A nutritious diet likely helps protects against lupus flare-ups, but contrary to what other studies have indicated, Vitamin D does not seem to make a difference, according to Ph.D. student Cecilia Lourdudoss of Sweden’s Karolinska Institutet. She recently spoke to The Lupus Foundation of America about her study of diet and glucosteroid use in patients with systemic lupus erythematosus (SLE).
The study, “The association between diet and glucocorticoid treatment in patients with SLE,” was published in the journal Lupus Science and Medicine, and was recently covered by Lupus News Today.
Lourdudoss, who performed the study at the Unit for Research Therapy, Inflammatory Diseases (ClinTRID), said she used glucocorticoids as a proxy for disease activity since steroids are used during active lupus or lupus flares.
“They are either initiated or increased in dose when patients’ lupus becomes active. Therefore, we considered steroids as a good substitute for lupus activity, ” she told the Lupus Foundation.
Contrary to what other studies have shown, Lourdudoss’ study showed that dietary Vitamin D was not associated with decreased lupus activity. However, her study did not look at Vitamin D from supplements or from its main natural source – sunlight.
But other nutrients were associated with lower disease activity. And while Lourdudoss points out that the findings need to be replicated, a well-balanced diet containing plenty of vegetables, fruit, fatty fish, and whole grains, and moderates amounts of red meat, is likely beneficial for people with lupus.
The study also found that beta-carotene from dark green, orange, and yellow vegetables and fruits, omega-6 fatty acids found in vegetable oils, nuts, seeds, and animal products, and vitamin B6 from fortified cereals, beans, poultry, fish, and some vegetables and fruits seemed to protect against increases in steroid dose.
High glucocorticoid levels were also associated with an increased appetite.
The study also found a protective effect of alcohol: “We should always be very cautious about recommending alcohol consumption given the risks associated with inappropriate or excessive alcohol intake. Our findings show that alcohol intake was associated with no steroid use. However, this does not clearly indicate that increased alcohol intake gives a protective effect to avoid steroid use. To give out recommendations regarding alcohol intake, our results need to be confirmed in a larger group of lupus patients, and in comparison with several other studies with similar results,” Lourdudoss said.
Lourdudoss also discussed findings of increased appetite in relation to glucosteroid use with the Lupus Foundation, and was asked if she had any recommendations to lupus patients about glucocorticoid treatment.
“It is common to gain weight during steroid treatment. Lupus patients taking steroids during longer periods may have an advantage of maintaining their original weight. Increased body mass index (or BMI, a measure of body fat based on weight and height) is associated with cardiovascular disease, worse lipid profile (the pattern of cholesterol in the blood) and poorer quality of life in people with lupus,” she said.
“A good way to decrease the total caloric intake is to consume more low energy, dense foods such as vegetables and fruits and to decrease or avoid certain energy, dense foods such as soda, chips, candies, chocolate, and processed meat. In addition, physical activity, as much as your lupus symptoms allow, can be beneficial.”
Lourdudoss told the Lupus Foundation that her research group recently submitted another paper investigating the link between diet and atherosclerosis in people with lupus. She also said the group is currently working on three other projects exploring dietary aspects in patients with rheumatoid arthritis, another autoimmune disease.
The Lupus Foundation presents information about lupus and diet in their Living Well with Lupus section.