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Diet and Lupus

 

Calories

So far, very few experiments of reduced calorie consumption have been conducted in patients with autoimmune diseases.  A trial in patients with rheumatoid arthritis showed that fasting was accompanied by a reduction in joint pain, stiffness & medication requirements.  However, the study was not well controlled.  There has also been a claim that some symptoms of rheumatoid arthritis can be improved by a vegetarian diet.


Fats

The effects of fat intake have been examined in some detail in the last 10 years, not only the total amount of fat ingested, but also the particular types of fat (notably saturated or unsaturated fat).  It is thought that the influence of fat on autoimmunity depends on the synthesis of prostaglandins & leucotrienes, which have various effects on the immune system.  A study in SLE patients who had their total fat intake reduced to 25 % or less of the total dietary calories with a fish oil supplement, improved the outcome over a three-month period.  The rationale behind supplementing the diet with fish & other oils is that high levels of certain polyunsaturated fatty acids change the balance of prostaglandins & leucotrienes & produce a more balanced & less inflammatory state.


Protein

The few studies that have looked at protein restriction have found that diets low in certain amino acids, as well as diets supplemented with particular synthetic amino acids, have all tended to prolong the survival & decrease the numbers of autoantibodies.


Vitamins

There is some evidence that vitamins may play a role in influencing autoimmunity.  For example, a diet deficient in vitamin A has been shown to aggravate autoimmunity.  A vitamin E enriched diet has been claimed to induce remissions in lupus patients, although evidence of these studies must be regarded as provisional.


Supplements

Taking evening primrose oil, & various fish oils appears to be useful in the management of some autoimmune diseases.  Vitamin B12 & folic acid can treat certain forms of anaemia, Vitamin B6 has a mild diuretic effect, & calcium & vitamin D can help manage osteoporosis which can result from steroid use.

Avoid any supplements that contain alfalfa (see the complementary therapies page for more info)


Diet & medications

Objectives-

- to counteract steroid therapy

- to replenish potassium reserves

- to reduce fever and replace nutrient loses

Corticosteroids (prednisone, prednisolone) often take as much as they give nutritionally. All too often the drug either stops the absorption of nutrients or interferes with the cells' ability to use them. Steroid therapy has been found to be related to lowered zinc levels. The following notation of drugs indicate induced deficiencies and the vitamins they deplete:

Drug Nutrients Depleted
Aspirin   Vitamins A, B-Complex
Diuretics C, Calcium, Potassium
Prednisone Vitamins B6, D, C, zinc and potassium
Indomethacin Vitamins B1, and C

Effects of steroids on nutrition

- Increased appetite
- Weight gain
- Loss of muscle protein: increased breakdown of muscle; decreased synthesis
- Changes the body's ability to handle glucose (blood sugar)
- Increased depositing of fat
- Reduces serum zinc levels
- Sodium retention
- Potassium loss
- Poor absorption of calcium
- Fluid retention
- Increased need for Vitamins B6 (pyridoxine), C and D
- Stomach irritation and gastric disturbances
- May aggravate or induce diabetes, hypertension or ulcers, may cause hypercholesterolemia (high cholesterol level), may cause type IV hyperlipoproteinemia.


Dietary recommendations

- Follow a high potassium diet. Foods high in potassium include: all fruit, especially bananas, blackberries, cantaloupe, honeydew melon, oranges, plums, dried fruits, rice. All vegetables, especially asparagus, brocolli, brussels sprouts,yams, whole grain, lima beans, parsnips, pumpkin, spinach, winter squash, tomatoes, dried beans and dried peas; milk and milk products.

- Mildly restrict sodium intake.

- When febrile (with fever), the diet should be high in protein and calories to compensate for nitrogen losses (protein).

- Include rich sources of calcium in your diet. To increase absorption, consume with an acid-containing food or vitamin C. Foods high in calcium include milk and milk products, tofu, soups made with cream, milk or cheese, broccoli, chard, all greens, okra, kale, spinach, sauerkraut, cabbage, soy beans, rutabaga, salmon, dry beans.

- Follow a low carbohydrate, high complex carbohydrate diet to maintain weight control and avoid excess fluid.

- Include foods rich in zinc. These foods include oysters, meats, seafood, poultry and eggs.

- Include rich sources of iron in your diet. To increase absorption, consume with an acid-containing food or one with vitamin C. Sources of iron include cream of wheat, liver, beef, lamb, pork, chicken, turkey, eggs, fish, beans baked with molasses, prunes, prune juice, apricots, green peas, enriched breads, and cereals.

- Increase your intake of foods high in Vitamin C. These foods include broccoli, oranges, strawberries, cauliflower, cantaloupe, cabbage and green peppers.

- Include foods rich in Vitamin B6 (Pyridoxine). These foods include whole grain cereals, breads, liver, avocados, spinach, green beans, bananas, fish, poultry, meats, nuts, potatoes, green leafy vegetables.

- Include foods rich in Vitamin D. These include foods primarily of animal origin: eggs, butter, milk, fish oils, cereals, margarines and breads. This along with calcium decreases the risk of osteoporosis.

- Take medications with food to decrease the irritating effect on the stomach and small intestine. Foods and drugs taken together also increase the time available for the absorption of the drug.

- Eat a relatively high protein diet.

- Follow a diet moderately low in saturated fat and cholesterol.

- Stay away from cured meats and hot dogs. Both contain compounds that in large amounts can aggravate symptoms in people with lupus, says Joseph McCune, M.D., associate professor of rheumatology at the University of Michigan Hospitals in Ann Arbor.

- Take it easy on mushrooms and beans. They add flavor to any dish, but both contain hydrazines and amines, compounds that in large amounts can aggravate symptoms in people with lupus, says Sheldon Paul Blau, M.D., clinical professor of medicine at the State University of New York at Stony Brook and co-author of Living with Lupus.


Comments

"I have found that altering my diet helps. I stopped using any dairy products. I suspect a mild allergy. Of course I have to supplement my diet with calcium and vit d as I can't go out in the sun. I am looking for a way to get off steroids. I would appreciate any information anyone can give me there. I also use acupuncture to reduce stress."

"My weight loss is a result of a low carbohydrate eating style which was secondary to the elimination of gluten from my diet which was recommended by an M.D. specializing in lupus who stated that he has NEVER had a lupus patient not respond favorably to the elimination of gluten."

"I lost 11 kilos with my diet, reducing the fat and increasing the apport in vitamins and potassium ( fruits like bananas, oranges...). I have less pains in knees because of this weight loss, and it seems that vitamins reduce the butterfly appearance on the face. I don't know if diet can help for SLE but when you have to many kilos the pains are more difficult to support. And now I feel better too with other people because I feel pretty in my new body! For the moral it's important!" Val

 
 

 

 
 

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