Treating autoimmune-related diseases with proper diet

By Katherine Shagoury

Rheumatic diseases are chronic and greatly influenced by an individual’s lifestyle, said Yehuda Shoenfeld, MD, FRCP (hon.), MaAC at the 2019 Integrative Healthcare Symposium in New York City.

More than 80 autoimmune and immune mediated diseases have been defined, said Shoenfeld, and they are affecting 5-20 percent of the global population. Most autoimmune diseases are more prevalent among women, he said, and they are among the top five leading causes of death for women up to 64 years of age. Incidence of autoimmune disease is increasing worldwide.

Several endogenous and external factors impact susceptibility to autoimmunity, including genetic predisposition, stress, hormones, gender, immunodeficiency, infections, toxins and pollution, diet, smoking exposure, vaccines and other drugs, and obesity, Shoenfeld said.

Shoenfeld said he prefers a preventative approach to autoimmune disease and places a strong emphasis on coaching patients toward a proper diet. We are what we eat, he said, and several studies point to dietary components that affect risk for autoimmune disease.

Nutritional agents represent an attractive addition to conventional therapies, Shoenfeld said. For example, coffee and salt have been shown to increase risk, whereas capsaicin, omega-3 fatty acids, resveratrol, curcumin, and chocolate have been shown to decrease risk for autoimmune disease.  

Research shows that coffee could possibly contribute to rheumatoid factor production, and salt contains proinflammatory macrophages and increase TH17 cell potency and IL-17 levels, while decreasing regulatory T cell production.  Many studies link both coffee and salt consumption to increased risk for autoimmune disease, Shoenfeld said.

On the other hand, capsaicin, a chili pepper extract, modulates neuroimmune inflammatory response, can reduce pain, decrease proliferation and activation of autoreactive T cells, and increase anti-inflammatory macrophages. Omega-3 fatty acids decrease proinflammatory cytokine production, Tc cell proliferation, IL-2 production, and autoantibody production. Curcumin, found in ginger, increases regulatory T cell proliferation, regulatory B cell function, and antioxidant and anti-inflammatory genes, while decreasing TH1 cell proliferation. Resveratrol decreases NFKB activation, cyclooxygenase 2, and ROS production. Finally, chocolate decreases proinflammatory cytokines and autoantibody production and decreases anti-inflammatory cytokines.

Whereas salt and coffee seems to promote inflammation via several mechanisms, consumption of curcumin, capsaicin, and chocolate might attenuate immune hyperactivity, Shoenfeld said. Further research is still needed, however, to determine clear recommendations for dosing and frequency of consumption of these dietary factors, he said.

In addition to proper diet, Shoenfeld strong encourages use of vitamin D supplementation, avoiding exposure to the sun, and physical activity.

“There are measures we can recommend to patients that may slow down or lead to prevention of autoimmune disease,” said Shoenfeld.