Today I want to talk a little bit about autoimmune diseases and what role nutrition plays in regards to reducing the risk of developing, slowing the progression, improving the symptoms of autoimmune disease, and/or minimizing pain of autoimmune diseases.
This is not to say that nutrition can prevent or cure autoimmune diseases, but that certain nutrients and diet styles may reduce the risk or help with symptoms.
This site contains affiliate links (See full disclosure here.)
But first, what is an autoimmune disease?
Autoimmune diseases are a disorder of the immune system. With autoimmune disease, the immune system is overactive and thus your body attacks itself. Although the causes are unknown, researchers think it comes from genetics. It is believed that Autoimmune diseases are developed when genes are triggered by something in the environment, like a virus.
Common autoimmune disease includes Lupus, Multiple Sclerosis (MS), Type 1 Diabetes, Vasculitis, Rheumatoid arthritis, Hashimoto’s, Psoriasis, Irritable Bowel Disease (IBD), Henoch-Schoenlein purpura (HSP), and Crohn’s Disease. During this article, we will look at what the studies say about the impact nutrition may have on these autoimmune diseases.
Inflammation and Autoimmune Diseases
Inflammation is present in most autoimmune diseases AND most autoimmune diseases cause inflammation. So the question is does inflammation increase the risk of autoimmune disease or does autoimmune disease merely cause the inflammation.
Either way, inflammation could exacerbate symptoms; therefore, an anti-inflammatory diet is recommended. The anti-inflammatory diet is similar to the Mediterranean-style diet. The Mediterranean diet has been linked to an expanded lifespan and reduced symptoms of some autoimmune diseases like Rheumatoid Arthritis (11). To eat an anti-inflammatory diet, eat foods high in antioxidants and omega-3s like fruits and vegetables, including leafy greens, nuts, seeds, and fish and limit consumption of sugar, high fructose corn syrup, processed food, trans fat, vegetable oils, refined carbohydrates, processed meats, and excessive alcohol. In fact, according to the Current Allergy and Asthma Reports, the western diet, which is high in sugar, processed food, trans fat, refined carbohydrates, and processed meat, may promote autoimmune diseases (1).
In this same article, the authors state that most autoimmune disease show a response to diet and nutrition. In a review of the studies, the authors reported that calorie restriction, polyunsaturated fatty acid, and green tea extract (antioxidant) were beneficial in the treatment of MS and diets high in fat, especially saturated fat, and salt appeared to make MS symptoms worse. In fact, a high saturated fat diet tripled the risk for an MS relapse. High fat diets may make IBS and Collagen-induced arthritis worse as well. Other risk factors for MS include vitamin D deficiency, low sun exposure, smoking, viral exposure, and obesity, especially in adolescents.
Antioxidants
Although individual antioxidant supplements have been studied, like most nutrients, antioxidants appear to work best when eaten in whole foods and in combination with other antioxidants and nutrients. In fact, some antioxidants appear to have no effect when they were singled out and taken as a supplement. This is why eating a Mediterranean-style diet with lots of varieties of antioxidant-rich foods appears to be most beneficial (7).
Antioxidant-Rich Fruits and Vegetables
Fruits and vegetables, especially cruciferous vegetables, which are rich in antioxidants are associated with a decreased level of patient-reported disease activity and disability as well as decreased frequency of relapses in MS patients. Excluding the nightshade vegetables, potatoes, and legumes, a 1 cup increase in vegetable intake decreased the rate of relapse of MS by 50%. (13). Moreover, when individuals ate a high vegetable and low protein diet for one year instead of the western diet, pro-inflammatory indicators were decreased. Also according to research, Vitamin E (am antioxidant) deficiency is found on 50-60% of patients with Rheumatoid Arthritis (3).
Vitamin D
According to research, vitamin D deficiency may increase the risk of autoimmune disease. Moreover, vitamin D supplements may lessen the severity and frequency of MS symptoms. Researchers have found that if you are born below 35 degree latitude (in American, that is around Atlanta, GA), and live there for the first 10 years of your life, you have a 50% reduced risk of developing MS. It has been theorized that this is because people below 35 degrees latitude get more sunlight and thus more vitamin D. One study also found that men and women who took an adequate dose of vitamin D supplements reduced their risk of developing MS by 40% (2).
According to a comprehensive review in Allergy and Immunology, studies show a vitamin D deficiency increases the risk for MS and lupus (14). There is also an inverse association between vitamin D levels and the developments lupus, type 1 diabetes, MS, Crohn’s disease, Ulcerative Colitis, psoriasis, and rheumatoid arthritis.
Omega-3
Omega-3 is known for being anti-inflammatory. Remember we discussed earlier how an anti-inflammatory diet can be beneficial, but let’s look at Omega-3 specifically. Studies have shown that Omega-3 can reduce symptoms of some autoimmune diseases. Extensive evidence indicates that Omega-3 supplements decreases inflammation and slows the progression of Rheumatoid Arthritis (11). In a randomized controlled study, omega-3 supplements reduced joint tenderness and decreased the use of nonsteroidal anti-inflammatory drugs in individuals with Rheumatoid Arthritis. Other studies have shown improvements in fatigue and grip strength in individuals with Rheumatoid Arthritis (3, 6).
According to the authors the Current Allergy and Asthma Report, Omega-3 may be beneficial for Collagen-induced Arthritis, but possibly not in MS. However this was only found in one study. Other studies showed a higher fatty-fish diet (a good source of Omega-3 and Vitamin D), reduced the incidence of MS.
Gut Health and Autoimmune Disease
Gut microbiome dysbiosis has been linked to autoimmune disease. Probiotics are often taken to help balance the gut microbiome. Forty years of animal and human studies have shown that probiotics can have a positive effect on the immune system. These studies have shown that probiotics have anti-inflammatory responses. Several randomized-controlled trials have shown that improving gut microbiome health with probiotics improves GI symptoms and inflammation in Rheumatoid Arthritis, Ulcerative Colitis and MS (8,13). Another meta-analysis found that probiotics appear to be beneficial for IBD, including ulcerative colitis and Crohn’s Disease (4).
IBD and Gut Health
IBD (Irritable Bowel Disease) is defined as a recurrent abdominal pain at least one day a week for greater than 3 months. Research has found that people with IBS often have a microbiome imbalance. Extensive research has shown that probiotics reduces the symptoms as well as the progression of IBS, ulcerative colitis, and Crohn’s disease. It has been well established that lactobacilli, bifidobacilli, and streptococcus thermophilis are especially effective in ulcerative colitis to the point that some have even gone into remission. Probiotics appear to only be effective in combination with corticosteroid treatment in individuals with Crohn’s disease (8).
RA and Gut Health
While the evidence for the effects of probiotics on Rheumatoid Arthritis are conflicting, many recent studies have found that probiotics improve pain, reduced inflammation, and improved disease activity score compared to a placebo. L. Casei is a probiotic that was specifically shown to reduce joint swelling (8). One study found that probiotic treatment improved pain and self-assessed disability in 45 adults with the autoimmune disease, rheumatoid arthritis (3)
Infant Colic and Gut Health
Infant Colic has been linked to gut inflammation and research suggest that probiotics may be helpful. A meta-analysis of nine trials also found that probiotics could prevent necrotizing enterocolitis in infants (8). Another meta-analysis looked at 23 trials and found probiotics did, in fact, reduce the risk of necrotizing enterocolitis.
Lupus and Gut Health
According to experimental and clinical trials, probiotics may also help with the autoimmune disease, Lupus by reducing inflammation (8). Although most of the trials were animal trials.
MS and Gut Health
MS is defined as a chronic relapsing of a progressive disease of the brain and spinal cord. Evidence from both animal and human trials suggests that microbiome dysbiosis contributes to the pathogenesis for MS. Research found that the probiotic, L. reuteri, was particularly helpful in improving symptoms and the quality of life in people with MS.
Gluten and Autoimmune Disease
A Gluten-free diet is a must for celiac disease; however, a gluten-free or at least a temporarily gluten-free diet may be beneficial to those who are sensitive to gluten that are suffering from autoimmune disease. If you are sensitive to gluten, a gluten- free diet may reduce the risk of developing autoimmune disease or may reduce the symptoms of autoimmune diseases. Also, since having one autoimmune disease increases your risk of having another; it is possible that people suffering from one autoimmune disease may have undiagnosed Crohn’s disease and may find relief when they omit gluten. The bottom line is that studies have shown that some people with autoimmune disease find relief when they omit gluten (3, 5) .
The AIP Diet and Autoimmune Disease
The AIP (Autoimmune Protocol) diet is an elimination diet specific for people with autoimmune disease. This diet is used to determine what foods in which a person may be sensitive or intolerant. AIP appears beneficial in IBD and Hashimoto’s Disease (9, 10).
For this diet, you would omit foods, then slowly add the foods back into your diet so that you can determine your specific food sensitivities. It is believed that one huge reason this diet is beneficial is because sugar and other additives are eliminated from the diet. Other foods that are omitted temporarily are nightshade vegetables (tomatoes, potatoes, peppers, and eggplants), grains, legumes, dairy, coffee eggs, nuts and seeds, food additives, refined sugar, and added sugar. Foods allowed on the AIP diet include vegetables (except nightshades), seafood and fish, fermented foods (a good source of probiotics), lean meats, olive oil, avocado oil, and a small amount of fruit.
Dairy
Researchers found an increased risk of MS among women with a high intake of whole milk during adolescents. Women who consumed whole milk 3 or more times a day had a 47% increased risk of developing MS compared to less than 1 serving per day (12). This would collaborate with the theory that those with a milk sensitivity are more at risk. Also, whole milk is higher in fat, which is a risk factor as well.
Intermittent Calorie Restriction and Keto Diet
Calorie restrictions and Intermittent Fasting may be beneficial for people with MS. Here is what a little bit of the research says.
Intermittent Calorie restriction is defined as an umbrella term for timing meals in order to have periods of fasting. For example, one popular intermittent fasting diet is to fast for 16 hours (usually the majority of those hours are at night) and eat during an 8 hour window. Other variations exist as well. Some preliminary mice studies demonstrate that intermittent calorie restriction may delay the onset, decrease the incidence, and decrease the severity of symptoms of MS. In another randomized human pilot clinical trial, participants on the fasting-mimicking diet and the keto diet, saw benefits compared to the control diet (20) It should be noted that when eating a keto diet, individuals should focus on eating healthy fats as saturated fats have been negatively associated with MS.
One reason the keto diet may be protective is it’s “fasting-like” effects on the body. However, you can get these effects from the Intermittent fasting method as well. The keto diet may also be beneficial for people who are sensitive to gluten because you would not eat gluten on this diet. Keto diet encourages eating antioxidant-rich vegetables as well. Again, you can eat an antioxidant-rich diet as well as a gluten-free diet without doing the keto diet. The keto diet is difficult to sustain for some and is not recommended for those at risk for disordered eating.
CBD
CBD has been shown effective in people with MS by improving pain, muscle tightness, and urination frequency (15).
Take Home Message
Eat a Mediterranean diet full of fruits, vegetables; especially leafy greens, whole grains, legumes, nuts, seeds, olive oil, fish, dark chocolate, tea, avocado, spices and herbs, and limit refined carbohydrates, sugar, trans fat, process food, including processed meats to reduce the risk or alleviate symptoms of autoimmune diseases. Avoid the foods in which you are sensitive and intolerant. Extensive studies have shown the benefits of gut health when it comes to autoimmune disease; therefore, include probiotic-rich and pre-biotic-rich foods in your diet as well.
Want to Learn more about Nutrition and our Health?
Lacy Ngo, MS, RDN is the author or The Nourishing Meal Builder and The Nourishing Meal Builder: the Gluten-Free, Dairy-Free Edition. In the Nourishing Meal Builder books, you will get:
- An evidence-based list of foods that boost mood; promote cognitive function, focus, attention, alertness, and memory; support the immune system; aid in weight loss; reduce the risk of chronic diseases, autoimmune diseases, Alzheimer’s disease, joint pain, and even seasonal allergies.
- A simple meal plan checklist that will help you eat balanced meals on a daily basis that fuels your mind, body, and spirit.
- A faith-based mindfulness and mindful eating guide.
- Printable Meal Builder cards.
Related Posts
A Comprehensive Guide to Nutrition and the Immune System
Nutrition, Asthma, & Seasonal Allergies
A Comprehensive Guide to Nutrition, Mood, & Mental Health
Copyright © 2020 Mindfulness in Faith and Food, LLC.
