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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