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What does nutrition care look like when you have an autoimmune disease?

By Juliana Tamayo posted 02-15-2021 08:11 PM

What does nutrition care look like when you have an autoimmune disease?

Headshot of Student Partner Juliana
By Juliana Tamayo, WH DPG Student Partner

Being chronically ill is a struggle, but having an autoimmune disease makes things much more complicated, especially when it comes to nutrition. I suffer from three different autoimmune diseases: systemic lupus erythematosus, Crohn’s disease, and eosinophilic esophagitis (EoE). All of these affect the way I’m supposed to eat and how my body utilizes nutrients.

However, access to adequate nutrition and dietetic services can be limited, particularly because there is still a large gap in knowledge on nutritional needs for those with       autoimmune diseases. This is even more complicated by the fact that there is some evidence that diet can influence risk for certain autoimmune diseases.

What are autoimmune diseases?

According to the National Institutes of Health (NIH), autoimmune diseases are those in which the body’s immune system attacks healthy cells by mistake. The damage done can occur in many parts of the body and result in various symptoms. As of today, there are more than 80 known autoimmune diseases, with some sharing characteristics, which makes them more difficult to diagnose.

Some of the common symptoms across these diseases include fatigue, muscle aches, joint aches, and even fever. There is also redness, swelling, and sensitivity to heat, cold, or light. These illnesses may have periods of remission and flare-ups, in which they tend to get worse and cause a lot of signs of pain[1].

Does diet influence autoimmune diseases?

 The answer here is tricky. All my life, I have had to watch what I eat. If I ate too much fiber, my Crohn’s disease would flare-up. If I ate something too crispy, I would have a reaction due to my EoE. Lupus can also make you gain or lose weight depending on the medication you are taking, and with fluid retention, some foods may be out of the question.

But many of us wonder, is there a connection between our diets and the risk of developing an autoimmune illness? According to a study by Manzel, et. al., “It is current knowledge that nutrition, the intestinal microbiota, the gut mucosal immune system, and autoimmune pathology are deeply intertwined[2].” What this means is that ultimately our diets do matter in the long-term, but there is not sufficient data to say whether it is a cause of autoimmune illnesses or just a factor that may precipitate illness onset. We should watch what we eat, nourishing our bodies, and try to prevent the destruction of healthy bacteria in our gut. However, the best diet to achieve these goals can be very different for each of us.

Regardless, there is sufficient evidence to suggest that diet does influence symptoms and treatment. There are many ways that we can get better treatment when we suffer from autoimmune diseases, including lifestyle changes, medication management, and in some cases, physical therapy.

In recent times certain diets have gained popularity in the treatment of autoimmune disorders, such as the anti-inflammatory diet, the ketogenic diet, or the gluten-free diet. While these have proven benefits for some autoimmune diseases, these disorders are so varied and affect everyone in such strikingly different ways, that there is no one size fits all approach. According to the Harvard School of public health, the immune response can be triggered by various factors including antigens, inflammation, infection, stress, lack of sleep, or environmental factors. But does any one diet work to mitigate symptoms? The same report from Harvard found that dietary patterns and lifestyle changes have a better effect on disease processes[3].