Exploring Dietary Insights and Lifestyle Choices in Egyptian Patients with Autoimmune Arthritis: A Closer Look from The Egyptian Journal of Internal Medicine

The diet can either elevate the likelihood of illness or serve as a preventive approach, influenced by specific food items. Certain eating patterns, such as the consumption of dairy and red meats, can provoke inflammatory responses. On the other hand, the inclusion of fruits, oily fish, and certain oils can mitigate inflammation. Substantial evidence supports the association between physical activity and disease progression, as documented by EULAR 2018, which established recommendations for lifestyle in the context of RMDs, underlining the impact of lifestyle choices on disease advancement. Hence, we aimed to evaluate the understanding of autoimmune arthritis patients regarding the influence of dietary and lifestyle practices on their symptoms and disease trajectory [21,22,23].

The primary findings indicated that the majority of our participants were female, with over half diagnosed with RA. This concurs with the findings of El-dadamony et al., who investigated the nutritional and lifestyle habits of RA patients and observed that 64.7% of their participants were female [24]. Moreover, Amon et al., reported that 65.5% of their subjects were female [25]. Pham et al., demonstrated that most of the patients were female, with 60% having RA, concluding that patients place significant importance on nutrition within their disease management strategies [26].

Vitamin D plays a critical role in immune modulation, exhibiting anti-inflammatory properties. A deficiency in vitamin D may be linked to numerous autoimmune conditions [27]. Regrettably, more than half of the participants did not receive calcium and vitamin D supplements.

Whole grains, including whole wheat, are abundant in carbohydrates and dietary fiber. As plant-based foods, they also incorporate anti-inflammatory phytochemicals. The fiber content in these foods may produce similar anti-inflammatory effects, acting as a prebiotic that could help alleviate inflammation. Furthermore, green tea is rich in a spectrum of phytochemicals and antioxidants that may provide anti-inflammatory advantages. Probiotics, which are beneficial bacteria, assist in managing inflammation [28,29,30]. The present study reflected limited awareness among the subjects concerning the advantages of consuming whole grain bread, created from a blend of white and brown flour, bran, and yeast [31], whole grains, sesame, spices, gut microbiota, and enjoying green tea relative to their symptoms.

The intake of various dairy products has been associated with elevated inflammation levels due to their saturated fat content [32, 33]. Nonetheless, participants in this study displayed little understanding regarding these facts. Polyunsaturated oils, such as fish oil and different vegetable oils (especially those high in omega-3), exhibit anti-inflammatory and anti-arteriosclerotic characteristics. Numerous studies have identified a notable trend emphasizing the protective effects of fish, particularly those rich in omega-3 fatty acids [34]. Strikingly, the patients evaluated had a strong understanding of the advantages of consuming omega-3 fish and poultry.

Hatami et al., emphasized the detrimental impacts of red meat and its connection to the advancement of certain rheumatic illnesses. Fortunately, our participants demonstrated a moderately high awareness of these negative effects [35]. The consumption of fresh vegetables and fruits is associated with a reduced risk of inflammation [36], and it is noteworthy that most of our patients were well-informed about these facts.

EULAR strongly recommends regular physical activity for rheumatic patients, as it enhances muscle strength and alleviates discomfort [23]. Our results suggest that participants exhibited moderate awareness regarding the significance of physical exercise.

Physical activity and uninterrupted sleep for 8 hours can bring about changes in gut microbiome composition, yielding advantageous effects on energy homeostasis and regulatory mechanisms. Conversely, excessive antibiotic use may negatively impact microbiota, which is crucial for reducing inflammation [37,38,39]. Regrettably, the patients studied demonstrated limited understanding of these lifestyle choices.

Individuals from rural areas and those who were unemployed displayed substantially less knowledge compared to their urban counterparts and those who were employed. This might be linked to the relatively high illiteracy rate in Egypt, which was recorded as 25.8% in 2017, as reported by the Central Agency for Public Mobilization and Statistics. To compensate for this, we did not rely exclusively on online forms; instead, the printed questionnaires were explained to them by either the physician or their relatives [40].