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Dietary Considerations in Myositis

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Managing Myositis

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Abstract

Diet has long been known to have a crucial impact on human health and diseases. Much of the research in dietary influence on rheumatic diseases was done in systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Little is known in the field of inflammatory myopathy. In this chapter, we review the impact of gluten, vitamin D, creatine, protein-rich diets, retinoid acid, dietary statin, anti-inflammatory diets, and the gut microbiome in the development and management of myositis. Overall, there are few studies and low patient numbers, but an increased incidence of celiac disease in idiopathic inflammatory myositis (IIM) including inclusion body myositis (IBM) was noted even though treatment with a gluten-free diet alone led to no improvement. Low serum vitamin D levels were reported in one Swedish myositis cohort, but no data to support vitamin D supplementation beyond osteoporosis prevention was identified. Creatine supplementation as an adjunctive therapy in myositis in two small randomized trials yielded conflicting results. Results of protein supplementation in patients with muscular deconditioning or muscle diseases are also disappointing. The use of retinoids, as a vitamin A derivative, was limited due to lack of efficacy and side effects in rheumatic diseases. In patients with immune-mediated necrotizing myopathy, one should inquire about the use of red yeast rice, oyster mushroom, soy products, and various grains which can be a source of statin. Although there is no definitive evidence of dysbiosis or an imbalance in the gut microbiome in myositis, a Mediterranean diet may be considered given its well-documented cardiovascular benefit. At present, no particular diet or nutritional supplementations can be endorsed in the management of myositis.

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Authors and Affiliations

  1. Division of Rheumatology, University of British Columbia, Vancouver, BC, Canada

    Kun Huang

  2. Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA

    Rohit Aggarwal

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  1. Kun Huang
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  1. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Rohit Aggarwal

  2. Division of Rheumatology and Clinical Immunology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA

    Chester V. Oddis

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Huang, K., Aggarwal, R. (2020). Dietary Considerations in Myositis. In: Aggarwal, R., Oddis, C. (eds) Managing Myositis. Springer, Cham. https://doi.org/10.1007/978-3-030-15820-0_34

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