• Introduction
• Celebrating Across Faiths and Cultures
• Navigating the Dinner Dilemma – Be in the Driver’s Seat!
• Is Fasting Safe?
• In Conclusion

Introduction

The holidays bring with them so many expectations. The ritual of coming together after long separations across time or miles should be a joyous experience, invoking feelings of excitement and pleasure.  More often than not, we build these visits around the sharing of painstakingly prepared meals – a time to share while breaking bread – sometimes, gluten-free bread.

These expectations, however, can be the cause of great distress for those of with lupus and those with special dietary requirements. The seemingly benign act of indulging in a piece of pumpkin pie or a helping of stuffing may be downright menacing for those who experience adverse reactions to specific foods, recipe ingredients or obscure additives. Couple the physical aspects of food dangers with the emotional anxiety of not being sure how far to indulge one’s self can make holiday gatherings a source of disappointment, if not tension or even fear.

With some major U.S. holidays upon us, now is an opportune time to examine some of the celebrations that occur across many faiths and cultures over the coming months, and how you, as an individual with lupus, can approach the food allergies and dietary restrictions in a way that respects yourself and others – whether you are the host or a guest.

Celebrating Across Faiths and Cultures: A Very Brief Survey

As you can see below, each of these holidays are celebrated with delicious – and potentially reactive –  specialty foods:

• Diwali is a five-day celebration also known as the “festival of lights” that is celebrated between October and November. Originally a Hindu holiday, it is celebrated across India and internationally. A lot of sweet treats are served as well as many vegetarian dishes and fry breads.
• Hanukkah is a Jewish holiday between late November and December over the course of an eight-day celebration. Hanukkah is also known as the “festival of lights.” Cheese is served as well as brisket, chicken, and sweet treats.
• Kwanza is a seven-day celebration that occurs from December 26 to January 1, and celebrates African heritage and identity.  Kwanza is based on traditional African festivals (loosely translated, Kwanzaa means “fresh fruit”). A huge variety of food from meat to vegetables and sweets is served.
• Epiphany – the twelfth day of Christmas – is celebrated on January 6 by Catholics and Orthodox Christians primarily in Europe and Latin American countries. It’s the day when the three wise men visited the baby Jesus. Mainly delicious sweets and breads are served.
• Chinese New Year Is celebrated at the start of the Lunar New Year and the beginning of a new moon. Also known as the “Spring Festival,” Chinese New Year is the most important event on the Chinese calendar and each year is named after one of twelve animals. Noodle soup, symbolizing good luck, is served as well as other Chinese delicacies.
• Lent is celebrated for the forty days prior to Easter by Christians in anticipation of the resurrection of Christ and as a time to explore their relationship to God. It’s a time when many will give up something for the forty days and/or do something for others instead. Often a favorite food (i.e. candy) is given up. Strict followers will eat more modest meals and even abstain from eating meat, especially on Fridays.
• Passover  – usually celebrated in April – commemorates when the Jews were delivered from slavery in Egypt. It may be celebrated for up to eight days. Celebrants abstain from eating leavened foods such as breads, some pastas and instead prepare foods such as fruits, sweets, fish, lamb, simple fry breads, eggs, and leafy greens – often cooked using specific techniques.
• Easter is the Christian celebration of the resurrection of Christ.  Though the date can vary slightly depending upon the calendar that is used in different parts of the world, it usually falls from the end of March through April.   An Easter menu may include eggs, biscuits and buns, lamb, soups, potatoes, and a variety of cakes and sweets – again, depending upon the traditions of specific Christian denominations.
• Ramadan is the most sacred of holidays on the Islamic calendar and marks when Allah gave the first chapters of the Quran to the prophet Muhammad. Ramadan lasts approximately 30 days and is celebrated in the spring during the ninth month of the Islamic calendar – which recently has fallen in May. During that time, Muslims fast, abstain from pleasures, and pray to become closer to Allah.  The fasting occurs from sunrise to sunset and not only includes abstinence from food, but from oral medications as well. We’ll talk more about this kind of fasting later on.

Navigating the Dinner Dilemma – Be in the Driver’s Seat!

Navigating any holiday meal table can be the cause of tremendous angst. It can be difficult when you are unable to indulge in the foods others are enjoying because of possible dietary restrictions and/or allergies as a result of lupus.  It may be even more challenging to talk about why you can’t with friends and relatives who may not understand. Conversely, you may be the host of a big gathering and want to be respectful of a friend or relative who has special food requirements, but not sure how to go about opening the conversation around food.

If you are an individual with lupus who just can’t graze at the buffet or sample at the dessert table, it is really important to communicate any food restrictions in a direct and clear – not aggressive – manner. It’s important to remember that it may be difficult for someone who does not have food allergies or restrictions to understand what you mean.  So, be patient and thorough when explaining how a certain food may react in your system. It’s also important to keep the following in mind when framing your communication:

• Don’t assume.  Don’t assume right away that others will or won’t understand what you are saying or that they will or won’t react in the way you expect. Be clear about your diet and any allergic or negative reactions, and remain open to questions.  Most people do not intend to be disrespectful and may just need more clarity because it may be hard for them to imagine walking in your shoes.
• Offer to bring your favorite dish.  If the host seems open to suggestions, ask if it would be okay if you brought your favorite recipe for everyone to enjoy!  You may actually make the host feel more comfortable and in turn, you know you’ll have a meal you can safely rely on.
• Remain open-minded.  Being brave and broaching the topic of your food allergies/restrictions may surprise you!  Others may be inclined to share their challenges with food and who knows? You may all pick up some new suggestions about preparing food, maneuvering around the buffet, and eating out at restaurants!
• Know when to walk away.  If you’ve already been down this road and there just does not seem to be a way to make the other person understand, walk away (figuratively if you can, of course). If it’s a relationship you want to preserve, but you can see you are getting nowhere, it doesn’t mean the other person is inherently bad – it may just not be – or ever be – the “right time.” Chose to eat before you go to the event or bring your own tasty dish without bringing too much emotion into the situation.

If you are hosting an event and want to be considerate of a friend or relative who has lupus, there are several things you can do prior to the event to make sure everyone feels welcomed:

• Be clear about what you are serving.  Let your friend or relative know what you plan on preparing so they have a good idea about what to expect. Read labels and recipes carefully when preparing your meal in order to be able to answer questions such as, “Does the sauce include dairy? Is there gluten in that pudding?”
• Ask what happens if your friend or relative experiences an adverse reaction to food.  Be prepared and ask specific questions to know what to expect – and what to do – should an adverse reaction occur.
• Collaborate on meal preparation.  Don’t be afraid to ask your friend or relative if they have any favorite recipes you could prepare or welcome them to bring one. If you are unclear, be creative.  You don’t have to spend and arm-and-a-leg on meal options. Making sure to offer choices; be inclusive and show consideration. For example, there are many dishes that are allergen-free and made with minimal ingredients that can be found through a simple Internet search – and they are delicious!
• Try not to stigmatize.  Even though you have the best of intentions at heart, a friend or relative with lupus may be more comfortable with dealing with food options on their own. Don’t make it seem like a big deal or force the issue – it may draw unwanted attention or “dramatize” the situation. Your initial consideration of their needs alone may go a long way!

Is Fasting Safe?

The practice of fasting is worthy of its own discussion. If you are an individual with lupus who wants to fully practice your faith, this may require fasting intermittently for up to 16 hours in observance of special holidays. You may be confused as to whether this is healthy or not and may feel pressured by others to abstain without knowing if you can do so safely.

Contrary to what many of us may assume about fasting being detrimental to one’s health, Dr. P.A. Kareem, a physician at the Hygiene Naturopathy Hospital in South India, suggests that fasting may actually positively impact individuals with lupus. According to Kareem, fasting “provides a period of concentrated physiological rest during which the body can trigger its self-healing mechanisms to repairing and strengthening damaged organs.” Dr. Amy Myers would agree, “When you fast for an extended period of time, your body has the chance to rest and recover … This state of rest can … repair a leaky gut, reduce inflammation, [and] improve immune and stress response.”

If we take a look at Ramadan, which has strict fasting requirements, we can get a better idea of how safe this kind of intermittent fasting may be. A pilot study published in Rheumatology International in 2015 concluded that while there was an increase in the antibodies associated with more severe forms of lupus, disease activity and quality of life remained relatively unchanged and “Ramadan fasting probably has no detrimental effect on SLE patients in quiescent phase of disease. “

Fasting may also involve abstinence from medications. A study published in the Canadian Pharmacists journal in 2017 suggests that pharmacists should be consulted and dosing schedules should change to coincide with meals when an individual wants to fast in observance of holidays such as Ramadan. Pharmacists should also consider switching individuals to “long-acting formulations” or “changing dosing regimens to once or twice daily.” Other cautions should be taken to avoid triggers such as remaining adequately hydrated and staying out of direct sun.

According to Myers, however, fasting can have its drawbacks.  It can create hormonal imbalances, adrenal fatigue, and exacerbate thyroid disorders. Before fasting, you should always discuss your diet and medications with your healthcare practitioner, remembering to discuss your faith and/or culture and expectations around certain holidays. You may also consider consulting your faith or community leader about how you can reconcile your feelings and make changes to how you practice your faith and culture during holidays without compromising your beliefs.

In Conclusion

While this may seem like a lot to consider, your health and well-being as an individual with lupus and the health and well-being of anyone you know with lupus is worth the effort. There are so many beautiful celebrations across faiths and cultures that everyone should have a chance to fully engage in. Being open and having these discussions around food and observance shows compassion, inclusivity and respect. It provides an opportunity for everyone to enjoy what’s really important – community, family, faith and celebration!

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References

Abdollahi, B., Akbarian, M., Akhlaghkhah, M., Banihashemi, A. Faezi, S., Goharifar,…Paragomi, P. (2015). The effect of Ramadan fasting on quiescent systemic lupus erythematosus (SLE) patients’ disease activity, health quality of life and lipid profile: A pilot study. Rheumatology International. doi: 10.1007/s00296-015-3282-5.

Alsabbagh, W.,& Grindrod, L. (2017). Managing medications during Ramadan fasting. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5415064/

Avey, T. (n.d.). What is Passover? Retrieved from: https://toriavey.com/what-is-passover/

Bond, J. (2015). 7 ways to talk about food allergies. Retrieved from: https://www.huffpost.com/entry/how-to-talk-about-food-allergies_b_7104290

Bonney, G. (n.d.). Modern etiquette: Navigating food allergies and dietary restrictions. Retrieved from:  https://www.designsponge.com/2013/07/modern-etiquette-navigating-food-allergies-dietary-restrictions.html

Chopra, M. (n.d.). Food delights of Diwali. Retrieved from: https://www.desiblitz.com/content/food-delights-of-diwali

Epiphany, the feast of the three kings. (n.d.). Retrieved from: https://www.whychristmas.com/customs/epiphany.shtml

Filippone, P. (2018). 31 traditional Easter foods from around the world. Retrieved from: https://www.thespruceeats.com/traditional-easter-foods-from-around-the-world-4161077

Ghafour, P. (2007). Fasting during Ramadan is beneficial if done properly, says doctor. Retrieved from: http://www.arabnews.com/node/302959

How to prepare food for a food allergic guest. (n.d.). Retrieved from: https://www.wikihow.com/Prepare-Food-for-a-Food-Allergic-Guest

Myers, A., (2018). Should you try intermittent fasting if you have an autoimmune disease? Retrieved from: https://www.amymyersmd.com/2018/06/intermittent-fasting-autoimmune-disease/

Richardson, S. (2008). What is Easter: Understanding the history and symbols. Retrieved from: https://www.crosswalk.com/faith/spiritual-life/undertanding-the-history-and-symbols-of-easter-1256039.html

Ross, R. (2018). What is Ramadan? Retrieved from: https://www.livescience.com/61815-what-is-ramadan.html

What is Chinese new year? (2018). Retrieved from: https://www.bbc.co.uk/newsround/38668427

What is Diwali, the festival of lights, and how is it celebrated? (2017). Retrieved from: https://www.usatoday.com/story/news/nation/2017/10/19/what-diwali-festival-lights-and-how-celebrated/779643001/

What is Hanukkah? (n.d.). Retrieved from: https://www.chabad.org/holidays/chanukah/article_cdo/aid/102911/jewish/What-Is-Hanukkah.htm

What is Lent and why does it last forty days? (n.d.) Retrieved from: http://www.umc.org/what-we-believe/what-is-lent-and-why-does-it-last-forty-days

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Author: Liz Heintz

Liz Heintz is a technical and creative writer who received her BA in Communications, Advocacy, and Relational Communications from Marylhurst University in Lake Oswego, Oregon. She most recently worked for several years in the healthcare industry. A native of San Francisco, California, Liz now calls the beautiful Pacific Northwest home.

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All resources provided by us are for informational purposes only and should be used as a guide or for supplemental information, not to replace the advice of a medical professional. The personal views expressed here do not necessarily encompass the views of the organization, but the information has been vetted as a relevant resource. We encourage you to be your strongest advocate and always contact your healthcare practitioner with any specific questions or concerns.