13 February 2007

SLE and diet

Systemic lupus erythematosus (SLE), or lupus, is a chronic inflammatory disease that can affect many of the organs in the body. Significant dietary changes may be called for.

Systemic lupus erythematosus (SLE) or lupus, as it is often referred to, is a chronic inflammatory disease that can affect many of the organs in the body.

Classified as a multi-system disorder, lupus can involve the skin, joints, kidneys, heart, spleen, nerves, and connective tissues. SLE is much more common in young women and 90% of cases are reported in women around the age of 30, but this disease can also occur in men and in children.

SLE is regarded as an autoimmune disease of unknown origin, although genetics and certain environmental factors, such as virus infections and medications may play a role.

Patients with SLE exhibit a variety of symptoms depending on the severity of their disease. In some cases, the onset of SLE is sudden, with patients developing fever and a general feeling of malaise (that can be mistaken for an acute infection), whereas other patients experience less acute episodes of fever and feeling unwell over many months and years.

Up to 90% of patients also complain of joint pain (arthralgia) or may have acute arthritis. A history of ‘growing pains’ is not uncommon in children who develop SLE.

Patients may have a ‘butterfly’ rash on the face and many other types of skin lesions, particularly on those parts of the boy which are exposed to the sun. Ulcers and blisters may form in the mouth.

Patients with SLE are also prone to pleurisy (lung infections), heart problems, swollen glands, kidney problems, enlargement of the spleen, and neurological symptoms (headache, personality changes, epilepsy, psychoses).

SLE is generally treated with medications, such as anti-inflammatories (to alleviate joint pain and inflammation), aspirin (to control blood clotting), antimalarial drugs (help to reduce joint and skin symptoms), and corticosteroids.

Dietary treatment
Both the disease and the medications that are used to treat the disease, affect nutrient requirements. In patients with kidney involvement, large quantities of protein are lost in the urine and renal failure may occur.

Consult a dietician
Each patient should have a diet worked out for her/his specific needs, which include:

  • the severity of the disease,
  • acute or chronic phases,
  • organ systems that have been affected,
  • medications prescribed,
  • general health,
  • body weight and activity levels

It is, therefore, advisable for all patients with SLE to consult a clinical dietician who will work out a diet that takes these specific requirements into consideration.

Phone (012) 998-5650 (mornings) to obtain the name and address of your nearest dietician so that you can arrange a consultation.

General dietary adjustments
However, the following dietary adjustments may help patients with SLE in general:

  • Eat a balanced diet consisting of a variety of foods - this would include increasing your intake of fish, fresh fruit and vegetables, unprocessed cereals and grains, low-fat milk and yoghurt.
  • Do not exclude certain food groups unless your doctor or dietician has advised you to do so.
  • Try to maintain your ideal body weight. If you are overweight, ask your dietician to help you lose weight by reducing your energy intake.
  • Make sure that you are drinking sufficient liquid, which may include water, coffee, tea, rooibos, fruit juice, cold drinks and moderate quantities of beer or wine. You need three litres or 10 x 300 ml cups of liquid a day in total. This does NOT mean that you should drink all your regular beverages and then add another extra three litres of water. Remember 10 cups/glasses of LIQUID a day are sufficient.
  • Try to cut down on salt. Ideally you should only be ingesting one teaspoon (5 g) of salt (sodium chloride) a day. Don’t add salt when you cook foods and use as little as possible at table. Use lemon juice, herbs and other spices to give dishes flavour. Read labels on foods to exclude those that have a high salt content. Some medications also contain sodium and may have to be excluded.
  • Don’t eat too much protein as this may aggravate SLE. Use fish instead of red meat, chicken and organ meats to increase your omega-3 intake.
  • Cut down on fat as this may also have a negative effect on SLE and cause overweight. Avoid fatty foods, visible fat on meat, adding fat in cooking, fat-rich sauces and dressings, cakes, pies and chips - in fact any foods that have a high fat content, except certain types of fish and vegetable oils.

These are just some of the dietary adjustments that you can make if you suffer from SLE. – (Dr I.V. van Heerden, DietDoc)

Any questions? Ask DietDoc

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