What to include and what to avoid

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

The Lupus Foundation of America 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. 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?

Statistics show that lupus mainly affects people aged 15–44 years and that 90% of adults with lupus are female. In addition, 1 in 3 people with lupus have multiple autoimmune diseases.

Females from historically marginalized groups are two to three times more likely to have lupus than white females. These groups include:

• African Americans
• Hispanic Americans
• Latin Americans
• Asian Americans
• Native Americans
• Alaska Natives
• Native Hawaiians and other Pacific Islanders

Lupus can run in families, and 20% of people with the disease have a parent or sibling who already has lupus or may develop it.

Symptoms of lupus and how doctors diagnose it

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 weight loss, fever, and fatigue.

The ACR notes that doctors may find lupus hard to detect, as there can be many symptoms that develop slowly. However, symptoms that may help doctors diagnose lupus include:

Active lupus may lead to atherosclerosis and kidney inflammation, which can be severe if doctors do not detect them.

The ACR notes that although there is no cure for lupus, doctors may treat the disease using medications such as immune suppressants and antimalarial drugs. 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 is 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.

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.

Evidence suggests that eating a whole foods diet that limits added sugar and saturated fat can reduce inflammation. 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 is 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.