Blackmores Institute

The review, published in <a href="https://www.frontiersin.org/articles/10.3389/fnut.2019.00141/full">Frontiers in Nutrition</a> found that several studies have demonstrated joint pain and other symptoms of rheumatoid arthritis (RA) may be modified by dietary factors.
 
 “Excessive body weight and diets that include animal products (e.g., dairy, red meat) exacerbate RA symptoms, likely due to their pro-inflammatory effects. In contrast, diets rich in vegetables, fruits, and fibre are associated with lower body mass index (BMI), have anti-inflammatory properties and help reduce pain and inflammation in these patients,” the authors stated.
 
 According to the review, animal foods, including milk, eggs and dairy have been found to be particularly problematic for people with RA with studies showing symptomatic improvement with a vegan diet.
 
 “Previous research has shown that the microbiomes of RA patients not only lack microbial diversity but are dominated by Prevotella copri. This bacterial species appears to lower the abundance of other beneficial species and thrive in untreated RA patients. Thus, the gut microbiome and dietary fibre intake might have a significant impact on RA disease activity. The gut microbiome could mediate the connection between diet, inflammation, and RA, although these relationships remain speculative,” the authors said.
 
 The review also found a growing body of research suggesting that RA may have a gastrointestinal component, perhaps even originating in the gut.
 
 “Multiple studies have found improvements in RA patients placed on an elemental diet in which all antigenic proteins are eliminated from the patient’s diet. The individual is given, as a sole source of nutrition, a complete formula in which all proteins have been broken down into free amino acids.”
 
 “Elimination diets, which remove one or more foods likely to trigger symptoms, have also been shown to induce clinical improvement in RA patients in clinical trials. These improvements disappear when patients resume their normal diet.”
 
 As a chronic inflammatory autoimmune disease, RA commonly affects hands, wrists and knees causing inflammation, pain and eventually permanent joint damage. Although genetic factors may account for a portion of risk, according to the authors, the rest may be linked to environmental factors or a combination of genetic and environmental factors. While medications are a mainstay of treatment, they often come with unwanted side effects and/or a high cost, suggesting changes in diet to patients may prove an easy and economical intervention in the management of RA.
 
 “The lack of recent research on this topic is concerning, since emerging research has shown that diets eliminating specific foods can be effective for other inflammatory and autoimmune conditions, such as Crohn’s disease and eosinophilic oesophagitis. Eliminating gluten has also been found to not only ameliorate intestinal signs and symptoms in coeliac disease (CD) but also to improve arthritis/arthralgia in some CD patients.
 
 “The relationship between diet and RA is complex, and foods that trigger reactions in patients are individualised and therefore can be challenging to detect. However, a vegan diet comprised of fruits, grains, legumes, and vegetables can be a beneficial start for RA patients,” the authors concluded.
 
 Source:
 Front Nutr. 2019. doi: <a href="https://www.frontiersin.org/articles/10.3389/fnut.2019.00141/full">10.3389/fnut.2019.00141</a>

Researchers are calling for further studies into the effectiveness of plant-based diets in people with rheumatoid arthritis following results of a review suggesting that diet might play an important role in its management.

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