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Keeping calories in check has great potential to help manage weight. People with lupus that are also overweight have shown to be more fatigued, more depressed, and have increased pain. Before considering any major diet changes, speak with your lupus treatment team and a dietitian. (CALERIE) (Comprehensive Assessment of Long term Effects of Reducing Intake of Energy) was a study designed to determine the biological effects of two years of prolonged caloric restriction in humans. 218 middle aged, normal or moderately overweight people participated. Participants in the experiment group were told to reduce their calorie intake by 25% for 2 years. The control group continued eating the usual diet. These features, combined with the careful attention to detail in the collection of data, make the publicly available CALERIE data sets and biospecimens a unique and invaluable research resource for the investigation of innumerable hypotheses. These were the results…

The Experimental Group

This group was unable to reach the 25% mark. They reduced their caloric intake by 12% however. They maintained a 10% loss in body weight over two years.

Restricted Diet Group

Reduced risk factors for diabetes, heart disease and stroke. They lowered their blood pressure and cholesterol levels. Decreased some inflammatory factor. And had no adverse effects on sleep, quality of life, mood or sexual function.

Consider the Limitations

While these results are positive, it is important to consider the limitations of the study.

  • Small participant base
  • People with Lupus were not the study participants
  • Studies rely on self-reports of calories consumed
  • Can add a level of error

Additional large studies of this type are needed to truly assess the potential value of calorie-restricted diets. The National Institutes of Health says… “Scientists also do not know whether these eating patterns are safe or even doable in a long run. There is no enough evidence to recommend any such eating regimen to the public”.

What is a calorie-restricted diet?

Calorie restriction is a dietary regimen that reduces food intake without incurring malnutrition. “Reduce” can be defined relative to the subject’s previous intake before intentionally restricting food or beverage consumption, or relative to an average person of similar body type. More accurately, calorie-restricted diets mean both limiting the amount of food that you eat throughout the day, and avoiding high-carbohydrate & high-fat foods. A diet like this is not right for all Lupus patients. Most medical professionals recommend that Lupus related diets be tailored to each individual patient according to their nutritional needs. Restricting calories can hurt some individuals, particularly if they are already having a problem with energy levels. However, if weight is the primary issue, keeping calories in check has great potential to help manage weight. Obesity can be an issue for people with lupus and has been shown to be increase fatigue, pain, and depression.

How do these diets provide benefit?

Some research says calorie restricted diets can reduce inflammation and fatigue. Some could be due to weight loss but it could also be due to the microbiome. Low carbs and low fat diets are linked to healthier gut bacteria. A healthy gut has a diverse community of microbes, each of which prefers different foods. … Fruit, vegetables, pulses, nuts and wholegrain feed healthy bacteria. Avoid highly processed foods. They often contain ingredients that either suppress ‘good’ bacteria or increase ‘bad’ bacteria. This also reduces inflammation and is linked to lowered symptoms of lupus. Change through foo has the potential to help prevent lupus flares.

Foods to avoid…

  • Sugar – especially sugary drink like sodas and fruit juice
  • White Flour and White Rice – these carbs are stripped of their fiber and most of their nutrients. The body processes carbs efficiently which means more energy for the body but also more energy that can be turned into fat. We can’t live without them — but we’d be healthier if we got most of our carbohydrates from “smart carbs” like fruits, vegetables, legumes, low-fat dairy, and whole grains. The bottom line: White, refined foods can be part of a healthy diet, but moderation is key.
  • Cream or Butter – High fat products can hide in many foods. One of the first things to look for when eyeing the nutrition information label on a food is how many grams of fat the item has. Right under that find the grams of saturated fat . Be sure and check labels.

Limiting food intake

Speak to your lupus treatment team and decided if it would be a good thing for you to try this kind of diet. The following are some tips to help you achieve your goal…

  • Eat slowly and stop eating before you feel full
  • Portion out your food carefully, use measuring tools. small plates or bowls also help
  • Eat small meals throughout the day. This can help you never to feel hungry and gives you more energy than three large meals.

Are Calorie-restricted Diets right for Lupus patients?

Lupus is a systemic disease, so maintaining good nutritional habits will help your body remain as healthy as possible. Generally, doctors recommend a diet composed of about 50% carbohydrates, 15% protein, and 30% fat. However, since people with lupus often experience symptoms like weight loss or gain, inflammation, osteoporosis, kidney disease, high blood pressure, and atherosclerosis, certain specific nutritional concerns may also need to be taken into consideration. Calorie-restricted diets can be powerful tools for managing weight. But they are not suitable for all people with lupus. Much of the research remains uncertain. Studies have been short so determining long term value is challenging. Humans are different from one another and what works for one person may not work for another. Always prioritize nutrition over calories and talk to your doctor and your team before making any drastic changes .

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The Cincinnati Rheumatic Disease Study Group (CRDSG) is an organization of practicing rheumatologists dedicated to improving the care of patients with arthritis and other rheumatic diseases. It strives to do this by performing rigorous and ethical clinical research with the goal of developing better treatments for all patients with these conditions.
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