Diet taboos for vasculitis

Foods that have been identified as causing self-allergy, irritating processed foods that are high in salt, oil and sugar over a long period of time, and nutritional products with unknown ingredients or that may disrupt immune balance. In addition, there is no "absolute fasting list" that is universal across the Internet. The requirements for taboos for various "favorable foods" spread online need to be judged based on personal constitution and disease stage, and there is no need to be one-size-fits-all.

Two months ago, I met a 28-year-old girl with nodular vasculitis at the outpatient clinic. She was just diagnosed half a month ago. I searched the Internet for a list of food taboos. She stopped eating beef, mutton, seafood, eggs, and milk. She only ate boiled vegetables and white rice every day. When she came for a follow-up checkup, her hemoglobin was only 9 grams. She felt like she was floating when she walked, and her rash recurred. After asking, I found out that she was not allergic to milk or eggs, and she was suffering from malnutrition due to abrupt withdrawal, which in turn delayed her recovery.

Why are there so many confusing taboo words? In fact, vasculitis is essentially an autoimmune disease, and individual differences are huge. Some people can induce purpura and joint pain in their lower limbs after eating half a plate of shrimp, while some people are fine even if they eat seafood every day. Therefore, there is no unified list of must-dos in clinical practice. The first category of taboos currently recognized by all doctors is that you clearly eat something that you are allergic to - whether it is mango, nuts or beef and mutton. As long as the allergen test is positive, or if you have an itchy rash, joint swelling and pain, or worsening symptoms of vasculitis after eating it, then decisively avoid it. Here we can also mention what traditional Chinese medicine often refers to as "fat foods". In fact, most of them are foods that are high in histamine and can easily induce allergies. Although Western medicine does not recognize the general concept of "fat foods", it also supports patients to keep a simple food diary. Every time you eat something that makes you feel uncomfortable, just write it down and then avoid it. There is really no need to listen to what others say you can't eat and just stop eating it.

Oh, by the way, there is another category that almost all patients should avoid as much as possible, which are processed foods high in salt, oil and sugar. This is not to say that eating a mouthful of salted duck or drinking a mouthful of milk tea will cause the disease, but vasculitis itself will continue to attack the vascular endothelium. Long-term consumption of high-salt foods such as pickles, sauced meat, and puffed foods can easily increase blood pressure. If the kidneys are already involved, it will aggravate edema and increase creatinine. I had an old patient last year who was usually under good control. During the Chinese New Year, he greedily ate half a jar of home-pickled pickled radish. As a result, his feet were so swollen that he couldn't even put on socks. When he came for a follow-up examination, his creatinine rose from 80 to 120, and it took him a week to stay in the hospital before it came down. There are also high-fat and high-sugar fried chicken, cream cakes, etc. If you eat too much, your blood lipids will rise. Damaged blood vessels will be more likely to form plaque blockage. In severe cases, it may even cause ischemic necrosis of the extremities. Of course, this does not mean that you should not touch them at all. Occasionally, if you are craving for a small piece of cake or drink half a cup of milk tea, it is completely fine. Just don't eat it every day.

Finally, I would like to remind everyone to avoid the pitfalls of all kinds of supplements, which are also a category that is currently controversial in clinical practice. Some doctors have a more absolute attitude and feel that all nourishing products should not be touched, such as royal jelly, Ganoderma lucidum spore powder, human placenta, and various health products that claim to "increase immunity." After all, vasculitis itself is an overactivation of autoimmunity. Indiscriminate supplementation of these products is likely to disrupt the immune balance and induce disease activity. ； Some doctors also believe that if a patient takes hormones and immunosuppressants for a long time and has a particularly weak resistance, and often catches colds and fevers, it is not impossible to take regular supplements with clear ingredients and no illegal additions under the guidance of a doctor. My personal suggestion is, don’t buy them blindly, especially the dietary products sold in WeChat Moments and short videos that claim to “cure vasculitis”. Most of them secretly add a large amount of hormones. When you first take them, you will feel that the symptoms are gone. After you stop taking them, the symptoms will get worse. It is also prone to side effects of femoral head necrosis and elevated blood sugar. If you really need to take any supplements, ask your attending doctor first.

To be honest, what I usually tell my patients the most is, don’t be too nervous about dietary taboos. If you stare at the list of taboos on the refrigerator every day, you won’t dare to touch this or eat that, and you will be so anxious that you can’t sleep all night long. On the contrary, it will affect your immune status, and the impact is much greater than eating the wrong bite. To put it bluntly, just remember the two simplest principles: don’t eat anything that makes you feel uncomfortable, and try to choose fresh and light ingredients. This is more useful than any expensive taboo guide.