Diet and Nutrition for Lupus - Eating Right for Lupus

Introduction:

There is as such no food that can cause the development of lupus, an autoimmune disease, and an illness that can impact many body systems. The foods that an affected person eats, however, and the medications that they take may have an impact on some of their symptoms. Understanding the effects of lupus on osteoporosis and cardiovascular disease is also critical. Hence, healthy nutrition can profoundly affect those having these co-occurring diseases. Nutrition may influence the symptoms and outcomes of such co-occurring illnesses. This article will shed light on the healthy diet and nutrition that an individual with lupus can benefit from.

What Is Lupus?

Lupus is a multifaceted autoimmune disorder impacting different body areas, potentially inducing severe health complications. It occurs when the immune system mistakenly targets the body's own tissues, leading to the production of destructive antibodies that harm tissues through various mechanisms. The onset of this condition is influenced by various factors such as genetics, immune system activity, hormones, and environmental components.

How Can Food Impact Individuals With Lupus?

A balanced diet rich in essential nutrients can offer the following advantages for those managing lupus:

• Alleviate inflammation (redness and swelling) and alleviate other symptoms.

• Prevent deficiencies in essential nutrients.

• Support the maintenance of robust bones and muscles.

• Counteract side effects associated with medications.

• Assist in achieving or sustaining a desirable weight.

• Lower the risk of heart disease.

What Are Dietary Tips for Lupus?

Caloric Restriction: Currently, there is limited information about how diet affects autoimmune diseases. However, caloric restriction has been shown to offer various benefits to the immune system by influencing changes in gut microbiota. Obesity is a significant concern for adults with systemic lupus erythematosus (SLE), as 40 to 50 percent of these patients are obese and more susceptible to experiencing fatigue. For this subset of SLE patients, weight loss through a low glycemic index or a low-calorie diet has been found to effectively reduce fatigue levels, although it does not impact disease activity. Reducing calorie intake has demonstrated efficacy in preventing disease progression and antiphospholipid syndrome in mice. In human studies, one research project monitoring the dietary impact of two isocaloric diets on lupus highlighted that a diet higher in polyunsaturated fatty acids (PUFA) reduces the risk of fetal loss and symptoms in women with SLE and antiphospholipid syndrome. Substantial evidence supports the positive correlation between a hypocaloric diet and disease activity. Therefore, the recommended caloric intake for women is approximately 1,000 to 1,200 kelo calories per day, and for men, 1,200 to 1,400 kelo calories per day. This is particularly important for obese individuals or those prone to obesity, as well as for SLE patients undergoing long-term or high-dose corticosteroid therapy.

Polyunsaturated fatty acids: In individuals with stable lupus disease, adopting a diet rich in polyunsaturated fatty acids (PUFA), especially omega-3 fatty acids like eicosapentaenoic acid and docosahexaenoic acid, can pose a positive impact on their overall clinical condition. These fatty acids have anti-inflammatory properties, decreasing the levels of inflammatory markers such as C-reactive protein (CRP). The combination of caloric restriction and a well-balanced diet along with omega-3 PUFA aids in regulating cholesterol levels and also provides cardiovascular protection by lowering antibodies, interleukins, and TNF-α (tumor necrosis factor alpha). This dietary approach also helps in managing proteinuria and blood pressure. Additionally, other omega-3 acids like alpha-linolenic acid and gamma-linolenic acid provide beneficial effects by limiting the secretion of TNF-α and IL-2 (interleukin 2). Hence, incorporating omega-3 PUFA into the diet of individuals with lupus has demonstrated no adverse effects, unlike omega-6 PUFA supplementation, which may exacerbate lupus activity.

Primary sources of omega-3 PUFA are krill oil, fish oil, olive oil, canola oil, flaxseed oil, and fish varieties like salmon, tuna, sardine, and herring. In addition, omega-3 PUFA can also be found in primrose oil and soybean oil. Krill oil is derived from Antarctic krill and is considered superior to fish oil because of its higher omega-3 PUFA content and antioxidant effects, which lowers inflammation in the joints. Consuming 30 gm of flaxseed oil daily in a concentration of 70 percent omega-3 PUFA and rich in alpha-linolenic acid can lower serum creatinine in individuals having lupus with renal dysfunction. A high dosage of fish oil (18 gm per day) is also beneficial in reducing triglyceride levels by approximately 40 percent, while simultaneously increasing high-density lipoprotein cholesterol by a third.

Proteins: A beneficial approach for enhancing renal function in individuals with lupus involves maintaining a moderate protein intake of 0.272 grams (gm) per pound per day. The primary sources of proteins are meat and eggs.

Fibers: For managing postprandial glycemia and lipid levels, controlling hyperlipidemia, and lowering blood pressure and C-reactive protein levels, it is advised that men should have a daily fiber intake of around 38 gms, while women should have a 25 gms fiber intake. This fiber can be acquired from whole cereals, fruits, and vegetables. Also, sufficient water intake in relation to fiber consumption is essential. However, individuals should avoid surpassing recommended fiber intake as it may inhibit nutrient absorption.

Vitamins:

Vitamin D:

• It is essential for mineral metabolism and immune system balance.

• Deficiency in vitamin D is linked to higher lupus susceptibility and severity, especially in those with dark skin.

• The active form of vitamin D calcitriol regulates immune responses, and its low levels may be a risk factor for autoimmune diseases.

• Sunlight exposure is challenging for a person with lupus due to photosensitivity, making dietary supplementation crucial.

• Low vitamin D is associated with higher lupus activity scores.

• Some studies suggest benefits against fatigability, while others do not show improvement in fatigue for lupus.

Vitamin E:

• Combined with omega-3 PUFA from fish oil, reduces levels of inflammatory cytokines.

Vitamin C:

• It is a potent antioxidant that prevents oxidative stress and lowers antibody levels.

• A person with lupus should supplement their diets (up to 1 gm per day), potentially in combination with vitamin E for synergistic action.

• It is found in orange juice, tangerine, papaya, and broccoli.

Vitamin A (Retinoic Acid):

• Its antineoplastic effects reduce antibody levels.

• A person with lupus should take supplementation (up to 100,000 IU (international unit) vitamin A daily) cautiously to avoid adverse effects.

• Natural sources of vitamin A include carrots, pumpkins, spinach, sweet potato, and liver.

Vitamin B Complex:

• It reduces levels of Triglycerides and low-density lipoprotein cholesterol and improves clinical symptoms in persons with lupus.

• It is found in red meat, liver, fortified cereals, chicken, salmon, sardines, nuts, eggs, bananas, and avocados.

Flavonoids:

Isoflavones, which have estrogen-like properties, are derived from soybeans and exhibit anti-inflammatory and antioxidant effects. They can reduce proteinuria, antibody production, and decrease IFN-Υ secretion. Additional sources of isoflavones include black beans, olive oil, and cereals.

• Found in various fruits and vegetables, including oranges, lettuce, watermelon, kiwi, tomato, apple, lentils, and celery.

• Oranges are identified as the main source of flavonones in individuals with lupus.

• Dihydrochalcones are primarily obtained through apple intake. Dihydroflavonols are sourced from red wine consumption.

• Flavonol intake is possible through tea, apples, spinach, walnuts, white beans, lettuce, asparagus, broccoli, green beans, and tomato.

• A well-balanced diet, especially with high apple and orange intake, correlates with increased beneficial microorganisms in the feces of individuals with lupus.

Minerals:

Zinc and Sodium: It is advisable to limit the intake of certain minerals like zinc and sodium. Lowering zinc levels can improve symptoms in individuals with lupus and reduce antibodies. Zinc is mainly present in mollusks but it can also be found in milk, soybeans, and spinach.

Selenium:

• Exhibits antioxidant and anti-inflammatory properties.

• It is present in nuts, whole cereals, eggs, and ricotta.

Calcium:

• Obtained through dairy, spinach, sardine, or soybean consumption.

• Oral supplements (more than 1500 mg daily, with 800 IU vitamin D) help prevent bone mass loss.

Iron:

• Reserved for anemic individuals to maintain balance.

• Excessive iron can worsen renal impairment in those with lupus, while deficiency exacerbates clinical symptoms.

Conclusion:

Exploring the advantageous impact of customized diets for an individual with lupus involves understanding how diet influences their condition and taking personalized dietary plans. A well-suited diet for lupus contributes to maintaining bodily balance, prolonging periods of remission, mitigating medication side effects (especially systemic corticosteroid therapy), and enhancing both the physical and mental well-being of the person with lupus.