Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease estimated to affect 5 million people worldwide, with a prevalence of 210 cases per 100,000 inhabitants in Spain, according to the Spanish Society of Internal Medicine. 

The cause of SLE remains unknown, and no curative treatment is available. However, structured self-care, consistent medication adherence, and healthy lifestyle habits help reduce disease activity and long-term complications.

Disease Overview

Rheumatology specialists emphasized that “sun protection, infection prevention, smoking cessation, a Mediterranean-style diet, weight control, and both aerobic and resistance exercise support better disease stability.”

Speaking with Univadis Spain, part of the Medscape Professional Network, is Natalia Mena-Vázquez, PhD, from the UGC de Reumatología, Hospital Regional Universitario de Málaga, and Instituto de Investigación Biomédica de Málaga, Málaga, Spain.

“In the joints [SLE] can cause joint pain or, in some cases, inflammation. Environmental factors may trigger disease activity but can also improve disease progression and treatment response. For all these reasons — both as potential triggers and as modifiers of disease course — an appropriate lifestyle is essential.”

She noted, “Self-care includes skin care, photoprotection, infection prevention, and regular physical activity.”

Practical Measures

Eating a balanced diet, protecting oneself from the sun, exercising, and adhering to medical treatment are key to managing the disease. 

“Adherence to treatment and correct medication management are very important. Many patients who do poorly sometimes take medication incorrectly. That is why we monitor adherence with surveys and nursing consultations, and during medical visits, we ask extensively about treatment intake, stressing that it must be done correctly,” said Mena-Vázquez.

The prevention of infection is another important measure. “We recommend that patients keep vaccinations up to date to avoid infections. When attending crowded places where there is a risk for contagion, such as a hospital emergency department, they should wear a mask,” she said.

Daily broad-spectrum sunscreen with sun protection factor 50 is recommended. “In summer, patients should use hats and avoid the hours of strongest sunlight to prevent flares.” Smoking should be avoided because “tobacco triggers autoimmune disease and increases disease activity.”

Diet and Exercise

“The Mediterranean diet has been shown to improve disease control. A varied diet rich in fruits, vegetables, whole grains, fish, and lean proteins is recommended, while limiting ultraprocessed foods, sugars, and saturated fats, and maintaining good hydration. It is also important to avoid overweight and obesity because cardiovascular risk factors and the risk for cardiovascular disease are increased in these patients,” Mena-Vázquez said.

Physical activity is a core therapeutic strategy. “Physical exercise is fundamental,” stated Mena-Vázquez. “We recommend aerobic exercise, which mainly improves cardiovascular health because patients with autoimmune and inflammatory diseases have an increased risk for cardiovascular disease, and resistance exercises, which improve muscle condition, sarcopenia, and osteoporosis.”

Bone Health

Individuals with SLE have an increased risk for fractures due to impairments in bone quality and the effects of corticosteroid use, which reduce bone mass quality and quantity over time. “These patients may sustain fractures even with normal bone density because their bone quality is impaired. Resistance exercises aim to prevent this type of damage,” Mena-Vázquez said.

The recommended activities include brisk walking, tai chi, Pilates, and swimming. “High-impact sports are generally avoided to reduce trauma and joint damage. Exercises that are individual and low in contact are preferable,” she noted.

Mena-Vázquez reported having no relevant conflicts of interest.

This story was translated from Univadis Spain.