Jewish World Review Sept. 24, 2002 / 18 Tishrei, 5763
Dr. Ed Blonz
Dear C.S.: Unfortunately, there are no definitive answers on how to handle rheumatoid arthritis.
Arthritis is a general term for inflammation of joints. (In Latin, arthros means "joint," and itis means "inflammation of".) There are many types of arthritis, but rheumatoid arthritis is among the most serious. It's an autoimmune disease in which the body's own immune system attacks the hands, feet, knees and other joints, typically damaging the joints and surrounding tissues in the process. The end result is pain, inflammation, swelling and various degrees of misery.
A vegetarian diet -- often preceded by a fast -- may also offer some hope for those with rheumatoid arthritis. One study in the September 1999 issue of the American Journal of Clinical Nutrition found that those on vegetarian diets experienced fewer arthritis symptoms than the volunteers whose diet contained meat and other animal products. The study began with a seven- to 10-day modified fast that included 190 to 300 calories per day from foods such as herbal teas, garlic, vegetable broth, decoctions of potatoes and parsley and the juices of carrots beets and celery. After the fast, new foods were introduced every second day, and, if symptoms developed, the food was omitted from the diet and reintroduced later. If symptoms reappeared, the food was excluded for the remainder of the 3-1/2-month-long study. The patients then went on to develop their own individually tailored lacto-vegetarian diet (a vegetarian diet with dairy foods permitted) during the next nine months. The scientists reported significant benefits when compared to the patients on the control diet.
A review article in the Scandinavian Journal of Rheumatology (January 2001) looked at many studies and clinical trials that examined the fasting/vegetarian diet regimen. Their conclusion was that this approach might be useful in the treatment of rheumatoid arthritis. There are a number of possible explanations for the observed benefits. First, it is known that vegetarian foods contain different fats than animal products. Most of the fat in our bodies is used as an energy source, but a small amount goes to form powerful hormone-like compounds that can affect how the body operates. The connection with arthritis is that some of these compounds encourage inflammation, while others can keep things calm.
Previous research has found that certain dietary oils, such as those found in borage seed oil, evening primrose oil and, to some degree, the omega-3 fatty acids found in fish oil and flax seed oil, can decrease the painful symptoms of arthritis. Animal products, by contrast, contain compounds that can promote inflammation. A direct effect from the fats we eat may contribute to the problem, but they do not appear to be the entire answer. In the AJCN study, for example, there was no significant difference in the fats found in the blood of those who responded favorably and those who responded unfavorably to the fasting/vegetarian diet regimen.
Another possible explanation for the effect of the vegetarian diet is connected with the greater intake of antioxidant-containing fruits and vegetables associated with this style of eating. Antioxidant nutrients in foods can prevent fats from reacting with oxygen in inappropriate ways that can lay the groundwork for major health problems. This errant "oxidation" is also believed to kick into high gear during the inflammatory process associated with rheumatoid arthritis.
One final rationale offered in the AJCN study relied on the fact that what we eat affects the type of flora (bacteria) indigenous to the human bowel. Shifting to the vegetarian diet made definite changes in the mix and concentration of organisms in the intestinal flora, and these changes were directly associated with disease activity. Unfortunately, there are no definitive answers, but the connection between intestinal flora and rheumatoid arthritis is a very active area of scientific research.
It is important to note that the fasting/vegetarian diet treatment might not be appropriate for everyone, and it is essential to work with a physician or rheumatologist (a physician who specializes in the diagnosis and treatment of arthritis and other diseases of the joints, muscles and bones) to decide on the best course of treatment.
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