Leonard H. Calabrese
SCOTTSDALE, Ariz. — Growing evidence suggests that behavioral choices, including avoidance of excess alcohol, drugs and smoking, as well as engaging in exercise and healthy eating could have significant impact on the onset and course of immune-mediated inflammatory diseases, according to a presentation here.
Speaking before the Seventh Annual Basic and Clinical Immunology for the Busy Clinician symposium, Leonard H. Calabrese, DO, vice chairman of rheumatic and immunologic disease at the Cleveland Clinic and chief medical editor of Healio Rheumatology, highlighted that a patient’s own behaviors represent potent influences on their immune and metabolic functions and contribute significantly to overall wellness.
“We believe that if patients with immunologic diseases recognize that their behavior affects their immune system, and that their disease is affected by their immune system, then this can be a personal empowerment message to affect their behavior,” Calabrese said.
He added, “For those of you who practice integrative medicine, there is absolutely nothing that I will tell you here that is a secret—I have no ‘secret sauce’ whatsoever. If you want to discuss healthy diet, healthy exercise and healthy sleep, it is the same message for people with immunologic disease as those who are well.”
Calabrese noted that among the key tenets of wellness — including diet, exercise, healthy sleep and mental-spiritual health — diet continues to be the first, and most difficult, hurdle for patients with IMIDs.
“Immune health begins with lifestyle changes that try to manage the things that we know are bad for us,” Calabrese said. “There is copious evidence that the standard American diet — the high fat of the Western world is pro-inflammatory, and there is some extraordinary evidence in preclinical models that it upregulates the inflammasome metabolism and leads to an increase in inflammatory cytokines.”
In an effort to incorporate wellness behavioral changes into the spectrum of care for patients IMIDs, Calabrese noted that the Cleveland Clinic has incorporated online training and coaching as well as monitoring mobile monitoring of personal behaviors designed to empower patients to make changes to improve their own quality of life.
“At Cleveland Clinic, we have created a 10-week online program called Immune Strength designed for patients with IMIDs,” Calabrese said. “We are very excited about the potential for a program like this among patients. Additionally, with the educational modules provided, we are looking to answer questions about how this program can improve outcomes for patients. Can this type of program improve quality of life for patients with IMIDs? Can it impact immune parameters? Can we identify biologic signature of this?”– by Robert Stott
Calabrese LH. The immunologic basis for wellness: Why personal behavior can affect immune-mediated inflammatory diseases (IMIDs). Presented at: Seventh Annual Basic and Clinical Immunology for the Busy Clinician; February 15-16, 2019; Scottsdale, Ariz.
Disclosure: Calabrese reports he is a consultant for Abbvie, Bristol-Myers Squibb, Genentech, GlaxoSmithKline, Jansen, Pfizer and Sanofi; and is on the speakers bureau for Abbvie, Bristol-Myers Squibb, Crescendo Bioscience and Genentech.