What to include and what to avoid

Lupus is a long-term autoimmune disease that can cause inflammation in many parts of the body.

The Lupus Foundation of America (LFA) estimates that 1.5 million people in the United States and at least 5 million people globally have some form of lupus.

Systemic lupus erythematosus (SLE) is the most common type, affecting 70% of people with lupus, according to the LFA. SLE is what most people are referring to when they use the word “lupus.”

However, there are other types of lupus:

• Cutaneous lupus: This type mainly affects the skin, but it can progress to SLE.
• Drug-induced lupus: Some prescription medications cause this type of lupus, which usually disappears about 6 months after a person stops using the medication.
• Neonatal lupus: This type occurs in infants, and most symptoms disappear after 6 months.

Autoimmune diseases occur when someone’s immune system attacks their own tissues. In people with lupus, different branches of the immune system join this attack, so the body develops intense inflammation.

People with lupus experience flares, when the disease is active, which alternate with periods of remission.

Whom does lupus affect?

Lupus can affect anyone, but some individuals may be more at risk of developing the condition than others.

In a 2021 meta-analysis, researchers estimated that SLE is nine times higher among females than males in the United States. They also found that it was highest among Black females.

A 2017 study that used data from Danish residents identified through the Civil Registration System concluded that having a family history of SLE is associated with an increased risk of developing SLE.

Symptoms of lupus

SLE causes inflammation that can trigger various symptoms affecting the skin, joints, or other organs. According to the American College of Rheumatology (ACR), many people with lupus experience non-specific symptoms like:

Other symptoms of lupus include:

However, the LFA notes that lupus can cause wide range of symptoms and a person may not experience all of them. Additionally, the symptoms may flare up before going into remission and they may change over time.

The ACR notes that doctors may treat lupus using medications such as immunosuppressants, and steroids. Experts do not routinely recommend a specific diet for people with lupus, but some research suggests that certain dietary patterns may be beneficial.

For example, a 2021 study found that greater adherence to the Mediterranean diet was associated with reduced disease activity and cardiovascular risk in people with SLE.

Evidence suggests that the Mediterranean diet may be anti-inflammatory and reduces the risk of chronic diseases, such as cardiovascular disease. In addition, other research indicates that the Mediterranean diet may be beneficial for some autoimmune diseases.

However, it is important to note that further research into the benefits of the Mediterranean diet is necessary.

The Mediterranean diet is primarily plant-based, but it includes some fish, poultry, and dairy products. The diet bases meals on the following foods:

A 2020 review looking at the optimal diet for regulating the immune system in SLE concludes that the following dietary characteristics might modulate inflammation:

These characteristics reflect the Mediterranean diet, which contains lower levels of animal protein and higher amounts of plant-based foods than many other types of diets.

Depending on which medications a person is taking, a healthcare professional may recommend consuming foods that help manage their side effects. People should speak with a doctor about any side effects they experience.

Foods to help with nausea and upset stomach

According to the LFA, certain medications may increase a person’s risk of developing stomach ulcers, which can cause symptoms like nausea and vomiting. These medications include nonsteroidal anti-inflammatory drugs (NSAIDs) and prednisone.

People may manage these symptoms by eating:

Foods to help with folic acid loss

Doctors may prescribe methotrexate for some individuals with lupus. Because this medication may cause folic acid loss, they may also prescribe folic acid supplements.

People should not change their diet while taking methotrexate unless their doctor instructs them to do so. However, some foods that contain folic acid include:

Foods to help with high blood pressure

Some people with lupus may take prednisone. According to the United Kingdom’s National Health Service, long term prednisone use may lead to high blood pressure.

The American Heart Association notes that people should include the following foods in their diet to help manage their blood pressure:

• whole grains
• fruits
• vegetables
• nuts and legumes
• skinless poultry and fish
• low-fat dairy products
• non-tropical vegetable oils

According to the Centers for Disease Control and Development (CDC), people may need to ask a doctor which foods to limit or avoid because of their lupus.

The CDC notes that a doctor may advise a person to avoid foods with a high fat content if they develop hyperlipidemia due to lupus.

An older 2015 review cited research that suggests saturated fats may promote endotoxins that trigger an inflammatory response. Endotoxins are poisonous substances that are present in some types of bacteria. A 2020 review also indicates that consuming sugar may negatively affect SLE.

Therefore, limiting high fat and high sugar foods may be beneficial for lupus symptoms.

Foods that people may wish to avoid or limit include:

• processed meats or meat with a high saturated fat content, such as:
  • sausages
  • hot dogs
  • bacon
  • pork
  • spareribs
  • red meat
• lard, margarine, and shortening
• sweets, cakes, biscuits, and baked goods
• frozen meals, ultra-processed packaged foods, and fast food
• high sugar breakfast cereals
• sodas and sugar-sweetened drinks
• alcohol
• sugar- and fat-laden dressings, sauces, and syrups

People can speak with a doctor or dietitian to find out what foods may trigger their symptoms and help them plan their meals.

A person with lupus may benefit from following the Mediterranean diet. Studies suggest that this diet may be anti-inflammatory and may help regulate the immune response. However, research into the benefits of this diet is still ongoing, and healthcare professionals do not currently recommend any particular diet for people with lupus.

Some evidence suggests that eating a whole foods diet that includes plenty of vegetables, a moderate amount of whole grains and legumes, and smaller amounts of animal protein may be beneficial. Avoiding foods high in added sugars and saturated fat may also have an anti-inflammatory effect.

A person can seek advice from a doctor or dietitian regarding which foods to include and avoid in their diet.