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. 2022 Jan;31(1):65-76.
doi: 10.1177/09612033211063795. Epub 2022 Jan 3.

Plant-based dietary changes may improve symptoms in patients with systemic lupus erythematosus

Aziyadé Knippenberg  1 , George A Robinson  2   3 , Chris Wincup  2 , Coziana Ciurtin  3 , Elizabeth C Jury  2 , Anastasia Z Kalea  1   4
Affiliations

Plant-based dietary changes may improve symptoms in patients with systemic lupus erythematosus

Aziyadé Knippenberg et al. Lupus. 2022 Jan.

Abstract

Introduction: Previous studies have reported that patients affected by systemic lupus erythematosus (SLE) are interested in using diet to treat fatigue, cardiovascular disease and other symptoms. However, to date, there is insufficient information regarding the ways for patients to modify their diet to improve SLE symptoms. We investigated the relationship between the eating patterns of SLE patients and their self-reported disease symptoms and general aspects of health.

Methods: A UK-based, online survey was developed, in which patients with SLE were asked about their attitudes and experiences regarding their SLE symptoms and diet.

Results: The majority (>80%) of respondents that undertook new eating patterns with increased vegetable intake and/or decreased intake of processed food, sugar, gluten, dairy and carbohydrates reported benefiting from their dietary change. Symptom severity ratings after these dietary changes were significantly lower than before (21.3% decrease, p<0.0001). The greatest decreases in symptom severity were provided by low/no dairy (27.1% decrease), low/no processed foods (26.6% decrease) and vegan (26% decrease) eating patterns (p<0.0001). Weight loss, fatigue, joint/muscle pain and mood were the most cited symptoms that improved with dietary change.

Conclusion: SLE patients who changed their eating patterns to incorporate more plant-based foods while limiting processed foods and animal products reported improvements in their disease symptoms. Thus, our findings show promises in using nutrition interventions for the management of SLE symptoms, setting the scene for future clinical trials in this area. Randomised studies are needed to further test whether certain dietary changes are effective for improving specific symptoms of SLE.

Keywords: Lupus; SLE; autoimmune; diet; dietary patterns; plant-based; symptoms.

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Conflict of interest statement

Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Patients’ beliefs on the link between diet and their SLE symptoms. (A–D) Data is displayed as the percentage of total patients that responded to the question.
Figure 2.
Figure 2.
Patients’ experiences with dietary change and their SLE symptoms. (A–E) Data presented as the percentage of total patients that responded. (F) Paired T-Test, Mean and SEM. (G) Data presented as the percentage of total patients responding ‘yes’. (B–D, G) Number of respondents displayed to the right.
Figure 3.
Figure 3.
Patients’ symptom benefits by dietary restraint and length. (A) Scatter plot demonstrating patients’ decrease in symptom severity by their ratings for restraint in eating. Positive x-axis values indicate improvement in symptoms after dietary change. Pearson correlation. (B) Percentage of patients that benefited from dietary change for different diet durations. Number of patients that responded to each option is displayed to the right. Chi-square test. (C) Mean symptom severity ratings before and after dietary change and the decrease in symptom severity by duration of dietary change. Mean. Paired Samples Wilcoxon Signed-Rank Test; *p<0.001; **p<0.0001. (D) Percentage of patients undertaking eating patterns for different durations that responded ‘yes’ when asked whether their new eating patterns helped with specific symptoms.
Figure 4.
Figure 4.
Patients’ symptom benefits from specific new eating patterns undertaken. (A) Percentage of patients following a certain eating pattern that responded ‘yes’ when asked if they benefited from their dietary change. (B) Patients’ mean symptom severity ratings before and after dietary change by type of new eating pattern undertaken. The difference between these values is displayed as ‘decrease in severity’. Mean. Paired t-test (all-patients) and Paired Samples Wilcoxon Signed-Rank Test; * p<0.0001, ** p<0.00,001. (C) Percentage of patients responding ‘yes’ to whether their new eating patterns helped with fatigue, weight loss, mood or joint/muscle pain by type of new eating pattern undertaken. (D) Mean ratings for restraint in eating by new eating pattern undertaken. 1–10 rating scale, 1 = no restraint, 10 = total restraint. (E) Percentage of patients with the worst symptom severity ratings (score of 10) or score<10 undertaking each new eating pattern. (F) Percentage of patients undertaking dietary change for more than a year by the type of eating pattern undertaken.
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