A healthy diet can go a long way toward improving overall health. Some TMA members have found that their symptoms are greatly improved when they adopt special diets such as paleo or vegan. While these eating plans may take some special commitment, the anti-inflammatory plan (sometimes referred to as a Mediterranean diet) is easily adaptable and is one that all people, but especially those with an autoimmune disease, can benefit greatly from. It includes the following:
- Avoid processed and fast foods, including those with high fructose corn syrup, artificial ingredients, preservatives, and pesticides. Instead, opt for a wide variety of brightly colored fresh fruits and vegetables and unrefined foods.
- Reduce the number of foods made with wheat flour and sugar, especially bread, pasta, and most packaged snack foods. Choose instead foods containing whole grains, such as brown rice and bulgur wheat.
- Decrease intake of saturated fat by eating less animal fats and products made with palm kernel oil.
- Use extra-virgin olive and expeller-pressed canola, sunflower, and safflower oil.
- Include avocados and nuts, especially walnuts, cashews, almonds, and nut butters made from these nuts.
- Increase omega-3 fatty acids in your diet by eating salmon, sardines, herring, black cod, omega-3 fortified eggs, hemp and flax seeds, or take a fish oil supplement.
- Eat more vegetable protein, especially from beans and soy, and choose fish, cheese, and yogurt more often than you choose animal proteins.
- Avoid drinking soda, and choose tea instead of coffee.
- If you drink alcohol, red wine is preferable.
- And eat more chocolate (in moderation) with a minimum of 70% cocoa.
Special dietary considerations for those taking corticosteroids. People who must take corticosteroids (prednisone), especially in high doses and for longer periods of time, face a number of complications that carry considerations for what you eat.
- Prednisone increases appetite. To avoid weight gain, avoid high-calorie foods and eat frequent small meals to help maintain steady blood sugar levels. Getting plenty of exercise will also help.
- To reduce the risks of high blood pressure and fluid retention, limit salt intake to less than 1,500mg per day. You can do this by eating fresh rather than processed or canned foods and avoid adding salt food.
- If you take medication for high blood pressure, you may need to increase intake of foods high in potassium, such as bananas, apricots, cantaloupe, baked potatoes, and tomatoes.
- Prednisone can also irritate the stomach, so it is important to take it with food, not on an empty stomach.
- Diabetes is also a risk when taking steroids. To keep blood sugar levels within the normal range, avoid foods high in simple carbohydrates like sugar and keep carbohydrate intake to between 45 and 60mg per day.
Dietary supplements have a wide range of products and recommended uses. The following specific recommendations are offered for those who have myositis diseases:
- Calcium is a concern for those who take prednisone. You should eat foods rich in calcium, such as milk, yogurt, cheese, leafy green vegetables (kale, bok choy), almonds, and broccoli. Calcium supplements are also recommended to minimize bone loss and osteoporosis.
- Vitamin D is a hormone produced in the skin in response to sunlight. It is important in calcium absorption and many other processes. Because most people do not spend enough time in the sun (and dermatomyositis patients should not spend time in the sun), most people need to take dietary supplements of Vitamin D.
- Folic acid (also called folate) is a B vitamin that is abundant in leafy green vegetables, such as spinach, kale, broccoli, and other sources. Because methotrexate interferes with the way folic acid is used in the body, those who take this anti-inflammatory medication need more folic acid than can be consumed from dietary sources, so they should take folic acid supplements.
- Omega-3 fatty acids, which are anti-inflammatory, and omega-6 fatty acids, which are pro-inflammatory, should be in balance in the body. Most Americans, however, eat far more omega-6 foods (vegetable oils, safflower oils, meat, poultry, and eggs), causing a more pro-inflammatory state. To bring this back into balance, you should eat more foods containing omega-3 fatty acids, including salmon, mackerel, sardines, leafy green vegetables, flaxseed, canola oil, walnuts, and enriched eggs. Omega-3 supplements are also available.
Nutrition and supplements for inflammation – A presentation by Kelsey Peterson at the TMA Annual Patient Conference