Nutritional Interventions and Inflammatory Modulation in Autoimmune Diseases: A Narrative Review

Abstract

Autoimmune diseases arise from the interaction between genetic susceptibility, environmental exposures, and loss of self-tolerance, involving chronic inflammation, oxidative stress, and impaired intestinal barrier function. This narrative review examined dietary patterns, nutrients, bioactive compounds, and microbiota-targeted interventions as adjuncts in rheumatoid arthritis, systemic lupus erythematosus, multiple sclerosis, ulcerative colitis, and Hashimoto thyroiditis. PubMed/MEDLINE and the Cochrane Library were searched, prioritizing systematic reviews, meta-analyses, and clinical trials published from 2021 to September 2026, together with relevant seminal studies. The most consistent evidence supports nutrient-dense dietary patterns, particularly the Mediterranean pattern, as adjunctive strategies to improve diet quality and selected clinical and inflammatory outcomes. Potential benefits have also been reported for unsaturated fatty acids, prebiotic fibers, strain-specific probiotics, and some bioactive compounds, although findings remain heterogeneous and disease-, intervention-, and nutritional-status dependent. Exclusion diets, supplements, and restrictive metabolic strategies should not be generalized. Nutritional care should therefore be individualized, integrated with medical therapy, and centered on overall diet quality, adequate energy and protein intake, and correction of documented deficiencies [1-5].