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We have received several questions about diet for lupus. It's true that eating green leafy vegetables every day usually results in improvment in lupus symptoms and longer remission between flareups of the disease, but not for the reason you would expect.

Eating your daily greens can help you stay stronger longer if you have lupus, but not for the reason you might expect. A low-fat, low-calorie, plant-rich diet is beneficial in lupus and most other autoimmune conditions because of what you don't eat, not because of what you do.

Leptin, The Hormone Your Fat Cells Use to Send Messages to Your Brain

Lupus, it turns out, has a lot to do with a hormone called leptin. This hormone is a protein produced by fat cells that send a message to the brain that says "I'm full. You can go about your ordinary, everyday activities."

When the fat cells release leptin into the bloodstream and the brain senses it, the brain organizes the body's activities as if it were well fed. It allows vigorous exercise. In women of reproductive age, it permits pregnancy. It regulates the appetite so eating can occur at a normal rate. Neither voracious eating nor anorexia (loss of appetite) will occur if the brain senses the leptin released by fat.

In people who have weight problems, sometimes the brain just doesn't get the message that extra food is not still necessary, and they continue to eat and eat and eat. In people who don't have leptin resistance, however, it is the fat cells themselves that turn off your appetite.

Leptin Also "Talks" to the Immune System

That isn't all leptin does, however. Leptin also "talks" to the immune system. When the fat cells tell the brain that there is enough stored energy for normal activity, they also tell the immune system to start generating inflammation to protect against the hazards of normal activity. 

Inflammation enhances alertness. It prepares the blood vessels to tighten up and preserve blood in case of a bruise, a cut, a scrape, or a fight. And it activates the white blood cells that use inflammation to fight infection, the CD4+ cells.

The problem for people who have lupus is that these white blood cells, also known as helper T cells, also cause the inflammation that inflames and destroys the kidney in lupus. Filling up your fat cells sends a message to the immune system that it's OK to inflame your kidneys. And it's your immune system that actually carries out the tissue destruction that results in lupus.

People who have lupus, therefore, face a dietary dilemma. If they eat enough, their immune systems begin to attack the kidney. If they can go longer and longer times without eating at all, their immune systems are never given the message to go on the attack. Nobody, of course, can go without eating indefinitely.

Continue reading after recommendations

  • Brown AC. Lupus erythematosus and nutrition: a review of the literature. J Ren Nutr. 2000 Oct. 10(4):170-83.
  • Liu Y, Yu Y, Matarese G, La Cava A. Cutting edge: fasting-induced hypoleptinemia expands functional regulatory T cells in systemic lupus erythematosus. J Immunol. 2012 Mar 1. 188(5):2070-3. doi: 10.4049/jimmunol.1102835. Epub 2012 Jan 30. PMID: 22291185.
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