What to Eat When You Have Mixed Connective Tissue Disease

Anti-inflammatory medications are a cornerstone of treatment for mixed connective tissue disease (MCTD). But dietary choices are also important. Eating foods that suppress inflammation may help prevent MCTD flare-ups.

This article looks at why diet is important to those with mixed connective tissue disease, the benefits of an anti-inflammatory diet, how the diet works, possible risks, what to eat, and what to avoid.

Why Diet Matters

MCTD is an autoimmune disorder, a disease in which your immune system attacks healthy cells. While it is its own diagnosis, MCTD is actually a combination of at least two connective tissue disorders. These can include systemic lupus erythematosus, scleroderma, polymyositis, and less often, rheumatoid arthritis.

It can be hard to predict what will trigger a flare-up of any autoimmune condition. Day-to-day stressors or catching a cold can be enough to shift your immune system into overdrive.

For about half of people with MCTD, that means digestive issues. That's because the condition targets the smooth muscles of the gastrointestinal tract.

Digestive symptoms and concerns can include:

• Problems swallowing
• Heartburn and acid reflux/gastroesophageal reflux disease, GERD)
• Abdominal pain
• Nausea, vomiting
• Alternating diarrhea and constipation
• Fecal incontinence
• Malabsorption of nutrients
• Unintentional weight loss
• Overgrowth of gut bacteria

Rarely, MCTD can also cause volvulus, which is an obstruction caused by twists in the stomach or intestine.

Diet is important for those with MCTD because choosing certain foods over others may help promote healthy gut bacteria, which reduces inflammation and related digestive issues.

In addition, it can help prevent other chronic diseases. In particular, those with MCTD have an increased risk of metabolic syndrome, diabetes, cancer, depression, osteoporosis, heart disease, and high blood pressure in the lungs (pulmonary hypertension). The basics of an MCTD diet are considered heart-health strategies too.

Many people with an autoimmune disease will eventually go on to develop another, so keeping the immune system calm—through diet and other means—can also have benefits in this regard.

MCTD Diet Basics

Most healthcare providers advise that people with autoimmune disorders follow a balanced meal plan composed of:

• Roughly 50% carbohydrates
• 15% protein
• 30% fat

There's no official consensus on the best way to eat for MCTD specifically. However, emerging science on diet and autoimmunity suggests an anti-inflammatory diet focusing on:

• Fresh fruits
• Fresh vegetables
• Fiber
• Omega-3 fatty acids
• Prebiotics
  

And avoiding:

• Sodium
• Sugar
• Highly processed foods
• Certain immune-boosting ingredients
  

What to Eat

Focusing on simple, whole foods can help you with an anti-inflammatory diet. Many of those foods contain antioxidants. Those are vitamins, minerals, nutrients, and other substances that fight inflammation and cellular damage.

Some people may also be advised to also use supplements in order to avoid muscle loss from complications such as unintentional weight loss or absorption issues.

Fruit

Fresh fruits that are red, purple, or bluish contain high amounts of antioxidants called anthocyanins. They are antioxidants and also antimicrobial, meaning they help kill bacteria and viruses.

Studies suggest anthocyanins reduce inflammation, improve eye and brain health, and protect against disease. They're also good for your heart.

Citrus fruits are known for their vitamin C, which is also an antioxidant/anti-inflammatory.

Fruits to focus on include:

• Blackberries
• Blueberries
• Cherries
• Grapes
• Pomegranates
• Raspberries
• Strawberries
• Tomatoes
• Grapefruit
• Lemons
• Limes
• Oranges

Fruit is also a good source of fiber.

Vegetables

Fresh vegetables also contain fiber and antioxidants like vitamin K. Research suggests vitamin K can significantly reduce inflammatory markers in the blood. Good sources include:

• Broccoli
• Cabbage
• Kale
• Lettuce
• Spinach

Choose vegetables that are dark or vividly colored. They have the highest amounts of antioxidants.

Whole Grains

Whole grains are packed with fiber. Studies have shown that fiber can lower levels of inflammatory markers in your blood. Because it's filling, fiber can also help you reach and maintain a healthy weight.

Good choices include:

• Whole-wheat bread, pasta, cereal, etc
• Oatmeal
• Brown rice
• Quinoa
• Amaranth
• Popcorn

Be sure the products you buy are using the entire grain.

Omega-3 Fatty Acids

Omega-3 fatty acids are believed to be good for your brain, heart, lungs, and cellular health. They are also anti-inflammatory.

Foods rich in omega-3s include:

• Fatty fish: Salmon, mackerel, tuna, herring, sardines
• Nuts and seeds: Flaxseed, chia seeds, walnuts
• Plant oils: Flaxseed oil, soybean oil, canola oil, olive oil

You can also get omega-3s through supplements as well.

Prebiotics

Prebiotics are ingredients in food that you don't digest. Instead, they're plant fibers consumed by probiotics—the beneficial bacteria in your digestive system that make up your gut microbiome.

Prebiotics can help your probiotics flourish and keep your digestive system functioning well. They also help calm the immune system.

Foods with high prebiotic levels include:

• Artichokes
• Asparagus
• Bananas
• Blueberries
• Chia seeds
• Flaxseed
• Oats
• Onions
• Spinach

In a study on type 1 diabetes, researchers found that a healthy gut microbiome limited the number of autoimmune cells coming from the immune system and offered protection against the disease.

Probiotics have long been known to impact the immune system. More recently, they've been linked to improving digestive symptoms and lowering inflammation in autoimmune diseases such as rheumatoid arthritis, multiple sclerosis, and ulcerative colitis.

Some early research has even suggested that inflammation—spurred by imbalances in the gut—is a major contributor to the development of autoimmune disease.

What to Avoid

Autoimmune disease puts your immune system into overdrive. So avoiding certain "immune-boosting" foods can helps support a calm and effective immune system.

Research suggests you may want to avoid:

• Alfalfa sprouts: They contain an amino acid called L-canavanine, which boosts the immune system. That can prompt an autoimmune flare-up.
• Garlic: Garlic has multiple components that enhance your body's white blood cell response and may aggravate an already overactive immune system.
• Echinacea: Echinacea's impact on the immune system can lead to increased symptoms.

Some other foods are believed to exacerbate autoimmune conditions as well, such as:

• High-sodium foods: A high-salt diet alters the gut microbiome in a way that exacerbates some autoimmune diseases. Canned soups, frozen dinners, bottled salad dressings, and flavored rice mixes are examples of foods high in salt.
• Processed meats: Cold cuts, bacon, salami and other processed meats are loaded with sodium and solid fat, which is also known to exacerbate autoimmune issues.
• Sugar: Sugar has been shown to worsen autoimmune disease in mice by increasing an immune cell called T helper 17 (Th17), which triggers inflammation.

Check labels for problem ingredients. Garlic is in a lot of packaged foods and echinacea is in herbal teas and supplement blends. Many packaged foods have high levels of sodium and sugar.

Always involve your healthcare provider(s) in choices about diet and supplements. They can steer you away from selections that may affect your disease. You may also benefit from seeking advice from a dietitian.

What About Fasting?

Some studies suggest dietary restriction, calorie restriction, and fasting help prevent and treat autoimmune disorders.

Meal timing appears to impact gut bacteria, inflammation, circadian rhythm, and longevity. The research is promising, yet still too young to apply specific recommendations to MCTD management.

Finding What Works for You

Everyone's body is different, especially when it comes to digestion and metabolism. What helps one person may not help you.

For instance, gluten may trigger inflammation in those with gluten sensitivity but not in others.

General recommendations about diet are a good place to start. But it will take time and experimentation to see what helps you the most.

To figure that out, it may help to:

• Keep a food diary including what you ate and what symptoms you experience
• Try an elimination diet in which you eliminate a broad range of potentially problematic foods and reintroduce them slowly to gauge their affect
• Work with your healthcare team, including a dietitian, to be sure you're taking a healthy approach to dietary changes

Cooking Tips

Cooking at home is essential with MCTD because it gives you a wider range of unprocessed options. Look for simple recipes for things like:

• Salads with homemade dressing
• Soups and stews made with low-sodium stock and lots of vegetables
• Sugar-free fruit and yogurt parfaits
• Sugar-free cereal bars

Preparing these items at home lets you cut back on sodium and other preservatives, and helps you consume more prebiotic fiber.

You can make home-cooked meals especially healthy in many ways:

• To add more fiber easily, add ground flaxseed to foods.
  
• Choose fresh produce when you can. Keep frozen veggies on hand for times when you can't make it to the store. Avoid canned vegetables, which are generally high in sodium.
• Choose healthy oils (e.g., flax, olive, canola).
• Use an air fryer instead of frying food in fat.
• Use salt-free seasoning blends and fresh herbs.
• Experiment with spiralized veggies as noodles and puréed vegetables for sauces.

Summary

Your diet can help lower inflammation and balance gut bacteria, which can help reduce your MCTD symptoms. Fresh food is generally better than pre-packaged. Fruits, vegetables, fiber, omega-3 fatty acids, and prebiotics may be the most helpful.

Avoid immune-boosting foods and supplements, highly processed foods, and high sodium and sugar levels. A food diary and elimination diet can help you figure out what works for you.

Learning to make simple, fresh meals at home makes it easier to avoid processed foods.

Healthy eating is one piece of the puzzle when it comes to MCTD. Regular physical activity, maintaining a healthy weight, reducing stress, and getting enough sleep can help your body weather the ups and downs of autoimmunity.

Sometimes even when you do everything right, flare-ups strike. Work closely with your healthcare provider to manage your symptoms using lifestyle changes and medication.