The risks of obesity are well known and include a higher risk of heart attacks, cancer and strokes. Lupus patients have a higher risk of cardiovascular problems such as strokes and heart attacks. It is therefore even more important for lupus patients to try and maintain a healthy weight.
Many patients with lupus are concerned that a strict diet may be necessary to help their condition. Infact our general advice is to have a broad general and nutritious diet with perhaps a slightly increased intake of oily fish such as mackerel, sardines and salmon and perhaps a little less red meat. The only food that should be avoided is alfalfa sprouts as this may cause lupus to flare. Click here for our advice on diet.
It would be sensible to keep within the recommended calorie intake, which is roughly 1,900 calories per day for women and 2,500 calories per day for men. These figures are based on adults with a sedentary lifestyle wishing to maintain their current weight.
Patients on corticosteroids such as prednisolone often gain weight which may be very difficult to shift even on reducing the prednisolone. Steroids are known to upset cholesterol levels and blood sugar levels increasing the risk of diabetes. Furthermore, blood pressure may rise both with the steroids and associated weight gain.
We conducted a pilot study to test the effects of a standard calorie controlled diet, that is usually recommended from the dieticians department, compared to the low glycaemic index diet that is now a very established diet.
The principle of the low glycaemic index (GI) diet is that certain foods increase the blood sugar very rapidly as these sugar containing foods are easily digested. Thus low GI foods would include proteins such as fish and meat as well as vegetables and certain fruits such as strawberries. High GI foods would include any foods containing refined sugars such as biscuits, many breakfast cereals and sweets. Paradoxically dark chocolate which contains very little sugar may be taken in moderation. By keeping to low GI foods, weight loss can be achieved.
Our results showed that both diets were well tolerated by lupus patients on long term steroid tablets and both groups of patients lost significant amounts of weight ranging from 2 - 4 kg. Very few side effects were reported by the patients. One striking advantage of both diets was that severe tiredness improved significantly with the weight loss. One concern of the higher protein intake with the lower GI diet would be that cholesterol and blood pressure levels might be upset. However this was not the case and cholesterol levels remained the same as did blood pressure.
For patients on steroids who are finding it difficult to shift the weight gain it would seem reasonable to consider a low GI diet or a low carbohydrate diet.
In summary there are major benefits to losing weight in lupus - not least being the considerable improvements in tiredness that are such a major problem in patients with lupus. Keeping to a healthy weight will also minimise the risk to cardiovascular health that is increasingly important in lupus patients.
Other weight loss tips
- Keep a food diary, write down everything you eat, particularly at the start of a weight loss diet, it's easy to forget about the 'little added extras' that creep into your diet. A study in the Journal of the Academy of Nutrition and Dietetics showed that people who did this lost more weight (on average 6lbs) than people who didn't. There are now various apps that you can download to help keep track of your food & calorie intake.
- Eat before you go shopping, if you shop when hungry temptation is all around you. Take a list of what you need to purchase and stick to it. Don't buy or stock high calorie foods such as sweets and cakes as it will be difficult to resist them. The rest of your family don't really need them either, so buy plenty of fruit and vegetables to snack on instead.
- Get into a routine for eating, wherever possible eating at regular times during the day and start with a nutritious breakfast. Steroids can increase appetite so doing this may help control your appetite. Also, try to eat every 3 to 4 hours, adding healthy snacks if you need to.
- Use a smaller plate, a well known and useful diet tip. Also add plenty of vegetables to your meal, they're filling and lower calorie, if you eat them first by the time you get to the higher calorie foods you will already feel fuller.
- If you feel hungry try a glass of water, thirst is often mistaken for hunger pangs. Also ensure you drink plenty of water. Also are you really hungry? Try the 'apple test 'if you're not hungry enough to eat a whole apple', then you're not actually hungry.
- Get moving. Any form of exercise will help your metabolism. Click here for our article on exercise with lupus.