Should we recommend an anti-inflammatory diet for lupus?

Systemic lupus erythematosus (SLE), more commonly knows as lupus, is an autoimmune disease which influences numerous areas of the body including the kidneys, heart, brain, central nervous system, lungs and blood vessels. Through an inflammatory process triggered from the body’s immune system, healthy tissues and organs are attacked resulting in a lupus flare. Recognition of SLE has increased in recent years, as 1.5 million people in the United States currently suffer from this disorder. More incidence has been found in African American, Hispanic and Asian American females with diagnosis between the ages of 15 and 45 years of age.¹

While the exact etiology of SLE origin is unknown, researchers suggest this disease may stem from an individual’s genetic predisposition, medication, infection or environmental contributors. Symptom onset can vary in terms of timing, duration and severity. Most commonly seen symptoms in the lupus patient are a butterfly-shaped facial rash, skin lesions exacerbated by sunlight exposure and joint pain. Diagnostic testing encompasses blood and urine testing, imaging, and in certain individuals, organ biopsy. Multiple medications can be used for symptom management with the risks and benefits of each needing to be considered.¹

The anti-inflammatory diet: What is it?²

A spin-off of the Mediterranean diet, the anti-inflammatory diet encourages a balanced diet approach with inclusion of foods that naturally contain disease- and inflammation-fighting phytochemicals.  Specifics of this diet suggest choosing foods high in omega-3 fatty acids, selecting richly colored produce and purchasing complex carbohydrate and whole grain sources. Tea is preferred instead of coffee, and dark chocolate (70% or greater cocoa) and red wine are included in moderation.  Foods heavily processed or high in saturated fat are discouraged. Supplementation of 2 to 3 grams per day of omega-3 fatty acid, containing eicosapentanoic acid and docosahexanoic acid, is recommended if diet intake is insufficient.

Anti-inflammatory diet and lupus^3,4 

While many aspects of diet and nutrition have been studied with this patient population, the anti-inflammatory diet and heavy emphasis on omega-3 fatty acid, fruits and vegetable dietary incorporation has shown a positive correlation with decreasing lupus flares. With SLE inflammation, C-reactive protein and other inflammatory mediators are increased. Omega-3 fatty acid and phytochemicals from fruits and vegetables counteract this reaction to reduce inflammation. Further benefits of these foods have been seen with cardiovascular health protection in regulating the altered lipid profile often seen in SLE patients as a side effect from medications or disease.

Patient application^2-4

While continued research is needed, incorporation of the anti-inflammatory diet has shown promising benefits for the patient with SLE. As the nutrition experts, registered dietitian nutritionists should be comfortable in identifying the risks associated with SLE and providing individualized medical nutrition therapy to optimize patient care. Inclusion of omega-3 fatty acid sources from olive, canola or flaxseed oil and salmon, tuna and sardine is recommended. Diet with the SLE patient should also regularly include a variety of brightly colored fruits and vegetables.  Lupus has no known cure, but symptom management through diet and supplementation can be helpful to reduce comorbidity risk, inflammation and improve overall quality of life.

Note to readers: The information discussed in this blog is not intended as medical advice. Discuss diet supplementation with your physician and dietitian before making changes.

If you have more questions about managing lupus, it’s always a great idea to speak with a registered dietitian. Registered dietitians are the only credentialed experts qualified to address your unique health questions.

References:

Mayo Clinic: Lupus. https://www.mayoclinic.org/diseases-conditions/lupus/diagnosis-treatment/drc-20365790. Accessed March 13, 2020.

S. News and World Report: Dr. Weil’s Anti-Inflammatory Diet. https://health.usnews.com/best-diet/anti-inflammatory-diet. Accessed March 14, 2020.

Constantin M, Nita I, Olteanu R et al. Significance and impact of dietary factors on systemic lupus erythematosus pathogenesis. Exp Ther Med. 2019;17:1085-1090.

Borges M, dos Santos F, Telles R, de Andrade M, Correia M, Lanna C. Omega-3 fatty acids, inflammatory status and biochemical markers of patients with systemic lupus erythematosus: A pilot study. Rev Bras Rheumatol. 57;6:526-534.