Traditional and culturally relevant foods with anti-inflammatory potential in systemic lupus erythematosus: A systematic review

Abstract

Introduction: Systemic lupus erythematosus is a chronic autoimmune disease characterised by systemic inflammation and immune dysregulation. While pharmacological treatments are essential, their adverse effects have prompted growing interest in complementary nutritional strategies. This systematic review explored the impact of key nutritional components and dietary interventions on the inflammatory processes in lupus and identified traditional and culturally relevant foods as potential sources of anti-inflammatory nutrients. Methods: A systematic search was conducted in PubMed and Scopus for studies published between 2013 and 2023 to examine the relationship between nutrition and lupus. Outcomes were assessed based on both inflammatory biomarkers and clinical disease activity scores. In addition, traditional and culturally relevant food sources containing these nutrients were identified to support culturally adapted dietary strategies. Results: A total of 25 studies were included: six randomised controlled trials, three nonrandomised trials, and 16 observational studies. Intervention studies examined vitamin D, omega-3 fatty acids, and probiotics on markers such as C-reactive protein, interleukins, and disease activity scores. Observational studies assessed links between dietary quality, micronutrient status, and disease progression. Vitamin D deficiency was prevalent and associated with increased inflammation, while supplementation improved immune function. Omega-3 fatty acids and probiotics showed benefits, although dosage variation limited comparability. Locally available fish and other marine products, leafy greens, nutrient-dense legumes, and traditional fermented foods were recognised as culturally relevant dietary sources of these nutrients. Conclusion: Nutritional interventions demonstrated potential in improving outcomes, but heterogeneity across studies limits firm conclusions. Future culturally adapted trials are needed to validate long-term efficacy.