Exercise and Dietary Considerations for People with Systemic Vascular Disorders

Medical Q&A [Moderated]
1

Hey BBM crew, I have a more nuanced question that I can’t find many answers to in regards to training, programming, nutrition and health as it applies to a much smaller population. I have granulomatosis with polyangitis (GPA or wegeners disease, PR-3 type) and am currently being treated for such while also running your low intraset fatigue templates. As the primary etiology is unknown and there is no cure (it is an autoimmune disease) I have a few questions. Also assume no complications from the disease or comorbidities.

  1. Should caffeine intake be limited at all in individuals with this disease due to the vascular nature? (Assume no blood pressure issues.)

  2. Are there any special training considerations outside of the general population? I would imagine better cardio respiratory endurance would be good insurance for a population with these conditions.

  3. Any recommendations in regards to diet and exercise beyond what you would recommend for the general population (meet and/or exceed physical activity guidelines, health promoting dietary pattern, 8 hours of sleep etc)?

Any and all input is helpful as I have yet to find any evidence based information on physical activity and exercise guidelines for younger individuals with this disease as the majority of evidence is focused on the older adult population and associated comorbidities.​

2

Hi there,

Sorry to hear about this. I am quite familiar with this condition, having seen and diagnosed it numerous times as an inpatient physician.

  1. No concerns with caffeine

  2. No specific training considerations. In general, programming should fit a person’s current tolerance/level of fitness, preferences, abilities, limitations, and goals, while ideally working to meet/exceed PA guidelines, which does not change with this diagnosis. Cardiorespiratory fitness is great, but not necessarily “more” important than for the general population. Depending on the medications you’re being treated with, however, strength training may be even more important - for example while someone is taking prednisone for prolonged periods of time, given its catabolic nature. But longer-term GPA treatment often involves other, non-steroid medications for which this is not as much of a concern.

  3. No, nothing else is special here with respect to uncomplicated GPA.

This is all good news, as your rheumatologist (presumably) can focus on the immune-modulating medications, while you can focus on the lifestyle factors in the same way as anyone else.