Should we follow a special diet in lupus?

Yes.  Good food hygiene (a balanced diet) is necessary in all inflammatory diseases, and even for anyone!  As a starting point, the so-called Mediterranean diet provides benefits which are demonstrated in several rheumatic diseases.  This diet includes proportionally high consumption of olive oil, legumes, cereals, fruits and vegetables, moderate to high consumption of fish, moderate consumption of dairy products (mostly as cheese and yoghurt), and low consumption of non-fish meat products. The benefits of a specific lupus diet are very often mentioned.In reality, this diet can have three different objectives.


Diet can help control possible excess weight, and especially avoid the risk of atheromatosis of the arteries which is a significant problem in lupus (even in the absence of obesity).

Atheromatosis is a disease of the vessel walls, partly caused by fat abnormalities (hypercholesterolemia, hypertriglyceridemia), but also by the existence of a chronic inflammatory disease, such as lupus. A balanced diet should therefore allow cholesterol levels to be normalised, by avoiding “bad” animal fats (butter, cream, cold cuts), to the benefit of "good” vegetable fats (olive oil ...). In some cases, dietary and medical follow-up is essential.


The diet may aim to limit the risks related to cortisone.


The diet may also aim at trying to control lupus, by “tricking” the immune response. For this, different approaches have been suggested, but none of them has been validated in lupus. Some diets recommend the exclusion of one or more foods. Certain foods (dairy products, animal fats,  gluten, cereal products, etc.) could interfere with the immune system, modifying the intestinal tract’s flora. Even though these diets sometimes give the impression of improving the situation, there is no scientific evidence to prove this. Moreover, prolonged exclusion from these foods can lead to many dietary deficiencies, and can have consequences on the general condition and possibly on the bones (risk of osteoporosis).

In rare cases, some patients report painful manifestations after certain foods. These could reflect the existence of an intolerance food reaction to certain products (mainly dairy or cereal). This reaction is often difficult to demonstrate. This situation can be discussed with your doctor who may ask you to exclude the suspicious food from your diet for 6 weeks (stop test), and then to reintroduce it.

Fasting, possibly followed by a lacto-vegetarian diet, is said to help reduce inflammation, but this attitude has no basis in lupus. In addition, it is dangerous to fast for an extended period of time, due to the risk of vitamin deficiency. Scientific experiments have been done to try to modify the behaviour of the immune system through the absorption of different molecules with the objective of inducing an oral immune tolerance. For the time being, there is no application in lupus.