title: Healthy lifestyle habits for patients with systemic lupus erythematosus: A systemic review.
abstract: OBJECTIVE
  To assess the effects of lifestyle habits on the disease activity and damage, the occurrence of flares and quality of life of people with systemic lupus erythematosus (SLE).
  
  
  METHODS
  A systematic literature review was performed. MEDLINE, EMBASE, and SCI/SSCI were searched. Experimental and observational studies evaluating the effect of lifestyles for SLE patients were included. Two independent reviewers selected studies and extracted relevant data. Critical appraisal of the studies was assessed following SIGN criteria.
  
  
  RESULTS
  Eligibility criteria were met by 21 studies, five analyzed the effect of tobacco consumption, nine the effect of physical exercise and seven the effect of diet. Three studies on tobacco observed an association with increased SLE activity and the onset of cutaneous damage. The studies on physical exercise, of heterogeneous quality, reported that aerobic activity is safe for SLE patients, leading to an increase of tolerance to exercise, physical and functional capacity for those with moderate or low activity. A reduction in fatigue, anxiety and depression, as well as improved quality of life, is also suggested though evidence for these outcomes is limited. Better-quality studies on diet analyzed the effect of polyunsaturated fatty acids on disease activity. Three of the four randomized placebo-controlled trials revealed a positive effect both on overall SLE indices and individual symptoms that affect patients.
  
  
  CONCLUSIONS
  Tobacco smoking increases the risk of skin damage and disease activity in patients with SLE. A diet rich in polyunsaturated fatty acids, avoiding a sedentary lifestyle and supervised exercise should be recommended for patients with stable SLE.
authors.affiliation: Intensive Care Unit, Hospital Universitario de La Princesa, Madrid, Spain.
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Rodríguez Huerta
authors.affiliation: Canary Island Foundation for Health Research (FUNCANIS), Canary Islands, Spain; Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain; Centre for Biomedical Research of Canary Islands (CIBICAN), University of La Laguna, La Laguna, Tenerife, Spain. Electronic address: mar.trujillomartin@sescs.es.
authors.forename: Maria M
authors.initials: MM
authors.lastname: Trujillo-Martín
authors.affiliation: Department of Rheumatology, Hospital Universitario Doctor Negrín, Las Palmas de Gran Canaria, Spain.
authors.forename: Íñigo
authors.initials: Í
authors.lastname: Rúa-Figueroa
authors.affiliation: Canary Island Foundation for Health Research (FUNCANIS), Canary Islands, Spain.
authors.forename: Leticia
authors.initials: L
authors.lastname: Cuellar-Pompa
authors.affiliation: Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain; Department of Internal Medicine, Hospital Costa del Sol, Marbella, Spain.
authors.forename: Raúl
authors.initials: R
authors.lastname: Quirós-López
authors.affiliation: Spanish Network of Health Services Research for Chronic Diseases (REDISSEC), Madrid, Spain; Centre for Biomedical Research of Canary Islands (CIBICAN), University of La Laguna, La Laguna, Tenerife, Spain; Evaluation Service of the Canary Islands Health Service (SESCS), Santa Cruz de Tenerife, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Serrano-Aguilar
mesh_terms: D015444:Exercise; D006184:Habits; D015438:Health Behavior; D000070497:Healthy Lifestyle; D006801:Humans; D008180:Lupus Erythematosus, Systemic / Q000523:psychology*; D011788:Quality of Life
keywords: Diet; Healthy lifestyle; Physical activity; Smoking; Systematic review; Systemic lupus erythematosus