Nutrition

nutrition2

NUTRITION FOR VITILIGO

 

It is perfectly normal to want to control your vitiligo, due to its erratic nature,  and for many, trying new diets or supplements can be a really positive way of contributing to your overall health, and feeling more in control.

It’s important though to avoid any extreme diet or restricting completely healthy food groups, or pinning your hopes of a cure for your vitiligo on a regimen that you find on the internet because you may end up doing yourself more harm than good.

Read more about diet and supplements from John E Harris, Director of Vitiligo Clinical Care and Research UMMS, a champion of vitiligo in the United States, here

And from Science Based Medicine here

And above all else, do yourself no harm.

This area of the website is divided into six sections:

1.  General nutrition

2.  Intuitive Eating

3.  Are there specific diets to help vitiligo?

4.  Myths about vitiligo

5.  Supplements

6.  Resources online for general diet and vitiligo specific questions

GENERAL NUTRITION

Most people know about the principle of eating five fruit and vegetables a day.  You may also have been told to reduce the cholesterol you consume to control adverse symptoms related to a high cholesterol reading.  You may know that we need 25gms of fibre a day, less than 6gms of salt (2.4 gms of sodium) and to balance your Omega 3 and Omega 6 intake in favour of the former.

But what should we actually eat?

First of all, if you have any medical condition, be sure to consult with your doctor, patient support group or body, for example Diabetes UK, to ensure that you are taking care of your specific health needs.  For diabetics or those on the brink of diabetes, this may well mean reducing your carbohydrate intake.

The important thing for everyone is to find a way of eating that really nourishes you.

Here are some principles for improving your overall diet.

1. VEGETABLES AND FRUIT

Increasing a rainbow of vegetables and fruit in your diet can only contribute positively to your health.  If you can afford the extra expense, buy organic or local produce.  But increasing your levels of fruit and vegetables in any shape or form will help you.  Dietary experts emphasise the importance of vegetables over fruit.

fruit-and-veg-heart_623989

As an example of getting some more of both into your diet, you could try adding grilled tomatoes and cooked mushrooms to your breakfast, on wholegrain toast or with bacon or turkey bacon if you are carb-free.  You could try a small portion of green juice on the side – which you can buy in supermarkets, but check that they don’t have added sugar.

You could add red or yellow pepper and carrot batons with guacamole or a dip to your lunch, or a minestrone soup made with either summer or winter vegetables.  For dinner you could choose some protein, with either a large mixed salad, dressed courgette noodles or a mix of roasted vegetables.  You might even try kale crisps!

2. PROTEIN

Try reading the great book by Nina Teicholz The Big Fat Surprise before choosing your protein sources.  You can choose from any kind of meat or oily fish, dairy produce or nuts and seeds as the protein source in your meals.

protein

3. GRAINS

Brown or wild rice are a much better source of nutrition than white rice, and according to the British Dietetic Association, contain more:

  • fibre – both soluble (the type that dissolves in water) and insoluble (the type that doesn’t)

  • B vitamins and folic acid

  • essential fatty acids (omega 3 fat)

  • protein

  • antioxidants including vitamin E, selenium and

  • copper

Vitamin B in particular can be a deficiency risk for people with vitiligo.  It is covered in more detail in the “Supplements” section below.

You can buy a wide range of grains to include in recipes or to use as a side dish such as quinoa, bulgur wheat, buckwheat and freekeh.

grains

4. FATS AND OILS
Recent research showed strong heart benefits if you had a portion of cold olive oil (50 mls) every day, for example on a salad or drizzled on vegetables or soup.  You can add chilli or lemon peel to a bottle of olive oil to flavour it.  It is probably better to choose a fat that is not refined, like butter or olive oil, for cooking and spreading.  Refined fats like margarines have been shown to be less healthy.

5. OTHER ESSENTIALS

Adding spices, a small quantity of salt, freshly ground pepper and fresh herbs all increase the taste of your food, making it more pleasurable while avoiding less healthy options.  If you use a high-taste cheese like parmesan in cooking, you get a great flavour, with less saturated fat.  Adding flavours to a small bottle of olive oil and letting it steep for a few days gives you a natural condiment with no artificial additives.  Try out the delicious Togarishi pepper, available from Amazon, as an addition to vegetables and chicken.  Please see our note on turmeric below though!

herbs

INTUITIVE EATING

We also recommend the principles of Intuitive Eating.  Many women and some men find that the daily rigours of living with vitiligo may lead to comfort eating.  Intuitive eating is a way to focus on the pleasure of eating when hungry, and enjoying the mouthfuls, ending when you are full.  Though this may seem simple to many people, to others the messages about food may have become skewed by depression or family pressures from the past.

10 Principles of Intuitive Eating

1. Reject the Diet Mentality

Throw out the diet books and magazine articles that offer you false hope of losing weight quickly, easily, and permanently. Get angry at the lies that have led you to feel as if you were a failure every time a new diet stopped working and you gained back all of the weight. If you allow even one small hope to linger that a new and better diet might be lurking around the corner, it will prevent you from being free to rediscover Intuitive Eating.

2. Honour Your Hunger

Keep your body biologically fed with adequate energy and carbohydrates. Otherwise you can trigger a primal drive to overeat. Once you reach the moment of excessive hunger, all intentions of moderate, conscious eating are fleeting and irrelevant. Learning to honour this first biological signal sets the stage for re-building trust with yourself and food.

3. Make Peace with Food

Call a truce, stop the food fight! Give yourself unconditional permission to eat. If you tell yourself that you can’t or shouldn’t have a particular food, it can lead to intense feelings of deprivation that build into uncontrollable cravings and, often, bingeing When you finally “give-in” to your forbidden food, eating will be experienced with such intensity, it usually results in Last Supper overeating, and overwhelming guilt.

IF

4. Challenge the Food Police

Scream a loud “NO” to thoughts in your head that declare you’re “good” for eating minimal calories or “bad” because you ate a piece of chocolate cake. The Food Police monitor the unreasonable rules that dieting has created . The police station is housed deep in your psyche, and its loud speaker shouts negative barbs, hopeless phrases, and guilt-provoking indictments. Chasing the Food Police away is a critical step in returning to Intuitive Eating.

5. Respect Your Fullness

Listen for the body signals that tell you that you are no longer hungry. Observe the signs that show that you’re comfortably full. Pause in the middle of a meal or food and ask yourself how the food tastes, and what is your current fullness level?

6. Discover the Satisfaction Factor

The Japanese have the wisdom to promote pleasure as one of their goals of healthy living In our fury to be thin and healthy, we often overlook one of the most basic gifts of existence–the pleasure and satisfaction that can be found in the eating experience. When you eat what you really want, in an environment that is inviting and conducive, the pleasure you derive will be a powerful force in helping you feel satisfied and content. By providing this experience for yourself, you will find that it takes much less food to decide you’ve had “enough”.

eating mindfully

7. Honour Your Feelings

Without Using Food Find ways to comfort , nurture, distract, and resolve your issues without using food. Anxiety, loneliness, boredom, anger are emotions we all experience throughout life. Each has its own trigger, and each has its own appeasement. Food won’t fix any of these feelings. It may comfort for the short term, distract from the pain, or even numb you into a food hangover. But food won’t solve the problem. If anything, eating for an emotional hunger will only make you feel worse in the long run. You’ll ultimately have to deal with the source of the emotion, as well as the discomfort of overeating.

8. Respect Your Body

Accept your genetic blueprint. Just as a person with a shoe size of eight would not expect to realistically squeeze into a size six, it is equally as futile (and uncomfortable) to have the same expectation with body size. But mostly, respect your body, so you can feel better about who you are. It’s hard to reject the diet mentality if you are unrealistic and overly critical about your body shape.

9. Exercise–Feel the Difference

Forget militant exercise. Just get active and feel the difference. Shift your focus to how it feels to move your body, rather than the calorie burning effect of exercise. If you focus on how you feel from working out, such as energized, it can make the difference between rolling out of bed for a brisk morning walk or hitting the snooze alarm. If when you wake up, your only goal is to lose weight, it’s usually not a motivating factor in that moment of time.

StretchingHerBody

10 Honour Your Health – Gentle Nutrition

 Make food choices that honour your health and tastebuds while making you feel well. Remember that you don’t have to eat a perfect diet to be healthy. You will not suddenly get a nutrient deficiency or gain weight from one snack, one meal, or one day of eating. It’s what you eat consistently over time that matters, progress not perfection is what counts.

SPECIFIC DIETS FOR VITILIGO

At the moment  there is no study that has been, or is being, undertaken that links a specific diet with an improvement in, or reversal of, your vitiligo.

The difficulty with any dietary study is that the researcher needs a large group of people to make the study scientifically valid.  In addition the study needs to control all other aspects of the subject’s life to ensure that it is only the diet that has brought, or not, any improvements to the skin.

One example of a longitudinal study in Alzheimer’s was called “The Nun Study”, because it was able to use a population of Roman Catholic nuns in American convents to see what effect the very controlled environment in which they lived had on their neurological degeneration.  More information about the study can be found here.  The advantages of using the nuns in this example were that:

They weren’t exposed to a wide range of foods – diet in the convents was reasonably austere and controlled

There wasn’t any snacking – an element in diet that is very hard to control in the wider population

They had a moral code to be honest in answering questionnaires or researcher’s questions, which may not be true of all of the wider population who may under- or over-estimate the quality and/or quantity of their diet and

The nuns didn’t smoke or drink.

You can see from this some of the difficulties in completing research in this area with a group of vitiligo patients.

However, in 2006, Dr Karin Uta Schallreuter (about whom you can find more information in the “Treatments” section) did a very small study (15 patients) entitled “Turmeric (Curcumin) – a widely used curry ingredient – can contribute to oxidative stress in Asian patients with acute Vitiligo”.  This showed that in the group, where there was consumption of turmeric twice a day, there was also no repigmentation.  Dr Schallreuter writes that “Therefore, we advised 8 patients to avoid this spice ingredient in their diet and continue the application of PC-KUS twice daily. There was a significant improvement of the response already after 2 months in these patients. After 6 months treatment, the facial repigmentation was nearly completed in 6 of the 8 patients, whereas only minor to moderate or no response was obtained in the 7 patients who continued using turmeric together with PC-KUS.”

This might influence your consumption of turmeric.

The main principles behind a diet that is helpful for vitiligo would be about helping the body to deal with internal inflammation.

The principles of an anti-inflammatory diet are:

Prioritise Omega 3,  found in high quantities oily fish, natural nuts and seeds, raw or stir-fried/lightly cooked vegetables, especially the cruciform vegetables – broccoli, brussels sprouts, kale, cauliflower – and tofu.

Balance carefully your intake of Omega 6 when it’s in a unhealthy form, found in sweets, processed foods and hydrogenated or trans fats

More information on this balance can be found on the site for the Institute for Food, Brain and Behaviour which also contains other useful advice.

The link is here.

For example, you could consider adding some of the following to your diet, in a balanced way:

anti inflam foods

Blueberries

Beans

Almonds

Ginger

Green Tea

Tomatoes

Green leafy vegetables

Fatty fish

Berries

Olive Oil

DEBUNKING SOME OF THE MYTHS ABOUT VITILIGO 

Eating fish and milk together or shortly after each other does not cause or accelerate vitiligo.

Eating white foods doesn’t cause or accelerate vitiligo.

Eating sour foods such as citrus fruits doesn’t cause or accelerate vitiligo.

There may well be more out there, but if you take a look at our page “What is vitiligo?” you will see that research has not identified any dietary cause for the skin disease.

SUPPLEMENTS

Vitamin D

In July 2016 the UK Government’s Scientific Advisory Committee on Nutrition updated its advice on Vitamin D for the population as a whole.

It advised that, because it is hard to get sufficient naturally rich food sources of  Vitamin D into your diet, people should take a supplement.

If you have vitiligo, wear camouflage and/or sunscreen or avoid the sun, you are even less likely to be able to produce sufficient levels of Vitamin D from exposure to sunshine.

We therefore echo the government’s advice to take a Vitamin D supplement.

The government report stated that the amount to take was recommended to be “10 μg/d (400 IU/d)… for the UK population aged 4y and above”

This means, when purchasing a supplement, you should look for one that has 400 IU in it, of cholecalciferol or vitamin D3.  So, for example, search for “Vitamin D3 400 iu”.  On Amazon there are a number of supplements you can purchase that fit that requirement.

Folic Acid and Vitamin B12

There has been one particular study with vitiligo patients in this area, indicating that an addition of Vitamin B12 and Folic Acid, through supplements, may help in repigmentation after exposure to sun light.  The study was not of a large group of people, and wasn’t ‘blinded’ (so that patients in this trial were told what they were taking, and the purpose for it, which can influence the results) or ‘controlled’ (so that there wasn’t in this case a control group who didn’t receive the therapies with whom to compare and contrast).

A lack of Vitamin B12 can manifest due to an auto-immune disorder called ‘pernicious anaemia’.  This is not particularly common, usually develops over 50 years old and is more common amongst women.  If you have more than one auto-immune disorder, or have a family member with pernicious anaemia, it is worth being aware of the symptoms and making sure that you haven’t developed this.

In a review of the study mentioned above, vitiligo patients are referred to as “some of the most needy patients dermatologists see”.  Despite this discouraging comment, it is worth reviewing your levels of these two vitamins, perhaps through a nutritionist rather than your GP, to see if you have low levels.

If you decide to supplement, it is recommended that you take both B12 and Folic Acid together as they work in tandem.  Do keep an eye on the symptoms of pernicious anaemia.

ONLINE RESOURCES

If you battle with your weight and body image, we recommend this blog that explores fitness over weight, and the positive effects of becoming stronger.  Bethany introduced us to Intuitive Eating.

Power Peace and the Porch Gym

Harvard University has a great set of resources and information from the US about diet which you can find here

The Institute for Food Brain and Behaviour has an interesting set of studies showing the development of nutritional information in the UK which can be found here.

If you are looking for a nutritionist to see privately to help with any specific dietary issues, check the register of The British Nutrition Foundation, which also usefully explains the difference between a dietician and a nutritionist.  The home page can be found here.