Eating Healthy When You Have Lupus

While eating a healthy diet is important for everyone, it is especially important for someone with lupus (and any other chronic disease). To fight a disease like lupus, the body needs protein, vitamins, minerals and calories. But there’s another reason why practicing sound nutrition is so important for the lupus patient. It can help fight off other diseases like cancer, heart disease and osteoporosis. Although many lupus patients might not think about such conditions, they are just as vulnerable to them as anyone else -- and sometimes even more so because of medications or a lack of activity.

Here, we answer some dietary questions commonly asked by many lupus patients.

Q. I have heard about vitamins and herbs that are supposed to “boost the immune system.” Why would I want to boost my immune system if lupus is caused by an overactive immune system?

A. Let’s look at this question in two parts. First, herbal, vitamin and other so-called “nutritional” products such as coenzyme A-10 that promise to boost the immune system
simply cannot live up to their promise, according to the Food and Drug Administration. Some may even be dangerous. Coenzyme Q-10, for example, can cause serious problems in people with poor circulation. Herbs may contain dangerous contaminants, some of which have been deadly (such as the chaparral herb). Such products are also expensive, robbing people (especially the chronically ill and elderly) of billions of dollars per year.

Secondly, you really can’t boost the immune system, or make it more active, with diet. What you can do with a healthy diet is to strengthen the other disease-fighting abilities of the immune system. But do that with healthy food, like fruits and vegetables, not with herbs and nutritional supplements

Q. If some vitamins are good, does that mean taking extra is even better?

A. No -- overdosing on vitamins may even be dangerous. Unfortunately, many people, especially people with chronic illness, jump on the vitamin bandwagon and carry a good thing too far by taking far more than the recommended amounts of vitamins and minerals (called recommended dietary allowances or RDAs). But this overzealousness can be downright dangerous. Consuming more than the RDA may cause toxic side effects, or interfere with the adsorption or metabolism of other nutrients. For some vitamins and minerals, amounts many, many times the RDA are necessary to cause undesirable side effects, but sometimes levels just slightly higher than the RDA are dangerous. The best advice is to buy a generic brand of multiple vitamins from your local discount drug store, and take just one per day. (There’s one exception to this rule: patients taking methotrexate are often told to take a folic acid supplement).

Q. Are there any foods a person with lupus should avoid?

A. There’s no overall advice for every lupus patient. While there’s some evidence from animal studies that some mice fed alfalfa sprouts develop lupus, there’s no evidence of that in humans. If you find that certain foods make you ill or consistently trigger a flare, you should certainly avoid those foods. Like everyone, you should avoid foods that are high in fat and sodium (as you’ll read more about later).

Q. What kind of diet should a person with lupus follow?

A. The same healthy diet that every American is advised to follow is a diet low in fat (with 20-30% of calories from fat) and rich in complex carbohydrate foods such as whole grain products, legumes, vegetables and fruits. The other key characteristic of a healthy diet is variety. Try to include at least 10 different foods daily, striving for 15 different foods each day. Ideally, aim to include at least five and hopefully nine different fruit and vegetable servings daily (where a serving is 1/2 cup or one piece of fruit).

Q. Should I avoid all red meat.

A. There’s absolutely no reason that beef and pork can’t be part of a healthy diet. The key is in how much you eat and how you prepare it. It’s true that most Americans eat too much protein. While many people eat six or eight ounces of beef or other meat at one meal, the healthier amount is just 2-3 ounces per meal, or a total of 5 ounces per day. A three-ounce portion is approximately the size of a deck of playing cards, or a small fist. Prepare you protein foods by first trimming all visible fat; broiling and grilling are much better than frying. The best advice about types of protein food is again to think variety; rotate chicken, turkey, fish, beef, pork and cheese for your protein foods at dinner. At lunch, try to get your protein from legumes -- such foods as lentils and dried beans and peas. These high-protein foods are also very low in fat and high in fiber.

Q. What of I’m too ill to cook? Are there any frozen foods that are okay to eat?

A. Tread carefully through the frozen food aisle. Frozen foods are fat and salt landmines that can wreak serious havoc on fluid retention and your waistline. Read labels carefully. Choose frozen meals that have 10 or fewer grams of fat and no more that 500-700 milligrams of sodium.

In addition to frozen food, you might consider having some of the lower-fat, lower-sodium soups on hand. Choose varieties with chicken or beef so that you get some protein. Low-fat yogurt is also a good food to keep on hand -- it’s not too high in sodium and a great source of protein. if you like it, low-sodium vegetable juice cocktail helps you get essential vitamins and minerals when you don’t feel like fixing a vegetable.

Q. Is there any way to keep from gaining weight when I have to go on prednisone or when my dose increases?

A. You’re very smart to think about how not to gain weight rather than later worrying about how to lose the weight you’ve gained -- the latter is very difficult for everyone, and almost impossible if you’re still taking Prednisone.

Unfortunately, the increased appetite you experience when you’re taking predisone (or other forms of cortisone) is not just a figment of your imagination -- it’s real. Be aware that you will feel hungry when you’re not, simply because your body doesn’t supply you with the internal clues necessary to tell you to stop eating. That’s why it’s important to design a healthy eating plan (consulting with a registered dietician is a great idea for people with lupus, especially those who take cortisone), and then follow it. This way, you’re relying on a sound nutrition plan rather than appetite signals (which aren’t reliable) to decide what to eat. Other tricks to try when your steroid appetite demands food:

*Drink a large glass of low sodium vegetable juice cocktail.

*Munch down a bowl of air-pooped (or low-fat microwave) popcorn.

*Snack on a plate of raw vegetables, dipped in fat-free sour cream, if you wish.

*If you can, go for a walk.

*Drink a cup of decaffeinated, flavored coffee with milk.

*At meal time, leave the food in pots on the stove, and fill your (and everyone else’s) plates from there. This reduces temptation.

Q. Are there any other nutritional problems associated with taking cortisone?

A. To feel best and avoid complications when taking cortisone, patients should also reduce sodium intake and check with a physician about how to get enough calcium. As anyone who has taken cortisone knows, it can make you retain fluid. While it’s not possible to prevent all fluid retention, it is possible to reduce it by cutting down on sodium. It’s not enough just to push away the salt shaker, though. Short of tallying sodium intake, here are general guidelines that will help limit sodium intake:

*Avoid processed and convenience foods when possible, choosing instead foods as they come from nature (fruits, vegetables and whole grains).

*When you use convenience and processed foods, check the label. Choose items with no more than 140-200 milligrams per serving, or if you’re choosing a whole convenience meal (such as a frozen dinner), stay around 500-700 milligrams.

*Use processed meats, such as luncheon meats, sausages and bacon rarely.

*Choose fresh or frozen vegetable over canned; if you use canned, buy sodium-free.

*Buy plain pastas and add your own spices rather than buying packaged pasta mixes.

*Remove the salt shaker from the table, or empty it of salt and replace with sodium-free herb; also add a bottle of lemon juice to the table.

*Replace garlic salt, onion salt and the like with powders.

*Leave out some or all of the salt when you’re baking.

Q. I have high cholesterol. Can diet bring it down?

A. In most people, yes. But, contrary to what most people think, limiting dietary cholesterol. In fact, dietary cholesterol. In fact, dietary cholesterol is relatively
insignificant to your final blood cholesterol reading, as just about 15% of dietary cholesterol is absorbed (the rest simply passes through the intestinal tract unabsorbed).
Most of the body’s cholesterol is made by the liver. The key is in controlling how the body recycles cholesterol. The most important dietary maneuver in this regard is reducing total fat intake, especially saturated fat.

Saturated fat is indeed the main dietary culprit in raising blood cholesterol levels. How? In addition to making cholesterol, the liver is responsible for filtering cholesterol from the blood. It does this via thousands of proteins that jut from the surface of each liver cell, which basically “snare” cholesterol particles as they flow by. Saturated fats somehow gum up the works, either by reducing the number of LDL receptors or impairing their efficiency. The result blood cholesterol levels rise.

On the other hand, moderate amounts of monounsaturated fats (such as olive, canola and peanut oils) and polyunsaturated fats (such as corn oil) can lower blood cholesterol levels. But remember that even too much of these better fats defeat the purpose and can actually raise cholesterol levels as well. Overall, limit fat intake to just 20% to 30% of you total calories each day.

Getting plenty of dietary fiber and enough B vitamins is also key to reducing heart disease risk.