An Overview of Systematic Reviews on Dietary Interventions for Chronic Fatigue in Diagnosed Rheumatological Diseases

Student Researcher:
David Antle

Supervisor / Principle Investigator:
Dr. David Antle

Additional Authors:
Gustaaf van Laar, MD
Lydia Thorne, PhD
Elaine Yacyshyn, MD, MSc
Jan Willem Cohen Tervaert, PhD-MD

MD Class of 2020


Many patients who suffer from rheumatic diseases also report experiencing chronic fatigue symptoms. To explain these associations, research has detailed intricate interplay between the immune system, inflammatory processes, and chronic fatigue syndrome. Evidence suggests that T-cell signaling and cytokine levels that influence fatigue may remain active even with disease modifying therapy. Therefore, adapting T-cell signaling may be an effective therapy. One such method to do this might involve changes in the gut flora through dietary changes. The objective of the present paper is to explore the potential impact that diet has on reducing chronic fatigue syndrome in rheumatologic diseases. An electronic literature search was conducted in Medline (Ovid), EMBASE (Ovid), and the Cochrane Library. The search strategies and study selection are outlined in the full poster. To date, 6 total systematic reviews met the inclusion criteria and have been reviewed. From data extracted from the available reviews, it is suggested that raw vegan and vegetarian diets might hold the greatest potential for positive impact on reducing symptoms. For patients, a diet that has a plant-based content and avoids processed foods, oils and sweeteners may be of benefit. Vitamin D supplementation was covered in one low quality review, that included 5 primary studies. There was no reported impact of vitamin D supplementation on fatigue in this review, but a better assessment of the primary studies using a better methodological approach to a systematic review is required before any conclusions on this intervention can be drawn. Omega 3 fatty acid supplementation was covered in 2 reviews that were rated as having moderate quality and included a total of 3 primary studies. As with the other interventions, the low number of primary studies would suggest that more research is required before drawing a final conclusion on effectiveness.