Mixed Connective Tissue Disease and Diet

Anti-inflammatory medications are a cornerstone of treatment for mixed connective tissue disease (MCTD) but your diet also is important. Eating foods that suppress inflammation may help prevent flare-ups caused by MCTD, which has overlapping features of a few autoimmune conditions.

It can take years to diagnose symptoms of mixed connective tissue disease, and your healthcare provider plays a key role in managing symptoms. Be sure to talk with your provider about whether an anti-inflammatory diet (including supplements) might offer benefits.

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

Avoid the following:

• Highly refined grains
• Processed meats
• Fried foods
• Beverages and foods high in sugar
• Fats (margarine, shortening)

Why Diet Matters

MCTD is actually a combination of at least two connective tissue disorders. These can include lupus, scleroderma, polymyositis, and less often, rheumatoid arthritis.

While there’s a wide spectrum of MCTD symptoms, a 2020 study involving 291 people found more than half of people diagnosed with MCTD experienced digestive issues. That’s because the condition targets the smooth muscles of the gastrointestinal tract.

These digestive symptoms and concerns can include:

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

Foods to Eat

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

Some people may 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
• Raspberries
• Strawberries
• 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
• 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 can help your gut probiotics to 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.

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

Foods 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.

Finding What Works for You

General recommendations about diet are a good place to start. But it will take time and experimentation to see what helps each individual 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 to assess their effects
• Work with your healthcare team, including a dietitian, to be sure you’re taking a healthy approach to dietary changes

Cooking Tips

Preparing meals at home lets you cut back on sodium and other preservatives, and helps you consume more prebiotic fiber to support an MCTD diet. 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

An MCTD diet is part of an overall strategy for managing MCTD. Regular physical activity, maintaining a healthy weight, reducing stress, and getting enough sleep can help your body deal with symptoms.

Look for foods that lower inflammation and balance gut bacteria: fresh fruits, vegetables, fiber, omega-3 fatty acids, and prebiotics may be the most helpful. Avoid highly processed foods, and foods high in sodium and sugar. It may help to cook your meals at home.

A food diary and elimination diet can help you figure out what works for you. Work closely with your healthcare provider to manage your symptoms using lifestyle changes and medication.