Arthritis lupus diet

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Inflammation is the common link among most of the more than 100 types of arthritis.

The process of inflammation starts with a trigger such as infection or tissue damage. In response, white blood cells are attracted to the area and release chemicals to begin the repair process. Among them are prostaglandins —which can both reduce and promote swelling, and leukotrienes—which intensify inflammation. White blood cells also release other chemicals such as digestive enzymes to remove bacteria and other foreign agents in the area. However, the enzymes can also digest normal tissue such as cartilage, bone, ligaments, and muscle. As this process proceeds, inflammation becomes a chronic self-sustaining process.

The role of diet in arthritis is controversial. Some scientists feel that foreign antigens can slip through the layer of mucus coating the intestines, enter the blood, and travel to joints. Antigens then attract white blood cells that initiate inflammation.

If these antigens are found inside food which a patient is allergic to, then eliminating that food from the diet could possibly reduce arthritis inflammation.

Another theory involves lectins, food molecules that act like antigens. Recent studies in both the British Journal of Rheumatology, and the British Journal of Nutrition point out that many foods commonly mentioned in discussions of food allergy, such as peanuts, beans, peas, lentils, barley, rye, oats, corn, and wheat, are loaded with lectins. Lectins are known to cause changes in the wall of the digestive tract that can allow antigens to leak into the blood and perhaps trigger arthritis.

Speculation also exists that arthritis patients may experience antigen transfer through the intestinal wall because of damage to the intestinal lining from medications such as non-steroidal anti-inflammatory drugs. Perhaps, it has been suggested, fasting for short periods of time, could reduce the amount of antigens available to traverse the intestines.

Arthritis is a disease that waxes and wanes. It's difficult, then, to tell whether a period of improvement is due to a specific therapeutic intervention or just part opf the disease course.

Elimination diets are a way of identifying a hypersensitivity to a particular kind of food. First a specific food or food group suspected of causing a reaction is removed from the diet. Then the withheld foods are reintroduced one at a time to see whether arthritis returns.

No specific "anti-lupus" diet has been proposed. For a time, experimental data indicated that alfalfa sprouts could induce lupus in susceptible animal models. Whether this holds true in humans is still debatable.

The amino acids, phenylalanine and tyrosine, may aggravate systemic lupus erythematosus (SLE), although the exact reason why is still unknown. Findings from both animal and human studies have confirmed the efficacy of removing these amino acids from the diet in some patients.

Studies of an animal model of SLE have found that high fat diets can promote the onset and progression of the disease by weakening immune responses, suggesting that a low fat diet could be beneficial.

A vegan diet may be ideal. Beef and dairy products are rich in phenylalanine and tyrosine. Vegan diets are low in fat.

In SLE, both linoleic acid (omega-6 series) and alpha-linolenic acid (omega-3 series) metabolites are low, suggesting that a perturbation in fatty acid metabolism.

Supplementation of the omega-3 fatty acids EPA and DHA has been beneficial in both animal and human studies. In a double-blind crossover study, 17 patients with active SLE randomly received MaxEPA (a proprietary fish oil preparation) 20 g daily or 20 g olive oil daily added to a standardized low-fat diet for 34 weeks. Fourteen patients achieved useful or ideal status while they were receiving MaxEPA, while 13 patients were rated as worse or unchanged while receiving olive oil placebo. The difference between the two treatments was statistically significant.

Theoretically, because lupus patients have have abnormal tryptophan metabolism, it is suggested that these patients might want to avoid supplementation with tryptophan or its metabolic precursor, 5-hydroxytryptophan.

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