Nutritional support in patients with systemic sclerosis

Reumatol Clin. 2014 Sep-Oct;10(5):283-7. doi: 10.1016/j.reuma.2013.12.011. Epub 2014 Mar 4.


Systemic sclerosis (SSc) is a chronic multisystem autoimmune disease which involves the gastrointestinal tract in about 90% of cases. It may contribute to nutritional deterioration.

Objective: To assess whether the application of a nutritional support protocol to these patients could improve their nutritional status and quality of life.

Methods: Single center prospective study, performed on an outpatient basis, in a county hospital. The Malnutrition Universal Screening Tool (MUST) was used to screen risk for malnutrition. Health questionnaire SF-36 and the Hospital Anxiety and Depression Scale were used to assess quality of life and psychopathology respectively. Weight, height, energy and protein requirements, macronutrient intake and nutritional biochemical parameters were evaluated. Nutritional intervention was performed in patients at risk for malnutrition.

Results: Of the 72 patients, 12.5% were at risk for malnutrition. Iron deficiency anemia (18.35%) and vitamin D deficiency (54%) were the most frequently observed nutritional deficits. The questionnaires on psychopathology and quality of life showed a high prevalence of anxiety and depression, and lower level poor quality of life in the physical and mental component. No significant improvements were observed in the weight, food intake, nutritional biochemical parameters, psychopathology and quality of life follow-up.

Conclusions: Dietary intervention was able to maintain body weight and food intake. Iron deficiency anemia and vitamin D deficiency improved with iron and vitamine D supplements. No deterioration was observed in psychological assessment or quality of life. Studies with larger numbers of patients are needed to assess the efficacy of this intervention.

Keywords: Ansiedad; Anxiety; Calidad de vida; Depresión; Depression; Dietic intervention; Déficit de vitamina D; Esclerosis sistémica; Intervención dietética; Malnutrición; Malnutrition; Malnutrition Universal Screening Tool; Nutrición; Nutrition; Nutritional support; Psychological assessment; Quality of life; Soporte nutricional; Systemic sclerosis; Valoración psicológica; Vitamin D deficiency.

Publication types

  • Clinical Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Male
  • Malnutrition / etiology
  • Malnutrition / prevention & control
  • Middle Aged
  • Nutritional Status
  • Nutritional Support*
  • Prospective Studies
  • Quality of Life*
  • Scleroderma, Systemic / complications
  • Scleroderma, Systemic / diet therapy*
  • Surveys and Questionnaires