Top 10 Troublesome Foods for Lupus and Other Autoimmune Conditions
What might set off a cascade of inflammation in one individual might not phase another. By examining the scientific literature, patient trends, and anecdotal evidence certain commonalities stand out - particularly in regards to gastrointestinal health.
Whether you have an autoimmune condition or you’re looking to be proactive in your health, it’s wise to avoid the following foods. Once you do for an extended period of time, your body will become more sensitive (in a good way) and in tune with your needs. You’ll better identify what you do and don’t tolerate by noting symptoms, reducing culprits, and simultaneously turning down the inflammation.
1) Genetically Modified (GM) Crops and Genetically Modified Organisms (GMO's) - Top GM crops to avoid include alfalfa, corn, soy, canola (aka: rapeseed), sugar beets, and mostly Hawaiian papaya. While research is limited due to food politics and financial incentives, we are learning the ramifications that GMO's have on our health.
According to the Institute for Responsible Technology (IRT), "Before the FDA decided to allow GMOs into food without labeling, FDA scientists had repeatedly warned that GM foods can create unpredictable, hard-to-detect side effects, including allergies, toxins, new diseases, and nutritional problems. They urged long-term safety studies, but were ignored."
Meanwhile The American Academy of Environmental Medicine (AAEM) reported that, “Several animal studies indicate serious health risks associated with GM food,” including infertility, immune problems, accelerated aging, faulty insulin regulation, and changes in major organs and the gastrointestinal system. In fact, the AAEM asked physicians to advise patients to avoid GM foods. You can do this by looking for non-GMO labels, the non-GMO Project verified logo and organic foods to reduce GMO’s in your diet. For more information, check out the IRT's article, 10 Reasons to Avoid GMOs, and watch the documentary Genetic Roulette.
2) Sprouts, particularly alfalfa - Not only is alfalfa 99% GMO (and therefore widely used as animal feed), but it also contains a natural plant toxin known as L. Canavanine (LC) that’s been shown to induce or exacerbate Systemic Lupus Erythematosus (SLE)-like symptoms when large amounts are consumed. This non-protein amino acid is found in alfalfa sprouts, broad beans (aka: Fava beans), jack beans, legumes and animal feed (primarily for cows).
Back in 1982 a study in the journal Science revealed, “L-Canavanine sulfate, a constituent of alfalfa sprouts, was incorporated into the diet and reactivated the syndrome in monkeys in which an SLE-like syndrome had previously been induced by the ingestion of alfalfa seeds or sprouts (1).” The Science Watch article Alfalfa and Immune Disease goes on to describe, "that L-canavanine takes the place of a related human amino acid, arginine, in forming proteins; the body then regards these proteins as foreign and launches an immunological attack against them."
Just a few years later in 1985 Arthritis & Rheumatology published a study entitled, "Effects of L-canavanine on T cells may explain the induction of systemic lupus erythematosus by alfalfa (2).”
A study on immunological effects of LC in 1989 suggested, "The lymphocytes of SLE patients were poorly responsive to LC stimulation, suggesting that CD8(-)Leu8(+) T cells are specifically deficient in SLE (3)."
In 1990 those findings were supported in a Clinical Immunology and Immunopathology study which reported, “the lymphocyte response to LC depends primarily on the existence of functional CD8(-)Leu8(+) cells. Moreover, it appears that suppressor-inducer T cells, responsive to LC, are especially deficient in SLE (4).” To understand these findings, it’s important to note that suppressor-inducer T cells are a subset of CD4 T helper cells that induce CD8 cells to become suppressor cells that reduce inflammation. Since SLE patients are deficient in these particular cells, they experience the inflammatory effects of LC while others may not.
The Rheumatic Disease Clinics of North America published a 1991 piece indicating, “a potential toxic and immunoregulatory role of L-canavanine in the induction of a systemic lupus-like disease in primates (5).”
Fast forward to 2006 and the Autoimmunity Reviews literature echoed "the role of (the) non-protein amino acid L-canavanine in autoimmunity (6)."
While the majority of these studies exist in the mid-80’s and early 90’s, we can turn to anecdotal evidence for clinical practice applications. For instance I myself (diagnosed with mild lupus in ’08), do not tolerate alfalfa or other sprouts without seeing a debilitating flare in symptoms ranging from pain, fatigue, joint pain, swelling and malaise. I have even experienced this reaction with sprouted nuts (resulting in a setback for weeks on two different occassions), so I have chosen to avoid all sprouts and encourage my lupus clients to do the same. In the past, I had a client (not diagnosed with lupus but experiencing autoimmune symptoms) who was eating alfalfa sprouts on her sandwiches and salads and experiencing increased joint pain and swelling. We immediately removed the sprouts to avoid exacerbating her symptoms and invoking the onset of SLE.
If you choose to consume sprouts, at your own risk, make sure that the seeds or sprouts are always grown into a mature plant until they produce leaves and avoid ingesting the sprouts on a daily basis or in large quantities to reduce your overall LC consumption.
3) Gluten and wheat, including processed gluten-free products - Today Celiac sprue, or gluten-sensitive enteropathy, has a wide range of symptoms from diarrhea to constipation and is more common than previously considered.
According to Dr. Mark Hyman, a functional MD, "A review paper in The New England Journal of Medicine listed 55 'diseases' that can be caused by eating gluten. These include osteoporosis, irritable bowel disease, inflammatory bowel disease, anemia, cancer, fatigue, canker sores, and rheumatoid arthritis, lupus, multiple sclerosis, and almost all other autoimmune diseases. Gluten is also linked to many psychiatric and neurological diseases, including anxiety, depression, schizophrenia, dementia, migraines, epilepsy, and neuropathy (nerve damage). It has also been linked to autism.”
Dr. Kenneth Fine’s research using Enterolab’s stool analysis has found that up to 35% of Americans are gluten intolerant, while nearly 80% of all Americans have one of the HLA DG gene types making them more likely to have an autoimmune disease, Celiac disease and gluten intolerance. His research goes onto suggest that, “1 in 3 Americans are gluten intolerant, and that 8 in 10 are genetically predisposed to gluten intolerance.” What this means is that very few people are exempt from the damage that gluten can cause.
According to Chris Kresser, “Several studies show a strong link between Autoimmune Thyroid Disease (AITD, like Hashimoto’s and Graves’) and gluten intolerance (7, 8, 9, 10, 11). The link is so well-established that researchers suggest all people with AITD be screened for gluten intolerance, and vice versa (12).” He goes onto explain that the molecular structure of the protein portion of gluten, gliadin, resembles the thyroid gland. "When gliadin breaches the protective barrier of the gut, and enters the bloodstream, the immune system tags it for destruction. These antibodies to gliadin also cause the body to attack thyroid tissue. This means if you have AITD and you eat foods containing gluten, your immune system will attack your thyroid."
Perhaps your thyroid is not an issue (to your knowledge), but if you have an autoimmune disease then the chances of your thyroid function and/or gut integrity being compromised are great. 90% of hypothryoid cases have been said to be autoimmune related, and there is data linking autoimmunity, GI activity and schizophrenia (13).
Keep in mind, the immune response to gluten can last up to 6 months each and every time you consume it (14). This explains why it is critical to eliminate gluten completely from your diet if you have AITD. I agree with Kresser when he says to, "avoid gluten if you have AITD, regardless of whether tests show an active antibody response. This is especially true if you have one of the genes (HLA DQ1,2, or 3) that predisposes you to developing gluten intolerance. In my opinion continuing to eat gluten when you have a confirmed autoimmune condition simply isn’t worth risking the immune destruction it could cause.”
Traditional Celiac testing using antibody tests and small intestine biopsies require gluten consumption for an extended period of time, which make you more susceptible to long-term inflammation. DNA tests (which don't waver based on diet) using an oral swab are more accurate and a positive result will detect the likelihood of your symptoms relating to CD, but they won't prove it. If you have risk factors such as European decent, a family member diagnosed with CD, an autoimmune condition (such as SLE, RA, Type 1 DM, AITD) and/or exude symptoms, you’re better off removing gluten from your diet all together.
While many people reserve gluten-free eating for Celiac patients on one end of the spectrum and trendy dieters on the other, there’s a vast space in between designated for gluten sensitivity. Dr. Hyman goes on to say that, "Gluten sensitivity is actually an autoimmune disease that creates inflammation throughout the body, with wide-ranging effects across all organ systems including your brain, heart, joints, digestive tract, and more. It can be the single cause behind many different 'diseases.' To correct these diseases, you need to treat the cause–which is often gluten sensitivity–not just the symptoms.”
This means removing gluten in it’s entirety through the use of whole foods like fresh or frozen produce (fruits and veggies), nuts, seeds (like flax, hemp, chia, pepita, sunflower), pseudo grains (like quinoa, amaranth and buckwheat) beans and organic animal products - all as tolerated. This does not mean using highly processed and pro-inflammatory “gluten-free” packaged products filled with ingredients like GM corn and soy and pro-inflammatory vegetable oils.
If all that is not reason enough to eliminate gluten from your diet, in 2013 The Journal of Nutritional Biochemistry stated, "Our data support the beneficial effects of gluten-free diets in reducing adiposity (fat) gain, inflammation and insulin resistance (15)."
4) Dairy, despite the casein type - Not only is dairy one of the most common food allergies, but it also contains casein which has been linked to increased cancer rates, allergies, asthma and mucous formation while beta casein is associated with type 1 diabetes, heart disease, autoimmunity and even schizophrenia. Upon a reivew of the literature, unbiased dairy research seems limited but some findings apply here. For instance, casein has been suggested as an environmental trigger of autoimmune disorders such as SLE (16), type 1 diabetes (17) and Behcet’s disease (18).
Those patients with Celiac Disease (CD), gluten sensitivity, or similar symptoms might also be sensitive to cow’s milk. According to the journal of Clinical & Experimental Immunology 2007 study exploring mucosal reactivity to cow’s milk protein in CD, "The major finding in this study is that rectal challenge with Cow’s Milk (CM) protein frequently induced a local inflammatory mucosal reaction in patients with CD but not in healthy controls (19).”
For these reasons and others mentioned below, it’s a good idea to avoid dairy. This includes any milk or cheese products from mammals, with the exclusion of eggs. Those who don't suffer from autoimmune conditions may find that they tolerate alpha casein or A2 cow products, but as an autoimmune patient I have not been able to tolerate either. I experience nasal congestion, constipation and joint pain when consuming dairy products (even goat’s milk). I believe this relates to the amino acids, phenylalanine and tyrosine, that are present in dairy and beef - two foods that I find problematic for lupus patients. If you commit to avoiding dairy be sure to read labels on your food, beverages, supplements and medications.
5) Beef, even if it's grass-fed and from A2 cows - It may not surprise you that excessive quantities of meat and dairy can rapidly alter gut bacteria and cause inflammation.
Care2’s article revealed the following:
"A new Harvard University study published in the journal Nature found that diet rapidly alters the microorganisms residing in the gut. These findings were not favorable for meat and dairy. It has long been known that diet influences the type and activity of the trillions of microorganisms residing in the human gut, but Harvard scientists found that even what we eat in the short-term can have drastic effects on the type and numbers of microbes in our gut and their capacity to increase inflammation in the gastrointestinal tract (GI)."
The article goes on to describe how, "researchers found that within two days of consuming an animal-based diet, microbes in the alistipes, bilophila, and bacteroides families increased. Harvard scientists also discovered that microbes found in the food itself, including bacteria, fungi, and viruses, quickly colonized the gut. And, perhaps most notably, they discovered that an animal-based diet caused the growth of microorganisms that are capable of triggering inflammatory bowel disease within only two days of eating these foods."
It’s worth noting that according to lead scientist Lawrence David, PhD, “the meat and cheese diet was extreme; however, it seems to have painted a clear picture of the outcome of a diet heavy in meat and cheese (20)."
Other considerations include the amino acids phenylalanine and tyrosine which appear to aggravate SLE, perhaps due to a specific intermediary block in their metabolism. Findings from animal and human studies have confirmed the benefits of removing these amino acids from the diet for those with connective tissue diseases (21, 22).
Most sources of beef are rich in phenylalanines while soy, dairy, seaweed and meats are high in tyrosine. For this reason it might be a good idea to limit these foods accordingly. Of course if you’ve removed many of the above foods, track your symptoms in a log, and still haven’t noticed any issues - then enjoy these foods from high quality, organic, gass-fed, wild and/or free range sources to increase the nutrient density while reducing your ingestion of toxins.
6) High lectin foods such as wheat, GMO’s, nightshades, grains and nuts - I find lectin issues to be highly individualized depending on the patient’s gut integrity and overall chemical sensitivity. With that said, many autoimmune sufferers do have trouble with high lectin foods.
Lectins are sticky proteins that bind to carbohydrates embedded in cell membranes and intestinal walls that over time may damage intestinal villi. A study in the journal PLoS One concludes, "Lectins potently inhibit plasma membrane repair, and hence are toxic to wounded cells. This represents a novel form of protein-based toxicity, one that, we propose, is the basis of plant lectin food poisoning (23)."
Body Ecology and other sources refer to lectins as “anti-nutrients” due to their ability to survive the digestive tract, to bind to cells lining the digestive tract, and to result in harmful reactions as antinutritive and/or toxic substances. The journal Toxicon goes on to say, "Locally, they can affect the turnover and loss of gut epithelial cells, damage the luminal membranes of the epithelium, interfere with nutrient digestion and absorption, stimulate shifts in the bacterial flora and modulate the immune state of the digestive tract. Systemically, they can disrupt lipid, carbohydrate and protein metabolism, promote enlargement and/or atrophy of key internal organs and tissues and alter the hormonal and immunological status. At high intakes, lectins can seriously threaten the growth and health of consuming animals (24).”
If you suffer from pesky symptoms like swollen joints, stomach issues and moodiness, you might want to explore the reduction of lectins for yourself. Although ubiquitous in nature, removing higher lectin foods proves helpful for some individuals.
I previously recommended the avoidance of wheat and GMO’s so that leaves nightshades (families of peppers, tomatoes, potatoes and eggplants), grains and nuts for you to experiment with personally. Your best options are to remove one category at a time for a minimum of three months, then add back one new food every 4 days and monitor symptoms. If you experience any symptoms upon the reintroduction of a food, remove that item once again.
7) Non-calorie sweeteners (NCS) and refined sugar - It’s well understood that refined sugar raises glucose levels, thereby increasing the release of circulating insulin levels which contribute to insulin resistance, weight gain, and inflammation. According to the American Journal of Clinical Nutrition, in 2008 researchers examined nine years of data on 1,222 adults. They found a positive association between weight gain and an increase in chronic inflammation (25).
Not only does increased insulin promote weight gain which correlates to elevated inflammatory markers, but so do NCS. Several studies have linked the long-term use of NCS to increased weight. A 2014 piece in the publication Appetite explored whether or not NCS produce unintended psychological, physiological, or behavioral changes that have implications on weight. Their findings reported that, "consuming NCS-sweetened beverages influence psychological processes in ways that - over time - may increase calorie intake (26).”
8) Alcohol, all types - Most alcohol raises blood sugar and insulin levels while increasing triglycerides and having a negative effect on your fat profile. The aftermath of alcohol withdrawal elicits side effects such as food cravings, increased appetite and caloric intake, with a crashing or “hypoglycemic” sensation that usually invokes more eating.
Alcohol is a hepatotoxin and for this reason often contraindicated with prescription medications. It also tends to contribute to dehydration depending on how it’s consumed. Alcohol reduces good bacteria in the gut and may contribute to small intestinal bacteria (the bad kind) overgrowth (SIBO). I’ve seen clients (myself included) break out in terrible mouth ulcers, migraines, body aches and flares from even the smallest intake of alcohol. It is a calorically dense, nutritionally poor beverage and is best avoided when seeking health and healing.
9) Psoralens in sunlight - Psoralens are chemicals which can cause toxic effects when exposed to sunlight. Since many lupus patients already suffer from light sensitivity, it’s a good idea to avoid excess amounts of foods with light-sensitive psoralens that can increase the risk of photosensitivity. Lupus flare-ups have been reported after the ingestion of large amounts of foods containing psoralens such as celery, celery salt, parsnips, parsley, coriander and figs.
Adjust your psoralen intake accordingly depending on your sensitivity to light, current medications (which can exacerbate photosensitivity) and climate.
10) Any and all food sensitivities unique to you - SLE patients have an increased risk of food sensitivity as evidenced in clinical application and research.
A nearly 30 year-old study by Allergol Immunopathol examined 63 SLE patients, 51 cases of other autoimmune diseases and 133 healthy individuals, the results disclosed that 76% of SLE cases, 37% of those with other autoimmune diseases and versus healthy controls had had one or more clinical manifestations (listed below) throughout their lives.
Scientists reported, "The frequency of each of urticaria, pharyngitis, conjunctivitis and food allergy was statistically increased in SLE. Furthermore, patients with SLE had the highest incidence of different types of clinical manifestations per individual. Allergic manifestations in SLE are thought to express: a higher level of hypersensitivity to exogenous antigens, or disease activity through cytotropic autoantibodies or through anaphylactoid products of complement activation (27).”
The good news is that eliminating offensive foods may lead to remission as seen time and time again through applications such as my food sensitivity detection and elimination program.
As detailed in the Journal of Pediatrics and reported by Dr. Melvyn Werbach, when a baby boy with symptoms and laboratory findings suggestive of lupus was found to have antibodies to milk, his symptoms resolved upon milk elimination, and returned on 2 occasions when he drank milk (28).
As you can see our immune health is closely related to our gastrointestinal health so it's crucial to identify root causes, remove them from the body, and begin repairing the gut to facilitate your recovery.
If you’re seeking personalized feedback, I will fine tune a plan for you based on an extensive history collection, additional testing and individual consultation. Book a session with me to discuss your options and to get your health moving in the right direction.
For additional suggestions on foods that reduce inflammation, please review my previous post: Ten Ways To Remove Inflammation From Your Food.