Sarah Schafer, MD
Diet and Sjogren's
Updated: May 31, 2022
What should I eat?
This is one of the first questions that Sjogren’s patients ask. A healthy diet is important. However, there is no one-size-fits-all Sjogren’s diet. Nutrition needs vary from one patient to another and in the same patient over time.
The nutrition/diet/health influencer industry
Most clinicians do not have the time, training, or resources to offer diet and other lifestyle support, even though these are an important part of Sjogren’s management. Not knowing where to turn, Sjogren’s patients may spend hundreds, sometimes thousands, of dollars on alternative practitioners or even non-credentialed health influencers. These practitioners often promote restrictive diets, claiming that their program can reverse or cure autoimmune diseases. Special diets may be just one part of a bigger “detox program” that includes expensive laboratory tests, supplements, and other products that are not supported by scientific evidence.
Why are restrictive diets so popular?
Desperate to feel better, people with Sjogren’s are often willing to try extreme diets. These diets are usually marketed by highlighting dramatic success stories. Testimonials are inspiring, but they are not scientific evidence. People who feel worse or do not benefit from a diet are not mentioned. That is not how science works. Every outcome must be looked at in a systematic way, not just the positive ones.
What about the Autoimmune Protocol (AIP) diet?
There are Sjogren’s patients who describe a remarkable, sustained improvement on the AIP diet. Others experience no obvious benefit or even feel worse on this diet. As with Keto and Paleo diets, current scientific evidence is inadequate to show that the AIP is effective for Sjogren’s patients as a group. It is possible that the AIP does help a subset of patients. While the AIP is more nutritionally sound than Keto or Paleo, I find these two aspects worrisome:
The AIP labels nightshade vegetables (eggplant, tomatoes, peppers, etc.) as inflammatory, despite a lack of evidence to support that claim.
Even though the AIP diet is designed to reintroduce foods slowly, some people hesitate to do this because they fearful of getting worse. When this happens, they deprive themselves of known anti-inflammatory foods such as nuts, seeds, legumes, and whole grains
I recommend the following resources for credible diet information:
This Creaky Joints article provides a simple overview of known anti-inflammatory foods. It is similar to the Mediterranean diet, which has been demonstrated by multipole studies to benefit a wide variety of inflammatory conditions.
Anti-inflammatory nutrition - talk by Jenifer Tharani, MS, RD
Food allergies, intolerances and sensitivities - talk by Kara Wada, MD (allergy/ immunology specialist)
Myths about food allergies - article by Kara Wada, MD
Nutrition Myths and Marketing, Part 1 and 2 - an eye-opening discussion by on the Crunchy Allergist podcast by Adrian Chavez, PhD nutritionist
MORE ABOUT DR. KARA WADA
I want to thank Dr. Kara Wada for reaching out to me this year. She is an MD-Sjogren’s patient who, like me, is committed to helping other Sjogren’s patients. I appreciate her scientifically minded approach to natural / lifestyle changes that can support our health. Her material complements Sjogren’s Advocate, which focuses on medical care. I highly recommend her podcast and website, The Crunchy Allergist.