Nutrition and Lupus
Marian Mc Namara BA Healthcare Mgt, Dip Nutrition, Personal Trainer and fellow Lupie!
Living with Lupus can be challenging at the best of times. Fuelling your body with the best sources of nutrition gives you the best chance of dealing with the symptoms and flares that Lupus causes. The following article is very informative on how to best deal with Diet and Nutrition in relation to Lupus. Following the article is some information on Carbohydrates, Proteins, Fats and Fruit and Vegetables. By eating within your portions of each food group will enable you to be in control of your diet and provide the necessary nutrition to maintain and enhance a healthy lifestyle.
All kinds of foods from vegetables to fruit to whole grains contain carbohydrates. Carbohydrates are made up from sugar molecules. There are many different types of sugar molecules and thus different types of carbohydrates. Common types of carbohydrates are:
The body converts all carbohydrates into glucose or blood sugar, which our body can use for energy or store as fat. The only exception to this is fibre, which cannot be digested into sugar molecules and therefore passes through the body. There is a type of fibre called soluble fibre which binds to fat in the digestive system and carries it out as waste.
Simple and Complex Carbohydrates
At a chemical level, carbohydrates can be grouped into two categories:
- Simple carbohydrates, found in foods such as fruit
- Complex carbohydrates, found in foods such as potatoes, bread, chips!
It is a misnomer that complex carbohydrates take longer to digest and are absorbed more slowly by the body because the chains of sugar molecules are much longer than those found in simple carbohydrates. In fact, some complex carbohydrates such as starch found in foods such as bread made from heavily processed flour, have been found to raise blood sugar level quicker than simple carbohydrates. If our body has more blood sugar than it needs at any given time, the body will store this excess blood sugar as fat.
Glycemic Index Explained
These days, people talk about the Glycemic Index (GI), which aims to classify carbohydrates based on how quickly they raise blood sugar levels. A study of women whose diet contained a lot of bread, pizza and rice has shown a doubling of their risk of heart disease. These foods have a high glycaemic index (GI), meaning they release energy and raise blood sugar quickly. Eating low GI carbohydrates keeps energy levels balanced because they enter the blood stream slower and keep you feeling fuller for longer.
Protein- Cellular Repair and Stable Blood Sugars
There are a number of benefits that accompany the addition of increased protein amounts into an individual's diet. Whether an individual in interested in losing weight, building muscle, or simply improving his or her overall health, the results can be very encouraging.
- Increase in energy levels - protein is a significant source of energy in the body.
- Improved metabolism - protein encourages improvements in the body's metabolic processes
- Increased immunity and recovery - protein plays an important role in improving the body's ability to not only fight off certain diseases, but to recover from trauma and stress as well
- Increased muscle mass - protein contains amino acids- the building block for muscles
- Satiated hunger - studies have shown that individuals who include high protein diet food in their daily menu remain less hungry and suffer from fewer cravings than those who consume more carbohydrate rich foods.
A high protein diet doesn't have to be as restrictive as one might think. There are a number of options available that include large amounts of protein without sacrificing variety.
- Meat - Most consumers are aware that meats supply a significant amount of protein in one's diet. Perhaps one of the most popular food choices for individuals concerned with protein intake, meats can be a wonderful high protein option. Whether one prefers beef, pork, chicken or turkey, there are various ways to prepare and enjoy meat.
- Eggs - Eggs are not only a wonderful source of protein, but they are extremely versatile as well. One egg can provide about 6 grams of protein.
- Dairy Products - Many people do not realize the amount of protein that is typical in most dairy products. One cup of milk, for example, contains approximately 8 grams of protein. Cheese can provide about 5 grams of protein per serving. Other sources are yoghurt.
- Fish - An excellent source of protein and omega 3 fatty acids as well, is fish. A serving of fish provides an average of 25 grams of protein.
- Nuts and Beans - Another great source of protein, providing from 5-10 grams of protein per serving. They can be included in various recipes, or consumed as a snack.
Fats: The Good & The Bad
Choose foods with healthy fats, limit foods high in saturated fat, and avoid foods with trans-fat. Good" fats—monounsaturated and polyunsaturated fats—lower disease risk. "Bad" fats—saturated and, especially, trans fats—increase disease risk. Foods high in good fats include vegetable oils (such as olive, canola, sunflower, soy, and corn), nuts, seeds, and fish. Foods high in bad fats include red meat, butter, cheese, and ice cream, as well as processed foods made with trans-fat from partially hydrogenated oil.
The key to a healthy diet is to choose foods that have more good fats than bad fats, vegetable oils instead of butter, salmon instead of steak, and that don’t contain any trans-fat.
Low Fat Fad!
“Low-fat,” “reduced fat,” or “fat-free” processed foods are not necessarily “healthy,” nor is it automatically healthier to follow a low-fat diet. One problem with a generic lower-fat diet is that it prompts most people to stop eating fats that are good for the heart along with those that are bad for it. And low-fat diets are often higher in refined carbohydrates and starches from foods like white rice, white bread, potatoes, and sugary drinks. Similarly, when food manufacturers take out fat, they often replace it with carbohydrates from sugar, refined grains, or starch. Our bodies digest these refined carbohydrates and starches very quickly, causing blood sugar and insulin levels to spike and then dip, which in turn leads to hunger, overeating, and weight gain. Over time, eating lots of “fast carbs” can raise the risk of heart disease and diabetes as much as, or more than, eating too much saturated fat.
So when you cut back on foods like red meat and butter, replace them with fish, beans, nuts, and healthy oils, not with white bread, white rice, potatoes, sugary drinks, or other refined carbohydrates.
Although it is still important to limit the amount of cholesterol you eat, especially if you have diabetes, for most people dietary cholesterol isn't nearly the villain it's been portrayed to be. Cholesterol in the bloodstream, specifically the bad LDL cholesterol, is what's most important. And the biggest influence on blood cholesterol level is the mix of fats and carbohydrates in your diet, not the amount of cholesterol you eat from food.
Fruit and Vegetables
This food group is very important for overall health. Fruits and vegetables contain the majority vitamins and minerals that our body needs to protect against illness and manage conditions such as Lupus. It is important to eat a wide variety of fruit and vegetables to ensure that you are getting a diverse range of vitamins and minerals. One easy way to remember how to do this is by “Catching a rainbow every day” choose fruit and vegetable that match the colours of the rainbow. The recommended daily allowance for fruit and vegetables is 5 per day.
Keep your Weight in check
Keeping your weight in check is extremely important especially when you have Lupus. I know it can be easier said than done especially with steroid treatment and certain medications. However excess weight does effect the following:
- Joints which can decrease mobility and increase pain
- Heart function, the heavier you weigh the more pressure your heart is put under to supply oxygen to the working muscles.
- JIncreased risk of certain cancers,
- JIncreased risk of stroke
- JIncreased risk of Diabetes Type 2
There is no specific diet for lupus, despite the numerous claims on the Internet and in various books and other publications. In general, you should try to eat a nutritious, well-balanced, and varied diet that contains plenty of fresh fruits and vegetables, whole grains, moderate amounts of meats, poultry, and oily fish, as fish oil has been found to help reduce inflammation.
2 Frequently Asked Questions- Sourced from The Lupus Foundation of America
Will eating nightshade vegetables increase my lupus flares or joint pain?
It seems that every place I read about this has a different opinion about this. The nightshade vegetables include white potatoes, tomatoes, peppers (sweet and hot), and eggplant. There are others, but they are not foods that are typically consumed in the U.S. While there is anecdotal evidence that some of these foods can be related to inflammation, there is no solid scientific evidence to support this concept. My advice would be for people to keep track of when they eat these foods, and to look for a pattern between consumption and a flare. They would want to observe a link between a particular food and a flare on multiple occasions -- not just a few times. If there does seem to be a connection, then by all means, a person could avoid one/all of the nightshade vegetables without creating any nutrient deficiencies. Peppers, for example, are high in vitamin C, but so are plenty of other foods (i.e. citrus), so limiting peppers in your diet isn't going to cause any problems. Bottom line -- there isn't any good scientific evidence linking nightshade vegetables to inflammation/flares, but if people believe there is an association for them, then it isn't going to hurt them to omit the offending food from their diet.
What can I do about the weight gain brought on by the prednisone?
Increased appetite is well recognized as a side effect of corticosteroid therapy. Often times, just being aware that this increase in appetite may occur with the steroid therapy, is the first step towards managing the potential weight gain. If you have to go on steroids or if you have to increase your dosage of steroids, you may want to consider planning out a healthy diet during the time you're taking steroids and making sure that you stick to it. During those times, however, when you're really hungry, here are some things you can do to combat the munchies:
- Drink a large glass of low sodium vegetable juice cocktail
- Eat a bowl of air popped or low fat microwave popcorn
- Eat a plate of raw vegetables dipped in fat-free sour cream
- If you can, go for a walk
- Drink a cup of decaffeinated flavoured coffee with low fat milk
These are low fat substitutions, which can reduce your overall caloric intake and hopefully curb your weight gain. Taking steroids can also increase water weight gain. You can help to cut down the amount of fluid retention by reducing your sodium and/or salt intake. This can be accomplished by avoiding processed or convenience food whenever possible. If you are going to be eating convenience or processed foods, check the label and make sure that no item contains more than 200 mg of sodium per serving. Or if you are eating a whole frozen dinner, for example, try and stay between 500 and 700 mg of sodium. If you can avoid processed meats such as luncheon meats, sausages or bacon, you'll be reducing your sodium intake and that's good. If you have a choice among fresh, frozen or canned vegetables, stay away from the canned and choose fresh or frozen because they are lower in sodium.
Support groups and commercial weight loss programs can assist in weight control efforts.
Omega-3 fatty acids found in oily fish appear to decrease the risk of coronary artery disease and may also protect against irregular heartbeats and help lower blood pressure. For these reasons, omega-3 fatty acids are important for women with lupus, who are at a 5-10-fold higher risk for heart disease than the general population. Omegas are also used to combat the effects of fatigue which is one of the most common symptoms of Lupus.
One food for people with lupus to avoid is alfalfa. Alfalfa tablets have been associated with reports of a lupus-like syndrome or lupus flares. The lupus-like effects may include muscle pain, fatigue, abnormal blood test results, changes in how the immune system functions, and kidney problems. These reactions may be due to the amino acid L-canavanine (found in alfalfa seeds and sprouts, but not in leaves), which can activate the immune system and increase inflammation.
The world health organisation recommends at least 30 mins per day of moderate exercise for optimum health. Again when living with Lupus this can prove difficult. The key is to exercise when you can and choose an activity that suits your own personal needs. If you have frequent joint pain and stiffness choose an exercise such as swimming or aqua aerobic which is low impact on you joints as the water cushions your joints. Swimming is an excellent form of exercise as it provides you with aerobic exercise and resistance training (the water) which will help tone the body.
How do you know if you are exercising efficiently? While you are exercising you should be able to hold a conversation in other words you should not be getting out of breath. If you are getting out of breath you need to reduce your exertion level. Over time your body will adapt and you will get fitter and be able to go faster and for longer without getting out of breath. If you decide to get involved with mini marathons and would like to give running a go, my advice is to start off slowly. Start by walking for 5 mins and jogging for 1 min for 5 intervals (30mins). Increase you’re jogging intervals and decrease your walking intervals steadily. Eventually you will be jogging steadily and over time your speed will increase to a run (over 6miles per hr)
Weight training is extremely important for muscle toning, weight loss and decreasing osteoporosis. Again start off steady. If using a gym start on light controlled machine weights, gradually increasing the weight and repetitions and sets as your body adapts. A general rule for toning is 15-20 repetitions and 2 sets 3-4 times per week. An example would be squats, squat for 15-20 times take a minutes rest and repeat the sequence twice then gradually increase to 3 sets. A good fitness instructor will develop a routine that is safe and effective. Fitness centres and gyms are a luxury these days so my advice would be to go on line and research a fitness DVD that would reflect your interests. My recommendations would be Jillian Michaels 30 day shred approx. €10 from Amazon, or if you can afford it KettleWork by Ryan Shanahan. Another option is to purchase a fitness magazine they always include home workouts that are highly effective. It’s important to remember that you will experience muscle fatigue from exercising this is caused by a build-up of lactic acid. However it is not as bad as the pain caused by joint soreness. If you strengthen the muscles it will stabilise the joints more efficiently. The key is to start off slow and steady. If you do get post workout muscle fatigue use Epsom salts in a hot bath to draw out the lactic acid, make sure you stretch before and after exercising holding each stretch for at least 30 seconds to 1 minute.
To finish off exercise is powerful at combating stress and depression. When you exercise the brain releases endorphins which are feel good hormones. The body loves these hormones and literally gets a boost or a high from them. This is why once you start exercising your body starts to crave it after it gets over the initial shock!
If anyone has any other questions I am on Facebook via The Lupus Support Group. Feel free to PM me with any questions. Coping with Lupus is tough but by taking control of your diet and increasing your exercise up take can make all the difference both physically and mentally.
Nutrition & Health Foundation