Why Do Plant-Based Diets Help Rheumatoid Arthritis?

“Why Do Plant-Based Diets
Help Rheumatoid Arthritis?” Rheumatoid arthritis
is a chronic systemic autoimmune disease
affecting millions, characterized by persistent
pain and stiffness, and progressive
joint destruction — particularly in the hands and feet,
leading to crippling deformities. What can we do to
prevent it and to treat it? In a famous 13 month long
randomized controlled trial of plant-based diets
for rheumatoid arthritis, patients were put on a vegan diet
for three and a half months and then switched to an egg-free lactovegetarian diet
for the remainder of the study. Compared to the control group
that didn’t change their diet at all, the plant-based group had
a significant improvement in morning stiffness
within the first month, cutting the number of hours they
suffered from joint stiffness in half. Pain dropped from five out of ten
down to less than three out of ten. A drop in disability. They reported subjectively
feeling better, significant improvements in their
grip strength in their hands, fewer tender joints, less
tenderness per joint, and less swelling, with the added benefit
of losing about 13 pounds and keeping most of that
weight off throughout the year. They also had a drop
in inflammatory markers in their blood, sed rate,
C-reactive protein, white count. The question is: “Why?”. What does diet have to do
with inflammatory joint disease? Well, rheumatoid arthritis
is an autoimmune disease, in which your body attacks
the lining of your own joints. Why would it do that? Well, there’s a different autoimmune
disease called rheumatic fever, in which your body
attacks your own heart. Again, why would it do that? Well, it appears to be
a matter of friendly fire. Rheumatic fever is
caused by strep throat, which is caused by a
bacteria that has a protein that looks an awful lot
like a protein in our heart. So when our immune system
attacks the strep bacteria, it also attacks our heart valves, triggering an autoimmune
attack by “molecular mimicry.” The protein on the strep bacteria
is mimicking a protein in our heart, so our body gets confused
and attacks both. That’s why it’s critical
to treat strep throat early to prevent our heart from
getting caught in the crossfire. So researchers thought
maybe rheumatoid arthritis might be triggered
by an infection as well. A clue to where
to start looking was the fact that women seem
to get rheumatoid arthritis three times more
frequently than men. What type of infection do
women get more than men? Urinary tract infections. So researchers started
testing the urine of rheumatoid arthritis
sufferers and, lo and behold, found this bacteria
called Proteus mirabilis. Not enough to cause
symptoms of a UTI, but enough to trigger
an immune response. And indeed there’s
a molecule in the bacteria that looks an awful lot like one of
our own molecules in our joints, so anti-Proteus antibodies
against the bacteria may inadvertently damage
our own joint tissues, leading eventually to
the joint destruction. Therefore, therapeutic interventions
aimed at the removal of this bacteria from
the bodies of patients, with consequent reduction of
antibodies against the organism should lead to a decrease
in inflammation. Well, as we saw before, urinary tract infections
originate from the fecal flora. The bugs crawl up from
the rectum into the bladder. And so how might one
change the bugs in one’s colon? By changing our diet. Some of the first studies
over 20 years ago in trying to fundamentally shift
people’s gut flora were done using
raw vegan diets, figuring that’s about
as fundamental a shift from the standard Western
diet as one can get. And indeed within
days one could significantly shift
someone’s gut flora. And you put rheumatoid arthritis
sufferers on that kind of diet, and they experienced relief.
And the greater improvements were linked to greater
changes in their gut flora. But the diet was considered
so intolerable that half the patients couldn’t
take it and dropped out, perhaps because they were
trying to feed people things like buckwheat-beetroot cutlets buttered
with a spread made out of almonds and fermented coconut juice.
Excuse me, not coconut; that might have been good.
Cucumber juice. Thankfully regular vegetarian
and vegan diets work too, changing the intestinal flora
and improving rheumatoid arthritis. But we didn’t specifically
have confirmation that plant-based diets brought down
anti-Proteus antibodies, until now. Those that responded to
the plant-based diet showed a significant drop in anti-Proteus
mirabilis antibodies compared to the control group. Maybe it just dropped immune
responses across the board? No, antibody levels against
other bugs remained the same. So the assumption
is that the veg diet reduced urinary or
gut levels of the bug. A shift from an omnivorous
to a vegetarian diet has profound influence
on the composition of our urine, for
example, higher levels of lignans in the urine
of those eating vegetarian. Up until now it was just thought
that they protected people eating more plant-based
from getting cancer. But now we know
lignans can also have antimicrobial
properties as well so may be helping to clear
Proteus from our system. Either way, this suggests
a new type of therapy for the management
of rheumatoid arthritis. This new treatment includes
anti-Proteus measures such as dietary manipulations
in the forms of vegetarian diets.
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