Understanding the impact of nutrition on autoimmunity

To make the most of the power of nutrition to improve quality of life for people with autoimmune conditions, it’s important to know the evidence-based facts. Nicqui Duffield-Grant, who is a registered dietitian with a special interest in autoimmunity, and a spokesperson for ADSA (Association for Dietetics in South Africa) says: “As Hippocrates is famous for saying ‘let food be your medicine’, nutrition should be the first port of call when it comes to all disease states.

"Food is not merely energy or kilojoules, it is information for our genes to upregulate or downregulate their responses to our environment. Quality nutrition is important for immune function and certain nutrient-gene interactions are responsible for the modulation of your immune response. Dysregulation in this modulation contributes to the development of autoimmune diseases.”

With the right dietary approach and professional support, you can better manage your symptoms, enhance your overall health and live a more fulfilling life despite your autoimmune condition.

Autoimmune diseases occur when our immune system, the body’s defence against invaders such as bacteria and viruses, mistakenly attacks healthy cells. This can lead to a wide range of chronic conditions, including rheumatoid arthritis, multiple sclerosis, and Crohn's disease. Proper nutrition helps in managing symptoms and improving overall quality of life.

What are the links between inflammation, nutrition and autoimmunity?

“A chronic inflammatory state is commonly an underlying trigger for the development of an autoimmune condition and is also a hallmark of many autoimmune diseases," says Duffield-Grant. "Unfortunately, the modern diet is laden with refined sugars, processed foods, additives, and omega-6 rich fats which are all pro-inflammatory. Obesity is also well known to be a pro-inflammatory condition. Therefore, weight management, insulin control and exercise are important to manage inflammation.

"Certain nutrients, such as omega-3 fatty acids found in fish and flaxseeds have anti-inflammatory properties. Phytochemicals, present in fruits and vegetables, combat oxidative damage, caused both by a poor diet and our environment, and protect against tissue damage. Vitamin D, obtained through sunlight, food fortification or supplementation is important for immune function and may mitigate responses that may trigger the development of autoimmune conditions.”

Making food choices that support reducing inflammation and limiting foods that exacerbate it is an important daily strategy for managing the symptoms of autoimmune diseases. Duffield-Grant adds: “Favour foods that your grandma would recognise and avoid highly processed foods. Try to eat less sugar and more oily fish such as salmon, pilchards, tuna and mackerel as well as fruit, vegetables, whole grains, nuts and seeds. Get outside in the sunshine and do a little exercise as often as possible.”

What are the links between the gut microbiome, nutrition and autoimmunity?

Another important consideration for people living with autoimmune diseases is the state of health of their gut microbiome. This is the community of bacteria and other microorganisms living in the digestive tract. A healthy gut microbiome can help to alleviate autoimmune conditions, while an imbalanced microflora community may contribute to the development of autoimmunity or worsen the disease.

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Association for Dietetics in South Africa  17 Apr 2023

Duffield-Grant says: “Nutrition plays a vital role in establishing and maintaining a good microbiome. A diet rich in fibre, from fruits, vegetables and whole grains, can promote the growth of beneficial bacteria and enhance gut barrier function. Fermented foods like yoghurt, kimchi and sauerkraut provide probiotics that support a diverse microbial ecosystem. Prebiotics, which nourish beneficial gut bacteria, are found naturally in foods such as garlic, onions, and asparagus. Limiting processed foods, added sugars, and artificial additives helps maintain a healthy gut environment, which in turn, mitigates autoimmune symptoms and improves overall health and resilience.”

Need to make some nutritional changes? You don’t have to go it alone…

Autoimmune diseases often involve complex dietary considerations. Different autoimmune conditions may have unique triggers or food sensitivities that vary from person to person. Some people may feel challenged by the necessity of making daily nutritional changes and need support. Given how important nutrition is to optimally manage autoimmune conditions, you may want a place for a dietitian on your health team.

“A dietitian will provide you with personalised guidance tailored to your specific needs, preferences, and lifestyle. Autoimmune diseases can affect nutrient absorption and metabolism. Some medications used to manage autoimmune conditions may also have an impact on nutrient status. A dietitian can help you navigate the complexities of the condition, and assess nutritional deficiencies, design appropriate meal plans, and recommend supplements if necessary to ensure optimal nutrient intake. With the right dietary approach and professional support, you can better manage your symptoms, enhance your overall health and live a more fulfilling life despite your autoimmune condition,” concludes Duffield-Grant.