Lupus is a chronic autoimmune disease where the immune system attacks healthy tissues and organs, leading to inflammation and potential damage throughout the body. While there's no cure for lupus, managing symptoms and improving quality of life often involves a combination of medication and lifestyle adjustments, including dietary changes. Although there isn't a one-size-fits-all "lupus diet," certain foods can help calm inflammation and minimize flares, while others may exacerbate symptoms. This article explores dietary approaches for managing lupus, providing a comprehensive guide to foods to include and avoid, and a sample meal plan to get you started.
How Diet Impacts Lupus Symptoms
It's crucial to understand that dietary changes alone cannot cure or treat lupus. However, they can play a significant role in managing symptoms and supporting overall health. According to rheumatologist Emily Littlejohn, DO, there are general guiding principles based on anecdotal evidence of how foods ease or worsen lupus symptoms, but individual responses to foods and drinks can vary significantly. Therefore, paying close attention to how your body reacts to different foods is essential.
The Best Foods for Lupus
A well-structured lupus diet emphasizes foods that protect your heart and bones. Cardiovascular disease is a leading cause of death for people with lupus due to inflammation damaging the heart and blood vessels, contributing to hardening of the arteries and heart disease. Additionally, lupus treatments can affect calcium absorption, increasing the risk of weak bones and osteoporosis-related fractures.
Heart-Healthy Foods
Adopting a heart-healthy diet, like the Mediterranean diet, protects the heart by lowering blood pressure and cholesterol. This anti-inflammatory meal plan also eases inflammation that causes joint pain. Heart-healthy foods are low in salt, saturated fats, and trans fats.
The Mediterranean diet emphasizes:
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- A Variety of Vegetables: Including green leafy vegetables such as kale, spinach, cabbage, and arugula.
- Whole Grains: Such as brown rice, couscous, oats, barley, bulgar, buckwheat, rye, and spelt.
- Healthy Fats: From extra virgin olive oil, avocados, and olives.
- Oily Fish: Such as mackerel, sardines, tuna, and herring.
- Nuts, Beans, and Legumes.
- Fruits.
Foods for Bone Health
Low-fat dairy products are rich in calcium and can help keep bones strong, unless you're lactose intolerant or have a dairy allergy. Good options include low-fat milk and yogurt. If dairy isn't an option, consider these alternatives:
- Milk alternatives.
- Fish, like salmon.
- Fortified cereal and fruit juice.
- Tofu and soy products.
- Vegetables like broccoli and spinach.
Foods to Avoid with Lupus
While there are few evidence-based, large studies on foods that directly cause lupus flares, certain foods are known to trigger inflammation in some individuals. The autoimmune protocol (AIP) diet may help identify trigger foods. This elimination diet involves cutting out potentially inflammatory foods and gradually reintroducing them while monitoring for lupus flares. However, it's crucial to start an AIP diet with the guidance of a registered dietitian.
Sugary Foods
Sugar causes the body to release inflammatory chemicals called cytokines. High sugar consumption can also lead to weight gain and high cholesterol, straining the heart. Be mindful of hidden sugars in foods like pasta sauce and ketchup, in addition to obvious sources like candy, cakes, and cookies.
Processed Foods
Additives in processed foods contribute to inflammation. These foods often contain high levels of fat, salt, starches, and oils, as well as preservatives that extend shelf life. Limit or eliminate these foods:
- Canned soups.
- Frozen meals.
- Processed meats like deli meats, hot dogs, and sausages.
- Snacks like potato chips, crackers, and cookies.
Alfalfa Sprouts
Alfalfa sprouts and seeds contain an amino acid called L-canavanine, which may trigger:
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- Inflammation.
- Fatigue.
- Muscle aches.
Avoid alfalfa supplements if you suspect alfalfa sprouts are causing symptoms.
Gluten
While most people with lupus can safely consume gluten, some individuals find it inflammatory. If gluten triggers a flare, consider a gluten-free diet, avoiding ingredients like:
- Wheat.
- Barley.
- Rye.
- Spelt.
Nightshade Vegetables
Research on nightshades' effects on inflammation and joint pain is inconclusive, but these vegetables contain alkaloids that may cause inflammation in some people. Nightshade vegetables include:
Other Foods to Limit or Avoid
In addition to the above, consider limiting or avoiding:
- High-Fat Foods: If you develop hyperlipidemia due to lupus, your doctor may advise avoiding high-fat foods. Saturated fats may promote endotoxins that trigger an inflammatory response.
- Alcohol: If you drink alcohol, do so in moderation (one drink or less per day), as it can interact with some lupus medications.
- Refined Vegetable Oils: Such as canola, corn, soybean, and sunflower oil. These are often used in processed foods and for frying and are high in omega-6 fatty acids, which can promote inflammation when consumed in excess.
- Farm-Raised Animal Products: Opt for grass-fed and pasture-raised animal products whenever possible, as they tend to be lower in inflammatory compounds and higher in beneficial nutrients.
- Synthetic Additives: Found in boxed foods, can contribute to inflammation and gut dysbiosis.
Specific Dietary Considerations for Lupus Symptoms
Depending on the medications you're taking and the specific symptoms you're experiencing, you may need to adjust your diet accordingly.
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Managing Medication Side Effects
- Nausea and Upset Stomach: Eat bananas, rice, applesauce, and toast. Avoid greasy, spicy, and acidic foods.
- Folic Acid Loss: If taking methotrexate, consume spinach, beef liver, avocado, rice, and asparagus. Consider a folic acid supplement as prescribed by your doctor.
- High Blood Pressure: If taking prednisone, include whole grains, fruits, vegetables, nuts, legumes, skinless poultry, fish, and low-fat dairy products in your diet. Limit sodium intake.
Addressing Common Lupus-Related Issues
- Weight Loss and Poor Appetite: Eat small, frequent meals. The doctor or nurse can assess your diet and suggest a program to help control your weight. The program will probably include a low-fat diet and exercise.
- Weight Gain: Follow a low-fat diet and exercise regularly.
- Heart Disease Risk: Follow a heart-healthy diet, including fatty fish rich in omega-3 fatty acids like salmon, sardines, mackerel, tuna, halibut, and trout. Also, include walnuts, pecans, canola oil, walnut oil, and flaxseed oil.
- Kidney Problems: If you have lupus nephritis, you may need to limit certain foods. Talk with your doctor or a registered dietitian for guidance.
- Skin Irritation and Dryness: Avocado, berries, cucumbers and melon.
Sample 30-Day Lupus Diet Meal Plan (1,500 Calories)
This meal plan is designed to provide inspiration for an anti-inflammatory diet, emphasizing nutrient-rich foods and avoiding potential triggers. Each day provides at least 52g of protein and 30g of fiber to support satiety and gut health.
(Note: This is a sample plan and may need to be adjusted based on individual needs and preferences. Consult with a registered dietitian for personalized recommendations.)
Key:
- B: Breakfast
- L: Lunch
- D: Dinner
- S: Snack
Week 1
- Day 1:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Salad with mixed greens, grilled chicken, avocado, and a lemon vinaigrette.
- D: Baked salmon with roasted vegetables (broccoli, carrots, and sweet potatoes).
- S: Apple slices with almond butter.
- Day 2:
- B: Raspberry-Kefir Power Smoothie.
- L: Leftover baked salmon and roasted vegetables.
- D: Turkey meatballs with zucchini noodles and marinara sauce.
- S: A handful of walnuts.
- Day 3:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Turkey meatballs with zucchini noodles and marinara sauce.
- D: Lentil soup with a side of whole-grain bread.
- S: A small bowl of berries.
- Day 4:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Leftover lentil soup.
- D: Chicken stir-fry with brown rice and plenty of vegetables.
- S: Greek yogurt with a drizzle of honey.
- Day 5:
- B: Raspberry-Kefir Power Smoothie.
- L: Salad with mixed greens, chickpeas, cucumber, and a tahini dressing.
- D: Baked cod with quinoa and steamed asparagus.
- S: A piece of fruit.
- Day 6:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Leftover baked cod with quinoa and steamed asparagus.
- D: Vegetarian chili with cornbread.
- S: A handful of almonds.
- Day 7:
- B: Scrambled eggs with spinach and whole-wheat toast.
- L: Vegetarian chili with cornbread.
- D: Grilled chicken with a side salad and baked sweet potato.
- S: Greek yogurt with berries.
Week 2
- Day 8:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Salad with mixed greens, tuna (packed in water), avocado, and a lemon vinaigrette.
- D: Baked salmon with roasted vegetables (broccoli, carrots, and sweet potatoes).
- S: Apple slices with almond butter.
- Day 9:
- B: Raspberry-Kefir Power Smoothie.
- L: Leftover baked salmon and roasted vegetables.
- D: Turkey meatballs with zucchini noodles and marinara sauce.
- S: A handful of walnuts.
- Day 10:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Turkey meatballs with zucchini noodles and marinara sauce.
- D: Lentil soup with a side of whole-grain bread.
- S: A small bowl of berries.
- Day 11:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Leftover lentil soup.
- D: Chicken stir-fry with brown rice and plenty of vegetables.
- S: Greek yogurt with a drizzle of honey.
- Day 12:
- B: Raspberry-Kefir Power Smoothie.
- L: Salad with mixed greens, chickpeas, cucumber, and a tahini dressing.
- D: Baked cod with quinoa and steamed asparagus.
- S: A piece of fruit.
- Day 13:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Leftover baked cod with quinoa and steamed asparagus.
- D: Vegetarian chili with cornbread.
- S: A handful of almonds.
- Day 14:
- B: Scrambled eggs with spinach and whole-wheat toast.
- L: Vegetarian chili with cornbread.
- D: Grilled chicken with a side salad and baked sweet potato.
- S: Greek yogurt with berries.
Week 3
- Day 15:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Salad with mixed greens, shrimp, avocado, and a lemon vinaigrette.
- D: Baked salmon with roasted vegetables (broccoli, carrots, and sweet potatoes).
- S: Apple slices with almond butter.
- Day 16:
- B: Raspberry-Kefir Power Smoothie.
- L: Leftover baked salmon and roasted vegetables.
- D: Turkey meatballs with zucchini noodles and marinara sauce.
- S: A handful of walnuts.
- Day 17:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Turkey meatballs with zucchini noodles and marinara sauce.
- D: Lentil soup with a side of whole-grain bread.
- S: A small bowl of berries.
- Day 18:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Leftover lentil soup.
- D: Chicken stir-fry with brown rice and plenty of vegetables.
- S: Greek yogurt with a drizzle of honey.
- Day 19:
- B: Raspberry-Kefir Power Smoothie.
- L: Salad with mixed greens, chickpeas, cucumber, and a tahini dressing.
- D: Baked cod with quinoa and steamed asparagus.
- S: A piece of fruit.
- Day 20:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Leftover baked cod with quinoa and steamed asparagus.
- D: Vegetarian chili with cornbread.
- S: A handful of almonds.
- Day 21:
- B: Scrambled eggs with spinach and whole-wheat toast.
- L: Vegetarian chili with cornbread.
- D: Grilled chicken with a side salad and baked sweet potato.
- S: Greek yogurt with berries.
Week 4
- Day 22:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Salad with mixed greens, grilled tofu, avocado, and a lemon vinaigrette.
- D: Baked salmon with roasted vegetables (broccoli, carrots, and sweet potatoes).
- S: Apple slices with almond butter.
- Day 23:
- B: Raspberry-Kefir Power Smoothie.
- L: Leftover baked salmon and roasted vegetables.
- D: Turkey meatballs with zucchini noodles and marinara sauce.
- S: A handful of walnuts.
- Day 24:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Turkey meatballs with zucchini noodles and marinara sauce.
- D: Lentil soup with a side of whole-grain bread.
- S: A small bowl of berries.
- Day 25:
- B: Sprouted-Grain Toast with Peanut Butter & Banana.
- L: Leftover lentil soup.
- D: Chicken stir-fry with brown rice and plenty of vegetables.
- S: Greek yogurt with a drizzle of honey.
- Day 26:
- B: Raspberry-Kefir Power Smoothie.
- L: Salad with mixed greens, chickpeas, cucumber, and a tahini dressing.
- D: Baked cod with quinoa and steamed asparagus.
- S: A piece of fruit.
- Day 27:
- B: Oatmeal with berries and a sprinkle of flax seeds.
- L: Leftover baked cod with quinoa and steamed asparagus.
- D: Vegetarian chili with cornbread.
- S: A handful of almonds.
- Day 28:
- B: Scrambled eggs with spinach and whole-wheat toast.
- L: Vegetarian chili with cornbread.
- D: Grilled chicken with a side salad and baked sweet potato.
- S: Greek yogurt with berries.
- Day 29:
- B: 1 cup low-fat plain Greek yogurt, ¼ cup raspberries, 1 Tbsp.
- L: 1 medium apple, 2 Tbsp.
- D: snack and increase to 3 Tbsp.
- Day 30:
- B: 1 cup low-fat plain Greek yogurt, ¼ cup raspberries, 2 Tbsp.
- L: 1 medium apple, 2 Tbsp.
- D: snack and add 3 Tbsp.
To adjust this plan to 2,000 calories, incorporate the suggested additions for each day, such as adding whole-wheat English muffins with toppings, extra servings of smoothies or toast with peanut butter, and additional tablespoons of snacks.
Can You Be Vegetarian or Vegan with Lupus?
Yes, individuals with lupus can follow vegetarian or vegan diets. Ensure a variety of healthy plant-based foods are consumed. Vegans need to take a vitamin B12 supplement, as it's only found in animal foods.
The Importance of Gut Health
A large body of research shows that a healthy, unprocessed diet is very important for managing autoimmune disorder symptoms, including those caused by lupus because it helps control inflammation stemming from poor gut health. The majority of your immune system is actually located inside your gastrointestinal tract, which is also known as the microbiome, and researchers believe that up to 90 percent of all diseases can be traced in some way back to dysfunction of the gut/microbiome.
General Dietary Recommendations
- Eat a Variety of Healthy Foods: Include lots of fruits and vegetables, whole grains, healthy proteins (lean meats, poultry, seafood, beans, nuts, and eggs), and healthy fats (olive oil, avocados, nuts, and fish).
- Limit Sodium, Saturated Fat, and Added Sugars: Reducing these can lower your risk for serious health problems like high blood pressure and diabetes.
- Stay Hydrated: Drink plenty of water throughout the day.
- Prioritize Sleep: Aim for seven to nine hours of sleep per night to support immune function and overall health.
- Manage Stress: Practice stress-reducing activities like yoga, meditation, or spending time in nature.
Consulting Healthcare Professionals
It's essential to work with a healthcare team, including a doctor and a registered dietitian, to develop a personalized lupus diet meal plan that addresses your specific needs and symptoms. They can provide guidance on food choices, potential trigger foods, and strategies for managing medication side effects.