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Nutrition, Omega-3 fatty acids and Gluten.
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R Swamy Venuturupalli, MD, FACR posted:
We keep putting stuff into our bodies that we shouldn't be and often we put too much. Caloric restriction or fasting actually helped Lupus in rats but I wouldn't recommend it for everyone. Once in a while it may be helpful though. However, prednisone makes you hungry so trying to get on the lowest dose of Prednisone is what you should aim for.

There are good fats and bad fats. Bad fats are the saturated fats such as animal fats, butter, lard etc. Good fats are unsaturated fats of which there are 2 types: Monounsaturated and Polyunsaturated. Monounsaturated fats are not bad in small amounts. They come from foods such as olive oil, avocados, almonds, peanuts and walnuts. Polyunsaturated fat comes from foods such as fish, seeds, flax seeds, soybean, walnuts and leafy greens. Within the polyunsaturated fats, there are Omega-3 fatty acids which are anti-inflammatory fatty acids.

A study published in 2008 showed that in humans, there was a big difference between the placebo group and the omega-3 fish oil group. There was a clear improvement in SLAM and BILAG -- which indicate how active your lupus is. So this was the first good published study that shows that omega 3's can make a difference in lupus. Omega 3's are the only 'good' fat to absorb into the body, and fatty fish are good although a lot of fish these days are tainted with mercury. A guide to which fish are safe can be found at: http://www.nrdc.org/health/effects/mercury/guide.asp

A lot of fish is farmed and farm fish don't have as much omega 3's as wild fish. This may have something to do with the fact that wild fish are more active, while farm fish don't move around as much. Another consideration is that wild fish is more expensive.

There are some good fish oil supplements made from wild fish because they extract the mercury out of the fish oil, however you need a lot of it to make a difference. One fish meal is probably equivalent to 9 or 10 capsules of fish oil.

One must be careful because some people have shellfish allergies and lupus patients especially seem to have more allergies than non-lupus patients because their immune systems are very activated and it's the immune system that causes allergies.

You should have about 4 grams of omega 3 fatty acids and there is also a prescription strength omega 3 called Lovaza (it's 4 grams) which is approved for the treatment of high triglycerides and low HDL.

Other foods that are rich in omega 3's are green leafy vegetables, soy, tofu. Don't consume soy and tofu in excess because they have estrogens in them and in women, breast cancer is a potential issue even though there is no conclusive evidence, it is still theoretically a risk. We are still trying to figure out the correlation between estrogen and lupus, so soy and tofu are ok in small amounts.

Some eggs are enhanced with omega 3's and whilst there's a huge cholesterol scare with eggs, they're not that bad. There are some good qualities in eggs and they are a decent source of protein.

Avoiding gluten rich foods can be beneficial. Gluten is found in wheat, rye barley, and it seems everyone loves bread, croissants, pasta etc, however this may not be good for you because these are insoluble fibers and proteins. They are very hard to digest and therefore are taking away precious energy resources. Since your immune system is already overactive in lupus it's already using up much or your energy and if you add hard to digest foods to that equation -- foods which not only take away energy resources but also aren't good for you -- you will increase fatigue. This is why I strongly recommend avoiding gluten rich foods.
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Dr. R. Swamy Venuturupalli is a board-certified rheumatologist practicing in Los Angeles. He is Clinical Chief of the Division of Rheumatology at Ce...More

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