Lupus a chronic autoimmune disease where the body’s immune system becomes overactive and attacks healthy tissues. This condition causes inflammation, swelling, and damage to joints and body organs, including the skin, heart, and kidneys, among others. Lupus is treatable and is often managed with medication and lifestyle therapies, including a healthy diet.
There are different types of lupus, with systemic lupus erythematosus (SLE) being the most common. In the United States, there are around 16,000 new cases of lupus yearly and up to 1.5 million Americans living with the condition.
While there is no set diet for lupus, focusing on healthy eating habits can help immensely with overall disease management. You should aim to eat a healthy and balanced diet that includes fresh fruits and vegetables, whole grains, and moderate amounts of lean meats and oily fish.
Here is what you need to know about how your diet can help you to manage the effects of lupus:
If you have lupus, eating a balanced and healthy diet has its many benefits, including:
Reducing inflammation and other disease symptoms. Because lupus is an inflammatory condition, it is possible eating foods considered anti-inflammatory can fight against inflammation and reduce lupus symptoms. Further, avoiding foods that promote inflammation may prevent disease symptoms.
Keeping bones and muscles strong. Good nutrition helps to maintain bone and muscle strength. Eating foods high in calcium and vitamin D are vital for your bone health and counteracting the effect of some of the medications you take to treat lupus, as some of these (such as corticosteroids) may increase your risk for osteoporosis, a condition that causes bones to be less dense, increasing the risk for fractures.
Managing medication side effects. In addition to counteracting the bone-damaging effects of corticosteroids, a healthy diet may help combat other drug side effects, including fluid retention and increased blood pressure.
Achieving and maintaining a healthy weight. Weight loss and loss of appetite are also common with lupus. Additionally, medication side effects can contribute to weight loss and gain. Weight gain is also caused by inactivity, often a consequence of living with joint pain from lupus. If you are having a problem maintaining a healthy weight, talk to your healthcare provider about assessing your diet and incorporating exercise into your lifestyle.
Reducing risk for co-morbid conditions. Lupus is associated with several comorbid conditions including heart disease, osteoporosis, thyroid disease, and Sjogren’s syndrome. Comorbid conditions are chronic in nature and exist simultaneously. For example, people with lupus have a higher risk of heart disease compared to others in the general population. If you have risk factors for heart disease or other comorbid conditions, eating a well-balanced, healthy diet and staying active may help reduce your risk for comorbid conditions.
How It Works
There is no specific set way of eating for people with lupus. However, because lupus is a systemic (entire body) disease, practicing good nutritional habits may help you to feel better and reduce symptoms and disease complications. Additionally, making healthy diet choices—even small ones—can reduce lupus-related hospitalizations and increase the effectiveness of lupus treatments.
Diet changes will affect each person with lupus differently. Some people will notice changes early, while others find symptoms improve slowly. Of course, diet changes may not help some people at all. Should that be the case for you, you may help to enlist the help of a dietitian to determine what changes might better help.
For many people with lupus, diet changes need to be lifelong in order to keep symptoms at bay. Others may want to prioritize their diet during periods of flare-up or when they feel they are at an increased risk for a disease flare-up, such as during stressful times.
What to Eat
It is a good idea to include a variety of fruits and vegetables, low calorie and low-fat foods, and foods high in antioxidants, fiber, calcium, vitamin D, and omega-3 fatty acids to your lupus diet. Having a healthy balance is important—that is, not eating too much of one thing or too little of another.
Fruits and vegetables
Plant sources of omega-3 fatty acids (walnuts, flaxseeds, legumes)
Yogurt and dairy
Processed or refined foods
Because lupus is an inflammatory condition so it is possible foods that fight off inflammation can reduce lupus symptoms. Some top anti-inflammatory foods to add to your diet include:
Fish: Omega-3 fatty acids—eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)—are found in fatty fish, including salmon, sardines, and tuna. EPA and DHA can reduce inflammation that leads to numerous medical conditions, including heart disease and inflammatory arthritis. Studies have shown people who consume salmon or EPA and DHA supplements experience reductions in C-reactive markers—proteins responsible for inciting inflammation in the body. Aim to eat fatty fish at least twice a week to enjoy its anti-inflammatory effects.
Fruits and vegetables: Colorful produce—spinach, lettuce, carrots, blueberries, oranges, and more—are loaded with contain antioxidants and polyphenols—natural plant compounds to fight inflammation. Aim for at least five servings a day from a range of colors.
Vegetarian omega-fatty acids. Plant sources of omega-3 fatty acids—walnuts, flaxseeds, kidney beans, soybean oil, edamame, and more—contain alpha-linolenic acid (ALA). The body converts ALA to EPA and DHA. While the process is slow, you can still get some anti-inflammatory benefits from eating foods containing ALA.
Whole grains: People with lupus should aim to eat whole grains instead of refined ones. Whole-grain options to include in a lupus-friendly diet include rice, barley, bulgur (cracked wheat), oatmeal, quinoa, and whole-grain breads, pasta, and/or cereals.
Yogurt and dairy: Research shows a type of healthy bacteria found in yogurt and other dairy products might reduce disease symptoms in some people with lupus. In addition, eating foods high in calcium and vitamin D is important for people with lupus because they have an increased risk for osteoporosis. When buying dairy products, pick ones that are low-fat or fat-free. If you cannot drink milk, good alternatives are lactose-free, soy, and almond milk, and juice fortified with calcium and vitamin D.
Foods to Avoid
There are some foods that may trigger flare-ups of lupus symptoms. It should be noted, however, that the research on any specific connection between these foods and lupus is limited.
Some foods that may increase lupus symptoms are:
Alfalfa: Some research has linked alfalfa sprouts to lupus flares. This is because of a compound called L-canavanine that accelerates the immune system. Some studies have revealed eating alfalfa sprouts can induce a lupus-like syndrome in people who don’t have lupus or reactivate lupus in people with inactive disease. If eating alfalfa sprouts induces a lupus flare for you, it may be a good idea to avoiding eating them.
Garlic: There has been evidence suggesting people with lupus should avoid garlic. Garlic contains three ingredients—allicin, ajoene, and thiosulfinate—that can amp up the immune system and cause an overactive response in people with lupus. Of course, eating small amounts of garlic will not hurt you, but it may help to limit the amount in your diet.
Processed and refined foods: Examples of processed foods are ones that come in a box or a can. These foods are often higher in fat, sugar, and salt. Refined foods, including white bread, pastas, and rice, also contain high amounts of fat, sugar, and salt. Studies show diets high in processed and refined foods can increase inflammation throughout the body. You should replace these types of foods with ones containing fresher and healthier ingredients, especially if you notice any increase in lupus symptoms after consuming them.
Nightshade vegetables: For some people with inflammatory conditions, including lupus, when eating nightshade vegetables—tomatoes, eggplant, peppers, etc.—they see an increase in inflammation. However, the Lupus Foundation of American notes there is no solid evidence to support this claim. Nonetheless, if nightshade vegetables increase your symptoms, you may want to remove them from your diet.
Alcohol: You do not have to give up drinking altogether. It is OK to have a glass of wine or beer every once in a while. But you should not drink too much alcohol because it may interfere with the medications you are taking to treat lupus. According to the Lupus Foundation of America, people with lupus who take certain drugs should avoid alcohol because of the risk for specific alcohol-medication interactions. For example, medications like methotrexate, a commonly prescribed medication for lupus, are metabolized in the liver and mixing them with alcohol could increase your risk for irreversible liver problems. Other drugs, such as prednisone and non-steroidal anti-inflammatory drugs (NSAIDs), when mixed with alcohol further increase the risk for gastrointestinal bleeding.
Salt: Eating too much salt isn’t good for anyone and especially people with chronic health conditions like lupus. Excessive salt consumption can also increase the risk of high blood pressure and heart disease. But reducing salt intake doesn’t have to be tasteless. You can substitute salt with herbs, such as mint and basil, spices, including cinnamon or pepper, or other foods, such as lemon to add great taste to food.
There is no specific meal timing recommended. You can use the eating pattern that best suits your lifestyle or that you find works well for you. A typical meal pattern is three meals per day.
Cooking and eating at home can help you to avoid fast foods and meals that are loaded with saturated fats. While cooking at home, here are some things to keep in mind while you plan and prepare meals:
Use healthy fats: Fat is not always bad for you and it helps add taste to your foods. Just make sure you are picking unsaturated fats, such as olive oil, avocados, or nuts, over saturated fats like butter and margarine.
Limit sugar and salt: Eating too much sugar or salt can over time put you at additional risk for lupus co-morbidities, such as heart disease and high blood pressure. Make sure you are checking labels and using salt or sugar sparingly as you prepare meals. Use herbs, spices, vinegar, or lemon over salt.
Try global flavors: Some of the healthiest dishes come from the Mediterranean and countries like Japan, Thailand, and China and are rich in vegetables and whole grains. They also use spices like curry powder and herbs like ginger that not only add great flavor but are also known for their anti-inflammatory properties. You will want to use herbs and spices sparingly as overconsumption of some of these may cause gastrointestinal symptoms.
Plan meals: Meal planning can make it easier for you to make healthy choices and set you up for success as you work towards managing lupus symptoms. It does not matter what your meal planning looks like as long as you make a plan and stick to it. And as you prepare meals, choose whole grains over refined grains, and smaller portions of leaner meats or vegetable proteins. You will also want to fill your plate with healthy vegetables.
Be mindful: Choose vegetables and fresh fruits whenever possible. Or you want to sauté foods with healthy oils instead of deep-frying. You should also have some idea of what healthy portions look like, so you don’t end up eating more than you had planned.
The diet choices you make with lupus cannot be successful if you are not managing other aspects of your life with lupus. This can include things like spacing out meals, not smoking, supplementing vitamin D if needed, staying active, getting enough rest, and keeping your stress levels low.
Space out meals: If you find you are having gastrointestinal symptoms, such as indigestion, you may want to try eating four or five smaller meals, instead of three large ones. Additionally, because fat is difficult to digest for people with lupus, you may want to avoid high-fat meals.
Avoid smoking: Smoking is known for complicating and accelerating the effects of lupus. It can also lower the effectiveness of the medications you take to treat lupus. If you need help quitting, talk to our healthcare provider about the best ways to accomplish this.
Supplement with vitamin D: Lupus, much like other autoimmune diseases, is associated with low levels of vitamin D. If you aren’t spending enough time outdoors, you may want to talk to your healthcare provider about getting your levels tested and whether you need a vitamin D supplement.
Stay active: In addition to diet, gentle forms of physical activity can help you to manage lupus symptoms. Try brisk walking, swimming, water aerobics, biking, or using an elliptical machine or treadmill. Commit to at least one activity every day.
Get enough rest: Make sure you are making sleep a priority and trying to get seven to nine hours of sleep every night. You should also take breaks throughout your day to unwind and rest.
Manage stress: Emotional stress and other daily challenges can trigger lupus flares. By finding ways to relax, you can keep your stress levels in check.
As you make changes to your diet, it is important to consider your ability to stick to a new diet and the things that can help you along the way.
The Dietary Guidelines for Americans recommend that most adult caloric intakes should come from the following:
- Between 45% to 65% carbohydrates
- Between 10% to 30% protein
- Between 20% to 35% fat
While it is helpful to follow these guidelines, you should still check with your healthcare provider on whether you need a diet plan based on risk factors and any co-morbid conditions. Your practitioner or a dietitian can provide specific information about managing your weight and making healthy diet choices.
Because people with lupus have problems digesting fatty foods, you will want to limit these foods from your diet. Additionally, these foods have been reported to increase inflammation. Some examples of foods containing saturated fats include high-fat dairy, fried foods, creamed soups and sauces, processed meats (sausages, hot dogs, luncheon meats, etc.), and red meats.
You can substitute saturated fats with healthier ones. Foods that contain healthier, unsaturated foods include nuts, seeds, avocados, and some oils, such as olive, soybean, peanut, and avocado. Because these fats are still high in calories, you should monitor the amounts used and consumed.
The diet changes you make to manage lupus are a lifestyle choice, rather than a specific diet. You are in control of the food choices you make and are not required to follow specific meal plans, food restrictions, or complicated recipes. The only thing you will need with a lupus-friendly diet is the self-discipline to make healthy choices and to stay away from processed and junk foods.
Other Dietary Approaches
A well-rounded diet focusing on anti-inflammatory and whole foods provides a wide range of nutrients and may reduce inflammation, keep lupus symptoms at bay, help with maintaining a healthy weight, and reduce the risk for disease complications and comorbid conditions. And while there is no specific recommended diet for lupus, there are some diets you may want to ask your healthcare provider or a dietitian about.
The Mediterranean diet emphasizes fruits and vegetables, whole grains, beans, nuts, legumes, seafood, and olive oil. Other foods, such as poultry, eggs, cheese, and yogurt are also permitted, but in moderation. A 2018 report in the journal Nutrients, finds “low adherence” to a Mediterranean diet is directly connected to high levels of inflammation.
Anti-inflammatory diets are based on the Mediterranean diet. They include extra recommendations, such as green tea and healthy sweets like dark chocolate, and heavy promotion of fruits and vegetables. An anti-inflammatory diet also includes regular consumption of omega-3 fatty acids and prohibits fried and junk foods. Studies on diet, autoimmune disease, and lupus confirm the consumption of omega-3 fatty acids, as part of an anti-inflammatory diet, can decrease levels of inflammatory proteins in the body.
Vegan or Vegetarian Diet
Some people believe by reducing the number of inflammatory foods—like meat and dairy—and increasing the number of fresh fruits and vegetables, whole grains, and legumes consumed, a plant-based diet can heal the body. While this is a good approach, it might be a good idea to include a multivitamin in your diet, as there are some nutrients you can only get from animal products. You should also talk to your healthcare provider before starting any diet that restricts an entire food group.
Following a gluten-free diet involves avoiding wheat and other grains and choosing healthy substitutes to provide you the nutrients you need for a healthy diet. But unless you have celiac disease or a gluten sensitivity, a gluten-free diet probably won’t improve lupus symptoms. In fact, there is little evidence confirming gluten worsens inflammation or that a gluten-free diet can improve lupus symptoms.
Elimination diets are helpful for learning whether or not certain foods are causing or making disease symptoms worse. If they are, removing or limiting these foods from your diet may reduce symptoms. You can figure out what these foods are by not eating certain types of foods for weeks at a time and noting how you are feeling. You then re-introduce eliminated foods slowly. If you notice a return in symptoms by eating a particular food, you may want to exclude it from your diet.
Researchers have described elimination diets as extensions of the paleo diet. With the paleo diet, you only eat foods rich in vitamins and nutrients that do not contain sugar or other additives. This usually includes lean meats, fruits and vegetables, nuts, and seeds. While there is definitely benefit in eating whole foods, there has been no evidence confirming a paleo diet can reduce or eliminate lupus symptoms.
A Word From Get Meds Info
Lupus affects each person with the condition differently. Diet changes that work for one person may not work for another. Keeping a food journal can help you to figure out which foods may affect you negatively and which foods might help to manage symptoms. Discuss with your healthcare provider or a dietitian about how different foods and diet plans can improve or worsen disease symptoms. It is also a good idea to talk to your practitioner before starting any diet, so they help modify a plan based on your known and unique health issues.