Awareness around the importance of nutrition and food as medicine is expanding. As a result, using foods as health enhancers and therapy agents have become increasingly popular. Many autoimmune patients, including those with mixed connective tissue disease, are following a specific diet to help mitigate symptoms. This is based on the growing understanding that diet and nutrition can either exacerbate or reduce symptom severity.
What is Mixed Connective Tissue Disease?
Mixed connective tissue disease (MCTD) is an autoimmune disorder that is considered an overlap disease, meaning it is a combination of other disorders. MCTD is characterized by symptoms similar to lupus, systemic sclerosis, and polymyositis; these three conditions usually occur one after the other over a long period of time. Furthermore, MCTD is a rare disease most commonly occurring in women under the age of 30.
The cause of MCTD is currently unknown, but one leading theory is that the disease is related to an immune response to ribonucleoprotein (RNP) molecules. Normally sequestered in the nuclei of cells, RNPs can become exposed to the acquired immune system when cells die and release their inner contents. As a result, immune defenses mistake RNPs for foreign invaders and attack normal body cells with the RNP signature.
Early symptoms include swelling of fingers and whitening/numbness of fingertips. Other common symptoms include Raynaud’s phenomenon (cold hands and feet), joint pain and arthritis. More symptoms include skin abnormalities, muscle weakness, heartburn, and problems with internal organs. Kidney disease, neurologic abnormalities, and anemia are less frequent symptoms. Genetics may predispose people to MCTD, although it does not appear to be inherited along simple Mendelian patterns. Environmental factors such as exposure to certain viruses (which trigger the cell death that exposes RNP to the immune system) may play a role as well.
Mixed Connective Tissue Disease Diet Do’s And Don’ts
Certain foods and food components may help manage MCTD symptoms. The Internet offers an overwhelming amount of diet recommendations, including the Autoimmune Protocol and Gut and Psychology Syndrome (GAPS) protocol for inflammatory diseases. We do believe that following a diet that emphasizes anti-inflammatory and antioxidant-rich foods should help people with MCTD. However, MCTD affects people differently and symptoms vary among patients, and we don’t believe in a one-diet-for-all approach. For this reason, we recommend starting with some type of autoimmune-specific protocol, then personalizing it for your unique symptoms. Check out our article on immune-boosting foods for ideas on which foods to incorporate into your diet.
That being said, there is some scientifically backed evidence to support certain foods over others for MCTD patients. This table highlights our best food recommendations for a mixed connective tissue disease diet, crafted with information from Personal Remedies, scientific research (1), and other scholarly tables.
Why MCTD Diet Matters
Eliminating processed foods, dairy, and added sugar, while increasing the consumption of vegetables, fruits, fish, and other whole foods may be important for MCTD patients for a variety of reasons. Iron deficiency is common in MCTD patients, so making sure to eat iron-rich foods is recommended. Vitamin D deficiency (2) is also common. Therefore, eating foods rich in vitamin D such as fatty fish, eggs, and fortified foods is recommended for MCTD patients.
Bromelain (3) is a supplement that can reduce arthritis pain and joint stiffness. It is found in pineapple juice, so drinking pure pineapple juice (without added sugar) could reduce joint symptoms. Drinking plenty of fluids is important in keeping your body functioning optimally. If you experience gastrointestinal issues, eat smaller meals and eat only when you’re hungry to minimize stomach pain. We recommend keeping a food diary to track any potential foods that trigger your symptoms, or any foods your body responds well to.
The Worst Foods for MCTD
In contrast to these anti-inflammatory foods, there are also pro-inflammatory foods that should be avoided in a mixed connective tissue disease diet. These pro-inflammatory foods include processed meats, sodas, salty snacks, packaged sweets, and refined carbohydrates. If you suffer from MCTD, these types of food are likely to intensify any symptoms you’re already experiencing.
Because inflammation plays a role in all autoimmune diseases and MCTD is an overlapping disease, avoiding pro-inflammatory foods is our best recommendation to keep symptoms at bay. In addition to these generic pro-inflammatory foods listed in the table below, there are some specific foods that might be harmful to MCTD patients. For example, too much salt can lead to high blood pressure. Consequently, we recommend limiting your sodium intake or increasing your potassium. Conventional products have more artificial chemicals (4). This could have greater effects on those with autoimmune diseases who already have compromised immune systems.
Other Tools for Managing MCTD
Engage in Mindful Eating
- Eat smaller, nutritionally-balanced meals to help ease digestion and help fight flare-ups.
- Chew your food slowly and engage your jaw to help activate your robust oral microbiome and promote beneficial oral health.
- Pay attention to your body’s short and long-term response to food – if it stings or produces cramping, or diarrhea the next day, consider it a likely bad actor in your case.
- Drink lots of water, especially when drinking tea, coffee, juice, or alcohol, to normalize the pH of your mouth (ideally 7.4). When we consume acidic foods and beverages, such as fruit juice and soda, oral pH is thrown out of balance (not to mention the additional sugar and calorie intake). When the pH within our mouths falls below 5.5, demineralization occurs, making us more susceptible to oral diseases, such as dental caries and periodontal disease.
Exercise, Exercise, Exercise
Stay active to help reduce inflammation and alleviate symptoms such as reduced joint motion, muscle strength, and aerobic capacity 5. Check out our free ebook on movement therapy to explore exercise options!
Relax and Reduce Your Stress
Reduce overall stress to avoid triggering or exacerbating autoimmune flare-ups. Constant stress is one of the hallmarks of modern life. Our stress responses were beneficial in helping our ancestors avoid predation and other life-threatening situations. However, constant but not life-and-death stressors brought about by modern society can be extremely harmful to our bodies.
Get Enough Rest
One of the easiest ways to do relax is to make sure you are getting enough sleep. Most people do not get the recommended 7-9 hours of sleep daily, and for autoimmune patients, this can have more serious consequences. Whether taking an afternoon nap, going to bed earlier, or (if scheduling permits) sleeping in, emphasis should be on consistent restful sleep. Additionally, relaxation throughout the day is also important. This could mean an early morning workout, an afternoon yoga class, even taking 15 minutes in the middle of the day just to focus on your breathing. Figure out what works best for you and do it. Take the time to be the best version of yourself: your stress will go down, your body will feel better, and your productivity may even increase!
All in all, Mixed Connective Tissue Disease is an autoimmune disease that can affect patients differently. Following some sort of autoimmune-specific, anti-inflammatory diet may help mitigate symptoms and improve quality of life. However, everyone is unique, so experimenting with variations of a mixed connective tissue disease diet may be a matter of trial and error. Try not to be overwhelmed by all of the recommendations and information out there, go slowly, and trust yourself. At the end of the day, you are your best advocate and you know your body best. Fearlessly experiment with your dietary options and be mindful of your reactions. Check out our ebook on food therapy to learn more about what makes you unique and how to kick-start your journey to finding your optimal autoimmune specific diet.
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Written by: Bonnie Feldman, DDS, MBA, Anna Simon, Ellen M. Martin
- Mixed Connective Tissue Disease (MCTD). (2017). https://rarediseases.org/rare-diseases/mixed-connective-tissue-disease-mctd/
- John A. Reynolds, Ian N. Bruce; Vitamin D treatment for connective tissue diseases: hope beyond the hype?, Rheumatology, Vol 56(2). 2017. 178–186. https://doi.org/10.1093/rheumatology/kew212
- Maurer, H. CMLS, Cell. Mol. Life Sci. (2001) 58: 1234. https://doi.org/10.1007/PL00000936
- Smith-Spangler, C et al. “Are organic foods safer or healthier than conventional alternatives?: a systematic review” Annals of Internal Medicine. Vol 157(5). 2012. 348-366. https://www.ncbi.nlm.nih.gov/pubmed/22944875
- Hicks, J. E. “Exercise in patients with inflammatory arthritis and connective tissue disease.” Rheumatic Diseases Clinics of North America. Vol 16(4). 1990. 845-870. https://www.ncbi.nlm.nih.gov/pubmed/2087581