A good diet should be a priority for everyone. However, when there are complex lupus symptoms to manage, you have to go above and beyond the basic nutritional guidelines. This isn’t always and easy thing to do.

• Introduction
• Basic Dietary Guidelines to Follow When You Have Lupus
• The Impact of Good Nutrition on Lupus
• Dietary Supplements and Their Role in Treating Lupus
• Intervention: The Benefits of Nutrition Counseling
• In Conclusion

Introduction

No one can deny the effects of a good, well-balanced diet on overall health and well-being. With the typical Western diet that is prone to being high in saturated fats, refined sugars and excessive amounts of sodium, many of us find ourselves in a constant battle choosing between a plateful of grease and a plateful of greens. If you have lupus, you find yourself needing to go a step further – or several steps –  in order to figure out which foods help your symptoms and which might worsen them or even lead to flares.

Even if you feel you have good dietary habits and are pretty sure you know what makes you feel good and what makes you feel awful, no one is perfect. It is so easy to get frustrated with lupus and the grind of having to give up those things that we love to eat.  So, many of us slip once in a while and consciously make the decision to indulge in something when we know we shouldn’t.  At other times, we may unconsciously make the wrong choice – either by not paying close enough attention or perhaps at times when we’re not given the right information.  Let us at least deal with the right information part now, and remind ourselves of the foods to consider including – and excluding – from a diet when you have lupus

Just a note – The following information has been taken from many reliable sources.  However, we are still learning about food allergies and food intolerances, so make sure you are careful when making any dramatic changes to you diet, and consult your personal healthcare practitioner or nutritionist to ensure that your diet is tailored to your own symptoms and needs.

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Basic Dietary Guidelines to Follow When You Have Lupus

According to Jillian Levy, Holistic Health Coach from the Institute of Integrative Nutrition, eating low or no processed foods is key to reducing inflammation and maintaining a healthy gut.  According to recent research, bad gut health has been linked to a growing list of diseases, especially autoimmune diseases, including lupus.  So, here are some basics.

Some of the top foods that you may want to add to your diet include:

• Organic, unprocessed foods.
• Raw and cooked vegetables.
• Fresh fruit.
• Wild-caught fish.
• Probiotic foods.

Some of the foods that you may want to avoid when you have lupus include:

• Trans fats/hydrogenated fats.
• Alfalfa sprouts – some studies have found that these may lead to flares.
• Pasteurized dairy products.
• Refined carbohydrates, processed grain and gluten products.
• Added sugars.
• High-sodium foods.

Other foods to use with caution until you know include:  nightshade vegetables, which are not known to affect lupus itself, but for some may trigger inflammation, and garlic, which may increase one’s immune response.

Many of these foods can have a profound effect on the amount of inflammation you experience.  They may also trigger flares or exacerbate symptoms, making you feel worse than your indulging was worth. It is also good to note that what you drink is just as important as what you eat – avoiding many fruit juices, flavored lattes and sodas may be in your best interest. Remembering to stay well-hydrated drink plenty of water should be a priority – a simple glass of water can sometimes make you feel better and may even be a good starting point for turning your diet around.

A word on special or “fad” diets – While it may be tempting to try the latest and greatest diet crazes because they tout amazing results, always discuss these trends with your healthcare practitioner before starting anything new. Fad diets tend to focus on one measure of health, such as weight, yet can leave you with deficiencies in other aspects of wellness. Also, a diet shouldn’t be one-size-fits-all.  Just as everyone experiences lupus symptoms in their own unique way, so can your body’s response to specific diets.

Also, as you look to try new diets, be careful not to make too many dramatic changes.  When you have lupus, if one part of you is off-kilter, it can cause a chain reaction of symptoms and overall feelings of malaise.  Continually altering your diet may find it harder to track your symptoms and predict the effects of any changes to your drug dosages.

The Impact of Good Nutrition on Lupus

Good nutrition is fundamental to keeping you holistically healthy. In 2017, researchers concluded that “diet modification and the use of supplements could be a promising way to approach SLE…without the side effects of the classic pharmacological therapy…reducing co-morbidities and improving the quality of life of patients with SLE.” In order to gain the upper-hand over lupus, adopting healthy eating habits is a natural way to manage lupus by:

• Combating Inflammation – According to WebMD, anti-inflammatory foods include foods rich in antioxidants such as fruits and vegetables. Omega 3 fatty acids which are found in foods such as fish, nuts flaxseed and olive oil may also help control inflammation.
• Improving Gut Health – The microbiome of your gut – the balance of good and bad bacteria and other microorganisms in your gut – may play a huge role in lupus. Shawn Radcliffe of HeathLine writes that keeping that balance stable by eating probiotic foods (yogurt, kefir, kimchi, sauerkraut, tempeh), or taking probiotic supplements may help to keep your microbiome healthy. Probiotic foods and supplements can also help with what has been called “leaky gut syndrome,” though this is an area that is still under study and some debate.
• Minimizing the Side Effects of Medications – According to WebMD, a diet that includes sufficient amounts of calcium and vitamin D can counteract the “bone-damaging” effects of corticosteroids. Foods high in folic acid such as leafy green vegetables and fruits are important to include in your diet if you are on methotrexate.
• Achieving and Maintaining Healthy Weight – Weight can swing either way when you have lupus. Some find themselves losing weight because of loss of appetite, while others may gain weight as a result of inactivity or taking corticosteroids. As unexciting as it sounds, eating the right amount of foods (calories in particular) and getting the right amount of exercise is a great first step to stabilizing your weight. Yet, we know for many, that is only the first step.  There is no one-size-fits-all for weight as well, and deciding upon the healthiest weight for you should come from honest discussions with your healthcare practitioner.  Achieving and maintaining this weight can have a great effect on your symptoms as well.
• Maintaining Healthy Muscle and Bone – If you take corticosteroids, you are at a significant risk for developing osteoporosis. Eating foods high in calcium and vitamin D can keep muscles and bones healthy and help ward off the detrimental effects of medications. If you are avoiding dairy products which are typically high in calcium and vitamin D, your healthcare practitioner can recommend alternatives or supplements.
• Reducing the Risk of Heart Disease – Low-fat, low-sodium diets are important if you have lupus as you are at a much greater risk for developing heart disease. Fatty acids from fish or fish oils may also help reduce triglyceride counts as well as help with blood pressure.
• Managing Stress and Emotional Wellbeing – Eating a healthy, well-balanced diet can also help you feel better emotionally. Avoiding things like sugar and caffeine can help you manage anxiety and stress. Including more vegetables in your diet and eliminating processed foods can keep blood sugar levels stable which can in turn help to keep your emotions on a more even-keel. The act of eating better itself can give you a sense of pride and boost confidence as you proactively play a role in your own symptom management. If you have the time and inclination, even the act of cooking a healthy meal can be a great way to relieve stress – and it has the added benefit of actually helping your digestion.

Dietary Supplements and Their Role in Treating Lupus

The Milton S. Hershey Medical Center at Penn State University suggests that several supplements may be beneficial in supporting good health and managing lupus. These supplements include:

• Flaxseed – Flaxseed contains both Omega 3 fatty acids and alpha-linolenic acids which may help reduce inflammation and support healthy kidney
• Fish Oil – Fish oil contains Omega 3 fatty acids and may help with inflammation, in particular krill oil. While experts are conflicted as to whether or not fish oil supplements are really beneficial for people who have lupus, they do recommend eating more fish such as salmon and halibut. It’s worth talking with your healthcare practitioner about fish oil supplements.
• Dehydroepiandrosterone (DHEA) – DHEA is made into estrogen and testosterone and may help with symptom management.
• Calcium and Vitamin D – If you are on a course of corticosteroids, you may be at greater risk for developing osteoporosis. As stated earlier in this article, calcium and vitamin D can help maintain healthy bone and muscle.
• Methysulfonylmethane (MSM) – MSM is a chemical found in humans, animals and plants and is sometimes used to treat arthritis as well as a number of other health conditions from wrinkles to ulcers. It is thought to support healthy joints and connective tissue, preventing them from deterioration.
• Turmeric – Considered a root and a cousin of ginger, Turmeric may help reduce disease activity.

As always, it is crucial to speak with your healthcare practitioner about your specific needs and any potential drug interactions before choosing to start taking these or any other supplements.

Intervention: The Benefits of Nutrition Counseling

Lupus is a complex disease and how you experience your symptoms may change over time. Keeping your practitioner – or team of practitioners – in the loop will help you all treat your symptoms in the most effective and efficient ways possible.  Since your diet and nutrition play a crucial role in how you feel, you may want to consider adding a nutritional counselor to your team. Your healthcare provider should be able to refer you to a nutritionist experienced in working with individuals with lupus or other inflammatory and autoimmune diseases. Nutritionists can not only discuss your specific dietary needs, but can provide food options, recipes and menu plans as well, making an overwhelming task a lot more manageable and somewhat fun.

Seeking guidance from an experienced nutritionist is proven to be helpful. A 2015 study showed that individuals with lupus who were referred to and attended nutritional counseling for six months were able to successfully reduce:

• Their sodium intake.
• The percentage of calories they consumed from saturated fats.
• The total amount of calories they ate.
• Their body weight.

The same individuals were able to successfully increase their intake of:

• Fruits and vegetables.
• Low cholesterol foods.
• High fiber foods.

Even though the researchers were unable to prove a notable difference in lipid levels, because six months may have not been enough time to study participants, they agreed that the overall impact of nutritional counseling was beneficial in building and sustaining healthy eating habits. The researchers also noted that the individuals who participated and stayed engaged in the study valued the nutritional intervention.

 

In Conclusion

Understanding the role nutrition plays in the management of your lupus may prove key to treating the way it continues to manifest itself in your body. Knowing that being healthy doesn’t mean compromising flavor and taste may help you consider taking on some dietary changes you may have avoided in the past. You don’t have to go it alone – having the support of compassionate and knowledgeable experts that treat you as an individual and help you make the right choices will help build your confidence when making intelligent diet choices in order to achieve success.

 

References

Aparicio-Soto, M.,  Sanchez-Hidalgo, M., & Alarcon-de-la-Lastra, C. (2017). An update on diet and nutritional factors in systemic lupus erythematosus management. Nutrition Research Reviews, 30(1), 128-137. Doi: 10.1017/S0954422417000026

Rojo, D., Hevia, A., Bargiela, R., López, P., Cuervo, A., González, S., … Ferrer, M. (2015). Ranking the impact of human health disorders on gut metabolism: Systemic lupus erythematosus and obesity as study cases. Scientific Reports, 5  Retrieved from: https://www.nature.com/articles/srep08310.pdf

Everett, S.T., Wolf, R., Contento, I., Haiduc, V. Rihey, M., & Erkan, C. (2015). Short-term patient centered nutrition counseling impacts weight and nutrition intake In patients with systemic lupus erythematosus. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4729294/pdf/nihms-749799.pdf

Ehrlich, S. (2015). Systemic lupus erythematosus. Lupus, 24(12), 1321-1326.  Retrieved from: http://pennstatehershey.adam.com/content.aspx?productId=107&pid=33&gid=000161

Elkaim, Y. (2014). Leaky gut: What is it and how to heal it. Retrieved from: https://health.usnews.com/health-news/blogs/eat-run/2014/03/06/leaky-gut-what-it-is-and-how-to-heal-it

Kessler, A. (2019). Diet for reducing inflammation, supporting gut health in lupus patients: A nutritionist’s view. Retrieved from: https://lupusnewstoday.com/2019/04/23/diet-recommendations-manage-lupus-nutritionists-view/

Levy, J. (2016). The lupus diet: Benefits, meal plan & recipe ideas. Retrieved from: https://draxe.com/health/lupus-diet/

Lupus diet and nutrition. (n.d.). Retrieved from: https://www.webmd.com/lupus/guide/nutrition-lupus#1

Azzouz, D., Omarbekova, A., Heguy, A., Schwudke, D., Gisch, N., Rovin, B., … Silverman, G. (2019). Lupus nephritis is linked to disease-activity associated expansions and immunity to a gut commensal. Annals of the Rheumatic Diseases, 78(7). 947-956.  Retrieved from https://ard.bmj.com/content/78/7/947

Radcliffe, S. (2019). How bacteria may be linked to lupus. Retrieved from: https://www.healthline.com/health-news/gut-bacteria-linked-to-lupus

Rodriguez, T. (2017). Lupus: Using diet and nutrition to improve symptoms and outcomes. Retrieved from: https://www.rheumatologyadvisor.com/home/topics/systemic-lupus-erythematosus/lupus-using-diet-and-nutrition-to-improve-symptoms-and-outcomes

Stanek, A. (2018). What is turmeric, anyway? Retrieved from: https://www.bonappetit.com/story/what-is-turmeric

 

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.

All images unless otherwise noted are property of and were created by Kaleidoscope Fighting Lupus. To use one of these images, please contact us at [email protected] for written permission; image credit and link-back must be given to Kaleidoscope Fighting Lupus.

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.