letarouilly JG et al. (2022). Dietary recommendations of the French Society for Rheumatology for patients with chronic inflammatory rheumatic diseases. Joint Bone Spine. 89: 105319. https://doi.org/10.1016/j.jbspin.2021.105319; PMid:34902577

Duffy EM et al. (2004). The clinical effect of dietary supplementation with omega-3 fish oils and/or copper in systemic lupus erythematosus. J Rheumatol. 31 (8): 1551-6.12.

Forsyth C, Kouvari M, Cunha NMD. (2018). SYSTEMATIC REVIEW The effects of the Mediterranean diet on rheumatoid arthritis prevention and treatment: a systematic review of human prospective studies. Rheumatology International. https://doi.org/10.1007/s00296-017-3912-1; PMid:29256100

Gioia C, Lucchino B, Tarsitano MG et al. (2020). Dietary Habits and Nutrition in Rheumatoid Arthritis: Can Diet Influence Disease Development and Clinical Manifestations? Arthritis and Nutrition: Can Food Be Medicine? 12 (5): 1456. https://doi.org/10.3390/nu12051456; PMid:32443535 PMCid:PMC7284442

Hahn BH, Grossman J, Chen W, McMahon M. (2007). The pathogenesis of atherosclerosis in autoimmune rheumatic diseases: roles of inflammation and dyslipidemia. J Autoimmun. 28 (2,3): 69-75. https://doi.org/10.1016/j.jaut.2007.02.004; PMid:17433865

Haugen M, Kjeldsen-Kragh J, Nordvåg BY, Førre O. (1991). Diet and disease symptoms in rheumatic diseases - results of a questionnaire based survey Clin Rheumatol. 10 (4): 401-407. https://doi.org/10.1007/BF02206660; PMid:1802495

Holick MF, Binkley NC, Bischoff-Ferrari HA et al. (2011). Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism. 96 (7): 1911-1930. https://doi.org/10.1210/jc.2011-0385; PMid:21646368

Jiayang Jin, Jing Li, Yuzhou Gan et al. (2021). Red meat intake is associated with early onset of rheumatoid arthritis: a cross-sectional study. Sci Rep. 11: 5681. https://doi.org/10.1038/s41598-021-85035-6; PMid:33707573 PMCid:PMC7952581

Khanna S, Jaiswal KS, Gupta B. (2017). Managing Rheumatoid Arthritis with Dietary Interventions. Front Nutr. https://doi.org/10.3389/fnut.2017.00052; PMid:29167795 PMCid:PMC5682732

Kvashninа LV. (2016). Alimentary deficiency of calcium in children and approaches to its correction. Sovremennaya pediatriya. 7(79): 26-32. https://doi.org/10.15574/SP.2016.79.26

Land MH, Rouster-Stevens K, Woods CR et al. (2005). Lactobacillus sepsis associated with probiotic therapy. Pediatrics Jan. 115 (1): 178-181. https://doi.org/10.1542/peds.2004-2137; PMid:15629999

Moonesinghe H, Mackenzie H, Venter C et al. (2016). Prevalence of fish and shellfish allergy: A systematic review. Ann Allergy Asthma Immunol. 117 (3): 264-272.e4. https://doi.org/10.1016/j.anai.2016.07.015; PMid:27613460

Nguyen Y, Salliot C, Gelot A et al. (2021). Mediterranean Diet and Risk of Rheumatoid Arthritis: Findings From the French E3N-EPIC Cohort Study Artritis and Rheumathology. 73 (1): 69-77. https://doi.org/10.1002/art.41487; PMid:32909390

Panush RS. (1991). Does food cause or cure arthritis? Rheum Dis Clin North Am. 17 (2): 259-272. https://doi.org/10.1016/S0889-857X(21)00569-X

Patterson SL et al. (2019). Obesity is Independently Associated With Worse Patient-Reported Outcomes in Women with Systemic Lupus Erythematosus. Arthritis Care Res (Hoboken). 71 (1): 126-133. https://doi.org/10.1002/acr.23576; PMid:29740985 PMCid:PMC6222022

Petersson S, Philippou E, Rodomar C et al. (2018). The Mediterranean diet, fish oil supplements and rheumatoid arthritis outcomes: Evidence from clinical trials. Autoimmun Rev. 17 (11): 1105-1114. https://doi.org/10.1016/j.autrev.2018.06.007; PMid:30213690

Proudman SM, James MJ, Spargo LD et al. (2015). Fish oil in recent onset rheumatoid arthritis: A randomised, double-blind controlled trial within algorithm-based drug use. Ann Rheum Dis. 74 (1): 89-95. https://doi.org/10.1136/annrheumdis-2013-204145; PMid:24081439

Ramadan G, El-Beih NM, Talaat RM, Abd El-Ghffar EA. (2017). Anti-inflammatory activity of green versus black tea aqueous extract in a rat model of human rheumatoid arthritis. Int J Rheum dis. 20 (2): 203-213. https://doi.org/10.1111/1756-185X.12666; PMid:25964045

Shilin DE. (2010). Vitamin-gormon D v klinike XXI veka: pleyotropnyie effektyi i laboratornaya otsenka. Klin. lab. diagnostika. 12: 17-23.

Skwldstam L, Hagfors L, Johansson G. (2003). An experimental study of a Mediterranean diet intervention for patients with rheumatoid arthritis. Ann Rheum Dis. 62 (3): 208-214. https://doi.org/10.1136/ard.62.3.208; PMid:12594104 PMCid:PMC1754463

Smallwood MJ, Nissim A, Knight AR et al. (2018). Oxidative stress in autoimmune rheumatic diseases Free Radical Biology and Medicine. 125: 3-14. https://doi.org/10.1016/j.freeradbiomed.2018.05.086; PMid:29859343

Smith EMD, Foster HE, Beresford MW. (2013). Adding to complexity: comorbidity in paediatric rheumatic disease. Rheumatology. 52 (1): 22-33. https://doi.org/10.1093/rheumatology/kes256; PMid:23024018

Tedeschi SK, Frits M, Cui J et al. (2017). Diet and rheumatoid arthritis symptoms: Survey results from a rheumatoid arthritis registry. Arthritis Care Res (Hoboken). 69 (12): 1920-1925. https://doi.org/10.1002/acr.23225; PMid:28217907 PMCid:PMC5563270

Teh P, Zakhary B, Sandhu VK. (2019). The impact of obesity on SLE disease activity: findings from the Southern California Lupus Registry (SCOLR). Clin Rheumatol. 38 (2): 597-600. https://doi.org/10.1007/s10067-018-4336-3; PMid:30357495

Vitales-Noyola M, Layseca-Espinosa E, Baranda L et al. (2018). Analysis of Sodium Chloride Intake and Treg/Th17 Lymphocytes in Healthy Individuals and Patients with Rheumatoid Arthritis or Systemic Lupus Erythematosus. Journal of Immunology Research. 11. https://doi.org/10.1155/2018/9627806; PMid:30116758 PMCid:PMC6079571

Voronkov LG, Nasonova TI. (2018). Klinicheskie proyavleniya ateroskleroza v razlichnyih sosudistyih basseynah i ih lechenie. Zdorov'ya UkraYini. 4 (59): 8-9.

Wright SA et al. (2008). A randomised interventional trial of omega-3-polyunsaturated fatty acids on endothelial function and disease activity in systemic lupus erythematosus. Ann Rheum Dis. 67 (6): 841-848. https://doi.org/10.1136/ard.2007.077156; PMid:17875549