Lupus Anti-Inflammatory Diet: Lifestyle changes advice [January 2025]

Anti-Inflammatory Diet Guide for Autoimmune Diseases

Eating an anti-inflammatory diet can significantly help manage autoimmune diseases like lupus and rheumatoid arthritis and is recommended for Lupus lifestyle changes. You gain better control over your symptoms when you avoid foods that trigger inflammation. A recent study from the University of California San Diego Medical Center proved this fact. Researchers showed that rheumatoid arthritis patients experienced significantly better disease control when sticking to this specific diet. Lupus studies show that diets rich in omega-3 fatty acids and low in omega-6 fatty acids actively reduce disease activity. High doses of omega-3 supplements and consuming krill oil reduce lupus onset and severity.

In a study, lupus mice show better disease control when they eat a diet rich in resistant starches. We discuss resistant starches in the probiotics section below. The Mediterranean diet features many of these excellent anti-inflammatory recommendations. You can find more information online or ask your doctor for a copy of a Mediterranean diet guide. If you find this nutritional guide helpful, please share it with others who might benefit.

NOTE: Johns Hopkins University Press, publisher of The Lupus Encyclopedia, is a nonprofit publisher. If you purchase JHUP books, like The Lupus Encyclopedia, you support projects like Project MUSE.

July 2024 Update: Omega-3s Help Lupus

Clinical evidence continues to grow regarding the powerful role of omega-3 fatty acids in treating lupus. A Harvard study proved that people taking high doses of omega-3 supplements (1,000 mg/day) significantly lowered their risk of developing autoimmune diseases. Family members of lupus patients should take daily omega-3 supplements and eat omega-3-rich foods. Krill oil provides one excellent source of high-quality fish oil. However, consumerlab.com recommends limiting omega-3 supplements to two grams daily. This limit helps you avoid risks like blood thinning, immunosuppression, and atrial fibrillation.

A 2024 multicenter study revealed that SLE patients with high disease activity experienced less inflammation after taking 4 grams of concentrated krill oil daily. Patients saw improvements at 4, 8, and 16 months compared to those taking a placebo. All patients taking krill oil showed significant increases in their omega-3 levels. This vital increase helps prevent heart attacks and strokes. The researchers noted no significant side effects during the clinical trial. This discovery updates my previous recommendation against taking omega-3 supplements. Numerous lupus centers now confirm krill oil is both safe and effective. You must always ask your doctor before starting any new dietary supplement. Omega-3 fatty acids thin the blood and must stop before surgery. They may also reduce blood pressure and interact with specific lupus medications like tacrolimus.

An Anti-Inflammatory Diet Guide for Autoimmune Diseases

This is the latest handout I provide to my own patients. It compiles the newest medical research on foods that decrease body inflammation. We discuss anti-inflammatory foods to enjoy and trigger foods to avoid. We also cover intermittent fasting, prebiotics, and probiotics below. For the best possible results, you must follow this diet while taking your prescribed medications. You also need to exercise regularly and get at least 8 hours of sleep each night. Finally, always protect yourself from harmful ultraviolet light.

Eat Omega-3 Fatty Acids and Limit Omega-6 Fatty Acids

You must increase your daily intake of specific healing foods. Focus on omega-3 fatty acids like walnuts, flaxseed, chia seeds, salmon, tuna, mackerel, sardines, avocado, and tahini seeds. You should also eat plenty of green leaf vegetables like arugula, broccoli, cabbage, zucchini, and Brussels sprouts. Add anti-inflammatory vegetables like onions, carrots, and pumpkin. You can safely eat garlic in moderation. Enjoy enzymatic fruits like pineapples, mangos, and papaya. Flavor your meals with anti-inflammatory spices like turmeric, black pepper, and ginger. Conversely, you must decrease your intake of omega-6 fatty acids. Reduce your meat intake to turkey or chicken just twice weekly. Eat more fish instead. You must actively limit or completely avoid red meats, fried foods, and butter another recommendation for a Lupus lifestyle change.

Consider Omega-3 Supplements and Selenium

Lupus inflammation damages body organs through a chemical process called oxidation. Anti-oxidative enzymes actively prevent this harmful damage from spreading. Selenium forms a crucial part of these protective enzymes. Unfortunately, SLE patients frequently have low blood levels of selenium. Selenium may protect against lupus damage. You can find selenium in meats, seafood, liver, grains, nuts, and seeds grown in selenium-rich soils. People from families with autoimmune diseases should ensure they get enough selenium in their diets. The healthiest selenium-rich foods compatible with an anti-inflammatory diet include cold-water fish like salmon, mackerel, sardines, tuna, and anchovies. You should also eat whole grains like quinoa, wild rice, brown rice, and barley. Seeds and nuts provide excellent nutrition, especially walnuts, which contain both omega-3 and omega-6 fatty acids. Finally, lentils and other legumes offer great health benefits.

Nightshade Foods and Gluten Guidelines

Many patients ask if nightshade foods and lupus mix well. Some experts recommend avoiding them due to insufficient data. However, nightshade foods are generally fine to eat when you have lupus. Researchers presented an anti-inflammatory diet study that successfully included nightshades at the 2020 American College of Rheumatology meeting. Tomatoes contain rich amounts of lycopenes, making them healthy rather than harmful. Like with any food, you only need to avoid nightshade foods if they predictably cause a flare. In October 2022, the famous integrative medicine doctors at the Osher Clinic officially included nightshade foods like tomatoes in their anti-inflammatory diet for lupus.

Regarding gluten, you should actively decrease your intake of heavy wheat products. Switch from wheat bread and pasta to rye bread, corn tortillas, quinoa, beet, bean, or chickpea pasta. This change helps reduce overall body inflammation. Most experts recommend completely avoiding gluten only if you have diagnosed celiac sprue or gluten hypersensitivity. Please note that these specific recommendations do not apply to people with severe gluten sensitivity. Some healthy alternatives like rye bread can still contain small amounts of gluten.

Intermittent Fasting Decreases Inflammation

Numerous medical studies prove that fasting decreases inflammation in the body. Animal studies also show that fasting lowers lupus disease activity. Numerous animal models demonstrate that animals eating a highly restricted diet live longer. One easy way to fast involves a method called intermittent fasting. This specific form of fasting lowers insulin spikes and decreases your risk of diabetes. It also causes weight loss and may help extend your overall life span. You can easily practice intermittent fasting by eating all your meals within an eight-hour window, then completely fast for at least 16 hours, which includes your sleep time. You can only drink water, black tea, and black coffee while fasting. By going to YouTube to watch helpful videos about intermittent fasting. You must discuss intermittent fasting with your doctor if you have diabetes, especially if you take insulin. You should also exercise regularly to get the full benefits.

The Microbiome in Autoimmune Diseases

Trillions of bacteria live inside our bodies to form our microbiome. Our gastrointestinal tract contains the largest immune system organ in our body. The continuous interactions between our microbiome bacteria and our immune system heavily influence autoimmune diseases. Having good bacteria decreases autoimmunity, while bad bacteria increase autoimmune problems. Studies of the microbiome and autoimmune diseases like rheumatoid arthritis and lupus remain in their infancy. We have performed many studies on animals with lupus, and smaller studies exist for humans. We realize that keeping good bacteria and eliminating bad bacteria remains crucial.

Poor dental health actually causes rheumatoid arthritis and makes it worse. New evidence shows poor dental health does the same with lupus. One study showed that treating periodontal disease in lupus patients improved their disease activity significantly. Make sure you floss every day using standard floss or flossing picks. Brush your teeth twice a day. If you have a dry mouth, ask your doctor about improving saliva to increase good bacteria. You must never smoke, as smokers lose their teeth at a much younger age. Chew gum that contains xylitol, use Xylimelts, or use a xylitol mouthwash like TheraBreath. Get your teeth cleaned every six months.

Second, improving the gut microbiome lacks large human studies, but researchers consider it highly important. Increasing resistant starches in your diet provides great health benefits. Resistant starches include cold overnight oats, potato starch, green banana starch, cold cooked potatoes, and lentils. Your body digests these starches in the large intestine, where they begin to ferment. Beneficial bacteria use these starches for food. They interact favorably with the immune system and decrease harmful bacteria. A study on lupus mice fed a high resistant starch diet showed their gut microbiome improved drastically. Their immune systems became less inflammatory, and their lupus improved. Including a daily serving of resistant starches is a great idea.

Exercise Helps Your Gut Bacteria

Do not forget to exercise to help your gut bacteria and microbiome. A 2023 study showed that individuals who maintained a healthy BMI and performed 150 minutes of moderate aerobic exercise per week had healthier microbiomes. The study also proved this true for people with a strong hand grip, which measures muscle strength. I put the word “healthy” in quotes because BMI does not accurately measure a healthy weight for everyone. Someone with low muscle mass can be medically obese and still have a healthy BMI. Bodybuilders can fall into the obese BMI category while remaining incredibly healthy due to low body fat.

Probiotics in Autoimmune Diseases

Probiotic beneficial bacteria can potentially heal the microbiome of your intestinal system. Research shows that probiotic supplementation in lupus mice provided benefits and improved disease activity. Bifidobacterium and Lactobacillus species improved disease activity in these models. Probiotics are live bacteria touted to have beneficial effects by living within our intestinal system. While probiotic supplements help general gastrointestinal problems like irritable bowel syndrome, no human studies have proven their benefit for autoimmune disorders yet. In animal research, some autoimmune disorders actually worsen with certain probiotic organisms. Therefore, we do not universally recommend any probiotic supplements. However, many foods contain rich natural probiotics. No studies suggest that these probiotic foods make autoimmune disorders worse. Therefore, you should consider consuming a daily portion of natural probiotic-rich foods.

Gastroenterologists may recommend probiotic supplements for stomach problems. If you take a supplement, I recommend looking closely at the bacteria list. I recommend avoiding products that contain Ruminococcus (blautia) gnavus and Lactobacillus reuteri. Both of these strains have worsened lupus in medical research studies. Getting probiotic bacteria from natural food sources remains the safest option until we learn more.

Probiotic-Rich Foods and Prebiotics

You can easily add natural probiotics to your daily diet. Eat foods like Greek yogurt, kefir, unpasteurized kimchi, kombucha tea, warm miso soup, and tempeh. Other healthy options include unpasteurized sauerkraut, fermented pickles, dark chocolate, cold green peas, olives, natto, beet kvass, and fermented beets. You can also eat cottage cheese with live cultures and soft, aged cheeses like gouda, parmesan, cheddar, and swiss.

You must not forget to feed your healthy gut microbiome by ingesting prebiotics. Prebiotics act as food for your probiotics. Lupus mice fed prebiotics like resistant starches developed less lupus disease activity. They also improved beneficial gut bacteria and strengthened their immune systems. Knowing that specific foods can improve lupus is incredibly exciting. Excellent examples of resistant starches include cold cooked oatmeal, cold cooked potatoes, green plantains, beans, legumes, cooled brown rice, and barley.

Avoid Alfalfa Sprouts and Mung Bean Sprouts

You must strictly avoid eating alfalfa sprouts and mung bean sprouts. Macaque monkeys fed diets high in L-canavanine developed severe lupus-like symptoms. This specific amino acid occurs abundantly in these sprouts. The monkeys suffered from autoantibodies, hemolytic anemia, and kidney inflammation. Researchers repeated these exact findings in another study. Likewise, lupus mice fed a diet high in alfalfa sprouts experienced worsening lupus.

Garlic or No Garlic?

Yes, you can safely eat garlic when you have lupus! Unfortunately, some well-respected lupus websites still recommend avoiding garlic. However, modern research does not base this warning on any real medical data. Zero medical studies show negative effects on lupus or any other autoimmune disease. In fact, researchers included garlic in a highly successful anti-inflammatory diet study called the ITIS Diet. Dr. Monica Guma led this study at the University of California, San Diego. It showed highly beneficial effects on rheumatoid arthritis.

Excerpt from “The Lupus Encyclopedia“:

“Some doctors recommend avoiding garlic because it contains substances (allicin, ajoene, and thiosulfinates) that could theoretically increase immune activity. Yet, no medical studies show that garlic causes lupus flares. The ITIS diet included garlic because of its rich phytochemical contents. Phytochemicals help plants resist infections, meaning garlic has health benefits. While we do not know whether garlic helps the immune system in SLE patients, we do not think it is harmful.“

Alcohol Guidelines for an Anti-Inflammatory Diet

 

You must always secure your doctor’s permission before drinking alcohol. Try to avoid it completely in medical situations like severe liver disease. You also need to avoid alcohol when taking specific medications. However, studies show alcohol remains safe in moderation with methotrexate. People predisposed to alcoholism must avoid all alcohol. Evidence shows an association between low to moderate alcohol consumption and beneficial effects on lupus. The highly regarded Osher Clinic includes red wine in moderation as part of its recommended anti-inflammatory diet. Alcohol provides anti-inflammatory effects and may protect against lupus. A 2020 Harvard research study of over 200,000 women measured immune system levels seen in lupus. Those who drank alcohol had lower stem cell factors. Numerous studies show that women who drink moderate amounts of alcohol have a reduced risk of developing lupus.

Moderate alcohol intake may decrease the risks of cardiovascular disease problems like heart attacks and strokes. It also increases your good cholesterol levels. However, heavy alcohol drinking increases the risk of death from sudden cardiac death. It may increase your risk of breast, colon, liver, and lung cancers. Heavy alcohol use also increases the risk of depression, gout, dementia, and severe liver damage. Any alcohol can impede reflexes and increase the risk of a motor vehicle accident. Before drinking alcohol, double-check with your doctor about medication interactions. Prednisone, NSAIDs, and antidepressants can have bad side effects when mixed with alcohol.

If you drink alcohol, you must drink a moderate amount. Women should not drink more than one serving within 24 hours. Men younger than 65 should not drink more than two servings. One serving equals 12 ounces of beer or 5 ounces of wine. Evidence shows red wine may have more health benefits due to antioxidants. If you do not currently drink alcohol, we do not recommend that you start. Women who drink should consider taking a daily folic acid supplement to reduce breast cancer risks.

Think of alcohol as a drug. In small to moderate amounts, it may have beneficial health effects. In large amounts, it is incredibly dangerous. It causes severe harm to the person and to society.

For More Information on the Anti-Inflammatory Diet and Lupus

Read chapters 38 and 39 of The Lupus Encyclopedia, edition 2. Look up your symptoms, conditions, and medications in the Index. If you enjoy this information, please click the “SUPPORT” button at the top of the page to learn how you can help.

What Are Your Comments and Opinions?

If you have diet advice for lupus, what has your experience been? What do you recommend for other patients? Do you have any questions to ask Dr. Thomas? Please click on “Leave a Comment” above to comment. Please support “The Lupus Encyclopedia” blog post page by clicking the support button at the top.

Dietitians and Nutritionists:

Consider seeing a dietician who specializes in lupus and anti-inflammatory diets. If you have any to recommend, please let us know in the comments. We recommend The Lupus Dietitian (Tanya Frierich). She offers virtual visits and in-person sessions in North Carolina. You can email her at tanya@tanyabnutrition.com or find her on Instagram at instagram.com/thelupusdietician.

References:

Other studies are linked directly in the post above in addition to the following clinical studies:
Bustamante MF, et al. Contemp Clin Trials Commun 2020.
Guma M, et al. Trial of diet to improve RA and impact on the microbiome. Presented at ACR Convergence 11/9/2020.
Zegarra-Ruiz DF, El Beidaq A, Iñiguez AJ, et al. A Diet-Sensitive Commensal Lactobacillus Strain Mediates TLR7-Dependent Systemic Autoimmunity. Cell Host Microbe. 2019;25(1):113-127.

Author

Written by Donald Thomas, MD
Author of “The Lupus Encyclopedia“
Arthritis and Pain Associates of PG County
301-345-5600
www.arthritispainpg.com

For more in-depth information on Lupus Anti-Inflammatory Diet: Lifestyle changes advice [January 2025]:

Read more in The Lupus Encyclopedia, edition 2

Look up your symptoms, conditions, and medications in the Index of The Lupus Encyclopedia

If you enjoy the information from The Lupus Encyclopedia, please click the “SUPPORT” button at the top of the page to learn how you can help. 

---

What are your comments and opinions?

If you have lupus, what has your experience been? What do you recommend for other patients?

Do you have any questions to ask Dr. Thomas?

Please click on “Leave a Comment” above to comment.

Please support “The Lupus Encyclopedia” blog post page

Click on “SUPPORT” at the top of the page to learn how you can support “The Lupus Encyclopedia“

This article includes contributions from