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Article written by
Kimberly Mugler, RDN, LDN
Lupus is a chronic, autoimmune disease that causes inflammation and pain in the body. With lupus, the immune system attacks its own tissues. Lupus can affect the joints, skin, kidneys, brain, heart, and lungs. The most common symptoms of lupus include extreme fatigue, headaches, painful or swollen joints, and anemia (low numbers of red blood cells or hemoglobin level).
There is currently no cure for lupus, but there are treatments that may help control or alleviate symptoms of lupus. Individuals with lupus are often concerned about dietary changes that may help manage their symptoms and avoid complications of lupus.
Individuals with lupus are often advised to follow an anti-inflammatory diet to help manage symptoms. While the title of the diet can seem vague, it generally applies to a Mediterranean diet — a diet rich in whole grains, nuts, seeds, lean protein, fruit, and vegetables. General guidelines include choosing healthy fish at least twice weekly; adequate fiber from whole grains, nuts, seeds, and vegetables; healthy fats (especially omega-3 fatty acids); and water as your main beverage. Red meat is limited to a few times per month, and regular physical activity is also encouraged.
Omega-3 fatty acids are a key component in the Mediterranean diet and can help prevent inflammation. Dietary sources of omega-3 fatty acids include chia seeds, flaxseeds, walnuts, soybeans, olive oil, flaxseed oil, salmon, tuna, sardines, mackerel, herring, and more.
Fiber from whole grains, beans, legumes, nuts, seeds, fruit, and vegetables has been shown to decrease inflammation. Berries tend to have the highest fiber content of fruit and are also a rich source of antioxidants, making them a wonderful choice for an anti-inflammatory diet. Women should consume 25 grams of fiber or more per day and men should consume 38 grams of fiber or more per day. This should be matched with at least 64 fluid ounces of water per day to properly digest fiber and minimize any nutrient malabsorption.
Inflammation is a comprehensive issue, and food is only one aspect. Managing your stress and getting adequate sleep helps to decrease inflammation in the body. Regular, moderate physical activity is important as well.
Sometimes foods and supplements are marketed as anti-inflammatory with little or no scientific research. To date, no dietary supplements are recommended for individuals with lupus to help decrease inflammation. There are, however, some well-researched foods that may reduce inflammation:
While some foods have been shown to lower levels of inflammation in the body, there is evidence that other foods may worsen inflammation and potentially exacerbate lupus symptoms in some people.
There is no scientific evidence suggesting that individuals with lupus should avoid red meat consumption, but red meat may contribute to inflammation. A plant-based diet is not necessarily recommended, but often is richer in fiber, vitamins, and minerals that may alleviate symptoms.
Some individuals believe that nightshade vegetables and gluten may lead to inflammation. To date, there is no scientific evidence to support these claims. Individuals with a diagnosis of celiac disease should avoid gluten, and those diagnosed with food allergies should avoid the foods to which they are allergic.
Lupus can lead to many health complications, but keeping nutrition in mind can help prevent these from getting worse. The nutrition recommendations for living with lupus can support overall health and quality of life.
Lupus nephritis is a type of kidney disease caused by systemic lupus. Your kidneys are important organs that filter extra water and waste out of your bloodstream. They maintain a proper balance of calcium, phosphorus, sodium, and potassium. Your kidneys are also important in regulating blood pressure and promoting bone health. If you experience lupus nephritis, or kidney disease, you may have to monitor what you eat. Moderate protein intake can help support renal function in individuals with lupus (0.6 grams per kilogram of body weight). This means if you weigh 150 pounds (68 kilograms), you should keep your protein consumption to around 40 grams per day.
Consuming less sodium is vital if you experience high blood pressure — a condition that commonly accompanies lupus. The most notorious source of sodium is salt. The American Heart Association recommends no more than 2,300 milligrams of sodium per day. Just a half teaspoon of salt contains 1,150 milligrams of sodium — about half your limit for the entire day. However, table salt isn’t the only source of sodium. Sodium comes from packaged foods (like crackers, pretzels, and chips), beverages, frozen foods, natural foods (like cheese, olives, and some seafood), and certain canned foods like legumes and vegetables. Takeout and restaurant foods are a common source of sodium as well. Limiting eating out, reading food labels, using spices instead of salt, and rinsing canned goods are important tips for keeping sodium consumption to a minimum.
Adequate calcium and vitamin D are important for bone health, especially for those experiencing kidney disease. Dietary calcium sources include dairy, fortified beverages like almond milk, and dark leafy green vegetables. Vitamin D assists with the absorption of calcium and is found in salmon, egg yolks, and fortified beverages. Our bodies also produce vitamin D from exposure to sunlight. Vitamin D deficiency has been associated with higher disease activity in people living with lupus.
If you experience anemia, it is especially important to get adequate iron in your diet. Dietary sources of iron include beef, oysters, tofu, beans, nuts, and some vegetables. Consuming a source of vitamin C with dietary iron helps to increase absorption. A good pairing for this is a meal such as red peppers (vitamin C) stuffed with lean ground beef (iron).
Individuals with lupus may also be concerned with dietary recommendations for weight management. Often, steroids such as prednisone are prescribed for specific conditions associated with lupus, and they may lead to weight gain, redistribution of fat stores, and overeating. Creating a calorie deficit with portion control and physical activity combined is the best and most efficient way to sustainably manage your weight.
Living with lupus can feel complicated and overwhelming. Choosing the right foods to eat shouldn’t cause more confusion or stress. Following a Mediterranean diet is a research-proven way to decrease inflammation and promote a healthier, longer life — and even lose weight when combined with a calorie deficit.
Some diets like autoimmune protocol (AIP) and paleo have been recommended for individuals with lupus. These may be more restrictive than necessary.
When evaluating claims about a diet, it is important to consider the source: Is the guidance written by a medical expert or a nutrition expert? Has the diet been studied in large samples and compared with other diets? Some foods may not be necessary to limit or introduce if there is not sound research on the matter. Furthermore, any exclusion of food groups may lead to nutritional deficiencies. It is important to discuss any changes in diet with your physician or dietitian to ensure your health and safety.
The right diet for you is one that you can sustain for a lifetime. It should be filled with foods that make your body feel energized and balanced. It shouldn’t cause you to sacrifice your social life. Keeping a food journal is an important tool for identifying any foods that may trigger inflammation. Working with your health care provider or registered dietitian is essential to ensure that your diet meets your individual needs.
When you join MyLupusTeam, the social network and online support group for those living with lupus, you gain a community of more than 169,000 people who understand exactly what you’re going through. Finding the right diet is one of the most discussed topics.
Here are some conversations about diet:
Here are some question-and-answer threads about diet:
Are there certain foods you feel exacerbate or improve your symptoms? Share your experiences in the comments below or directly on MyLupusTeam.