Stelara Diet: Foods To Eat And Avoid

Autoimmune diseases impact around 4% of the world’s population. 

If you have an autoimmune disease, your healthcare provider might suggest taking medication to help lower your immune system’s response, which can improve symptoms.

Stelara (Ustekinumab) is a medication used to treat certain autoimmune diseases. 

If you’ve been prescribed Stelara, you might be wondering if there are any specific dietary changes you need to make while taking it.

In this article, we’ll explain what Stelara is, what it’s used to treat, its potential side effects, and the types of foods you may want to eat or avoid while taking Stelara.

What is Stelara (Ustekinumab)

Stelara is the brand name for ustekinumab, a type of immunosuppressant drug. 

Stelara is considered a biologic, which entails “any substance that is made from a living organism or its products and is used in the prevention, diagnosis, or treatment of cancer and other diseases.”

Stelara works to suppress overactive immune systems that result in certain autoimmune conditions like psoriatic arthritis and Crohn’s disease. 

Autoimmune diseases occur when your immune system mistakenly attacks healthy parts of your body. 

In the case of psoriatic arthritis, this leads to painful joints and stiffness, similar to rheumatoid arthritis (another autoimmune disorder). 

Psoriatic arthritis is linked with psoriasis, a skin condition that causes red, scaly skin patches and nail issues.

Crohn’s disease is an inflammatory condition that impacts your digestive tract, specifically your small intestine and the beginning part of your large intestine. 

Crohn’s disease often causes symptoms such as abdominal pain, diarrhea, fatigue, reduced appetite, and bloody stools.

So how does Stelara work to treat psoriatic arthritis, psoriasis, and Crohn’s disease? Stelara works to block certain proteins (which are believed to cause inflammation) that are often increased in patients with autoimmune diseases.

What is Stelara used for?

According to the manufacturer of Stelara, it’s used for:

Stelara is an injection that comes in either 45-milligram or 90-milligram strengths. Stelara is typically administered once, again four weeks later, and then every 12 weeks. 

The specific dosing guidelines will vary based on your age, weight, and the condition you’re using Stelara to treat.

What are the side effects of Stelara?

Like all medications, Stelara comes with the risk of certain side effects. Some side effects are more minor and might disappear as you get used to the medication, while others might linger and be more serious.

Some of the more common side effects of Stelara include:

• Nasal congestion
• Sore throat
• Runny nose
• Upper respiratory infections
• Fever
• Headache
• Tiredness
• Itching
• Nausea and vomiting
• Redness at the injection site
• Vaginal yeast infections
• Urinary tract infections
• Sinus infection
• Bronchitis
• Diarrhea
• Stomach pain
• Joint pain

Some of the other potential side effects and risks of taking Stelara can include:

• Severe infections: Stelara lowers your immune system’s ability to fight off infections, which means you might be more susceptible to infections. Some infections, such as tuberculosis (TB), are very serious and may require hospitalization if you acquire it.

• Cancer: due to its immunosuppressive actions, Stelara might increase your risk of developing certain types of cancers.

• Posterior Reversible Encephalopathy Syndrome (PRES): this is a rare condition that impacts your brain and can be deadly if it’s not treated early. PRES is rare, and its cause is unknown.

• Serious allergic reactions: signs of being allergic to Stelara include symptoms such as swelling of your face or throat, chest tightness, or developing a skin rash.

• Lung inflammation: if you have a cough that doesn’t go away or experience chest tightness, you should notify your healthcare provider.

Foods to avoid while taking Stelara (Ustekinumab)

The potential foods to avoid while taking Stelara (Ustekinumab) will depend on the condition you’re using it to treat. 

For instance, the foods you need to avoid might be different if you have Crohn’s disease than if you have psoriasis.

There are no specific foods that are known to interact with Stelara, so these recommendations are based on helping to reduce symptoms of the conditions Stelara is most commonly prescribed to treat or for general safety concerns due to increased susceptibility to illness and infections.

Raw or undercooked meat and eggs

You’re more prone to getting a foodborne illness (from bacteria, viruses, or parasites) when taking Stelara since it lowers your immune system’s ability to fight infections. 

For that reason, you should avoid eating higher-risk foods that could cause a foodborne illness.

Meat and eggs should be thoroughly cooked, which means you should avoid the following foods while taking Stelara:

• Sushi made with raw fish
• Rare or uncooked meat
• Runny eggs
• Any dish or drink with raw egg yolks

These are the safe internal temperatures to cook meat and eggs to ensure proper food safety:

Dairy (if it’s a trigger for psoriasis or other inflammatory conditions)

You might find that dairy (milk, cheese, yogurt, etc.) can aggravate symptoms of your autoimmune condition, especially psoriasis. 

This isn’t the case for everyone, but some people taking Stelara for certain conditions might find that dairy products are triggers.

If dairy is a trigger for you, then you should avoid:

• Milk
• Cream
• Cheese
• Yogurt
• Kefir
• Ice cream
• Foods with a high concentration of dairy-containing ingredients

High-fiber veggies and grains (Crohn’s)

If you have Crohn’s disease or ulcerative colitis, you might not tolerate high-fiber foods very well. 

Fruits and vegetables that contain skin and seeds tend to be higher in fiber, especially insoluble fiber. 

Whole grains are also high in this type of fiber, which can irritate the already inflamed lining of your digestive tract. 

On the other hand, insoluble fiber absorbs water and forms a gel, so it’s not as irritating to your intestines, so you might be able to tolerate soluble fiber.

While high-fiber foods are generally considered very healthy, you might need to avoid them if you have Crohn’s or ulcerative colitis, especially if you’re experiencing a flare-up (increase in symptoms).

Some foods that are especially high in insoluble (rough) fiber include:

• Almonds
• Apples with the skin on
• Beans, lentils, and legumes (can also increase gas)
• Berries 
• Coconut 
• Dried apricots, prunes, raisins, dates, and figs
• Flaxseeds
• Green peas
• Oat bran
• Okra
• Pears with the skin
• Popcorn
• Potatoes with the skins on
• Radishes
• Rutabaga
• Spinach
• Sunflower seeds
• Turnips
• Walnuts
• Wheat bran and wheat germ
• Whole grains

Gluten (only if it’s a trigger for Crohn’s, psoriasis, etc.)

Like dairy, gluten can be a trigger for some people with autoimmune diseases. Gluten is a protein found in wheat, rye, and barley. 

If a gluten-free diet has improved your symptoms, then gluten is likely a trigger that needs to be avoided.

Many processed foods contain gluten, so you’ll need to check the ingredient labels to ensure you’re not getting any hidden gluten, such as in certain condiments, soups, and other processed foods.

Foods high in added sugar

Diets high in sugar are linked with more inflammation, which can worsen symptoms of autoimmune diseases. 

Aim to limit the amount of added sugar in your diet, which is prevalent in foods and drinks like:

• Sugar-sweetened beverages
• Desserts
• Sweets/candy
• Sugar-sweetened cereals, nutrition bars, yogurts, etc.
• Sugary grains like muffins, donuts, etc.

What foods should you eat while taking Stelara? 

Vitamin C-rich foods

Vitamin C can support a healthy immune system. Taking Stelara lowers your immune system’s ability to fight off bacteria, viruses, and other pathogens, so prioritizing your immune health through your diet is one of the most important goals for a Stelara diet.

Aim to get vitamin C in your Stelara diet by eating plant-based foods like:

• Citrus fruits – oranges, kiwi, lemon, grapefruit, etc.
• Bell peppers
• Strawberries
• Tomatoes
• Cruciferous vegetables like broccoli, Brussels sprouts, cabbage, and cauliflower
• White potatoes

Omega-3 fatty acids

The conditions Stelara treats (Crohn’s, psoriatic arthritis, etc.) all stem from inflammation. Omega-3 fatty acids are known for their anti-inflammatory benefits, which might help to improve symptoms.

Krill oil, fish oil, and other marine sources are among the best sources of omega-3 fatty acids. Some of the richest sources of omega-3 fatty acids come from foods like:

• Fatty fish like salmon and mackerel
• Cod liver oil and other fish oil
• Algae oil

You can also find omega-3 fatty acids in plant-based foods like:

• Walnuts
• Chia seeds
• Flaxseeds
• Hemp seeds
• Pumpkin seeds
• Soybeans/soy products

Probiotic-rich foods

The healthy bacteria in your digestive tract help your immune system to do its job. Things like antibiotics, stress, and diet can alter these healthy bacteria.

One way to help encourage healthy gut bacteria (and therefore support a healthy immune system) is by eating foods rich in probiotics, which help feed these gut bacteria.

Fermented foods are rich in probiotics and include:

• Yogurt
• Kefir
• Sauerkraut
• Tempeh (made from soybeans)
• Kimchi
• Kombucha

Protein-rich foods

Eating protein helps your body form antibodies to help fight off infections. Since Stelara lowers your body’s ability to fight infections, it’s important to eat adequate protein in your diet to support a healthy immune system.

In addition, eating protein can help rebuild damaged tissue and promote the growth of new, healthy tissue.

Some protein-rich foods to eat while taking Stelara:

• Meat (beef, pork, poultry, etc.)
• Eggs
• Yogurt
• Cheese
• Nuts
• Seeds
• Beans/lentils
• Soybeans

Other things to avoid while taking Stelara

• Avoid taking live vaccines while taking Stelara.
• You shouldn’t take Stelara if you’re planning on becoming pregnant or are breastfeeding.
• Practice good hand hygiene and avoid being in close proximity to people you know are sick.

Should you take Stelara with food?

Stelara is a long-acting injection (it stays in your system for a long time), so it doesn’t matter if you eat around the time of the injection or not. 

The half-life of Stelara (the time it takes for half of the starting dose to remain in your system) is 19 days, which shows how long it remains in your system after injection.

Conclusion

Stelara lowers your immune system’s ability to fight off infections. The primary goal for your diet while taking Stelara should be to support a healthy immune system and reduce symptoms of your autoimmune condition.

Some potential foods to avoid while taking Stelara include raw or undercooked meat and eggs, dairy (if it’s a trigger), gluten (if it’s a trigger), certain high-fiber foods (for Crohn’s), and large amounts of added sugar.

Foods to eat while taking Stelara include vitamin C-rich foods, omega-3 fatty acids, probiotic-rich foods, and good sources of protein.

Explore More

9 Ways to Keep Your Immune System Healthy.