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Some foods may improve the ailment, and others may worsen it. But
answers are hard to find.
Feb. 12, 2001 (New York) -- Jane, a 30-year-old financial analyst
in New York City, has had an autoimmune disorder called lupus since
1996, and has never been told to avoid alfalfa sprouts. So it's
a good thing she doesn't like them.
A review article appearing in the October 2000 issue of the Journal
of Renal Nutrition indicates that alfalfa seeds may worsen this
disease because they contain an immune system-stimulating compound
called L-canavanine, which may trigger lupus flares. But recommendations
on how diet and nutrition affect lupus seem to be few and far between
despite the fact that doctors postulated more than 15 years ago
that diet might be one of the possible future therapies for people
with this disease.
Affecting what the Lupus Foundation of America estimates is 500,000
to 1.5 million Americans, lupus is a chronic inflammatory disease
that affects various parts of the body, especially the skin, joints,
blood, and kidneys. The body's immune system normally protects the
body from foreign invaders, but with an autoimmune disorder such
as lupus, the immune system backfires and attacks normal tissues.
For most lupus sufferers, including Jane, lupus is a mild disease
affecting only a few organs. For others, it may cause serious and
even life-threatening problems.
"My doctor has advised me to eat a healthy and balanced diet because
everyone feels better when they eat better, but that's about it,"
Jane, who asked that her real name not be used, tells WebMD. "I
may have read an article once about how nutrition can affect this
disease, but there is not much out there."
More research is emerging. In the review article, Amy Christine
Brown, RD, PhD, an assistant professor of nutrition at the University
of Hawaii at Manoa in Honolulu, reports that certain foods and nutrients
may improve lupus, while others -- including those troublesome alfalfa
sprouts -- may exacerbate the disease.
"Patients with [lupus] may benefit from a balanced diet limited
in calories and fat (especially saturated and omega-6 polyunsaturated
fatty acids), containing rich sources of vitamin E, vitamin A (beta
carotene), selenium and calcium," she writes.
Vitamin E, vitamin A, and selenium are antioxidants and may have
anti-inflammatory properties in people with lupus.
Also potentially beneficial are fish oils (which contain omega-3
fatty acids), evening primrose oil, flaxseed, a plant herb called
Tripterygium wilfordii, and supplements of a weak male hormone called
dehydroepiandrosterone (DHEA), Brown says.
"Stay away from zinc, which is found in meat and shellfish,
especially oysters," Brown tells WebMD. "It enhances immune response,
and you don't want to help an immune system fight itself."
People with lupus should limit fat intake to less than 30% of total
calories, and may want to avoid substances rich in omega-6 fatty
acids including safflower oil, sunflower oil, poppy seed oil, and
corn oil, because these fats may exacerbate the disease, according
to studies in rodents, she says.
But the omega-3 fatty acids contained in the oils of several fish
varieties, including mackerel, tuna, whitefish, and herring, may
slow the disease and have an anti-inflammatory effect, Brown says.
Future studies may look at the use of bromelain, a complex of enzymes
found in pineapples, to more clearly define any potential anti-inflammatory
effect. "Boxers use bromelain as an anti-inflammatory agent, and
it would be interesting to study if it has such an effect in people
with inflammatory conditions," she says.
Supplements of bone-building calcium, along with vitamin D, which
helps the bones better absorb calcium, also may be beneficial to
people with lupus because the steroids commonly used to treat the
illness may result in the brittle bone disease osteoporosis.
"For people with lupus, there are potential benefits to healthy
lifestyle, including healthy eating. That said, there is no cure
for chronic autoimmune diseases such as lupus from diet," says H.
Michael Belmont, MD, director of the lupus clinic at Bellevue Hospital
and chief medical officer at the Hospital for Joint Disease in New
York City.
"There are examples of types of foods that have aggravated lupus,
and chief among them is alfalfa," he says. "I tell patients to avoid
alfalfa."
Many people with lupus may be at risk for early and aggressive
heart disease, so there are "strong reasons for women and men with
lupus to follow a general heart-healthy diet that is low in fat,
high in fiber, and replete with natural fruits and vegetables and
lean meat, fish, and veal," Belmont says.
If a lupus patient is taking steroids, Belmont recommends adding
1,500 to 2,000 milligrams of calcium, and 800 international units
of vitamin D.
"Lastly, DHEA may help relieve mild to moderate lupus, and may
allow a tapering off of [the steroid] prednisone," Belmont says.
Men are much less likely than women to develop autoimmune disorders,
possibly due to differences in hormone levels. For these reasons,
some studies also are looking at combinations of the male hormone
testosterone and supplements of DHEA.
"A caveat is that DHEA use must be discussed with treating
physicians," Abramson says -- a good idea for any of these dietary
interventions.
By Denise Mann WebMD Medical News
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