Food And Rheumatoid Arthritis

Transcript Of Video

(Edited for clarity)

Impact of food on RA. No specific RA diet.

Hi, welcome to Autoimmunity Now with Dr. Kar. Today, I’ll discuss a paper which came out in 2017 where they looked at whether there was any influence of food on symptoms of rheumatoid arthritis. So as you know, rheumatoid arthritis is an autoimmune condition where your joints are destroyed because of an inflammatory autoimmune response and it can lead to a lot of pain, joint deformities, difficulty moving, and there are different therapies used for it. However, when you have reached out to any Functional Medicine doctor like me, most of the time we start off with food. And we know that food has a huge impact on almost all autoimmune conditions. However, in traditional medicine, there is no specific diet that is recommended for rheumatoid arthritis. So what does this paper say?

Diet and Rheumatoid Arthritis symptoms survey results from a rheumatoid arthritis registry.

So this is a registry of about 1400 patients who have confirmed rheumatoid arthritis.((Ref)) In this survey, about 217 of them responded. So this registry is from the Brigham and Women’s Hospital in Boston and they have had this for a while. So what they do basically is these are people with rheumatoid arthritis who are on regular monitoring. There are rheumatologists who are checking on them. They have blood work and everything done. So this survey was done because a lot of people with rheumatoid arthritis have been telling their doctors that food has an impact on their symptoms. So who was included in the survey?

Description of people on this survey:

• 217 people responded, most of them were women and Caucasians.
• Rheumatoid arthritis duration was an average of 17 years (9 years to 27 years).
• More than half of them were taking some kind of a disease-modifying antirheumatic drug (DMARDs)

Which food were they asked about?

20 food on the list.

1. Milk
2. Cheese
3. Red meat
4. Tomatoes
5. Eggplant
6. White potatoes
7. Bell or hot peppers
8. Diet soft drinks
9. Beer 
10. Fish
11. Spinach
12. Blueberries
13. Strawberries
14. Chocolate
15. Red wine 
16. Soft drinks with sugar
17. Caffeinated coffee
18. Decaffeinated coffee
19. Caffeinated tea
20. Herbal or decaffeinated tea

24% of people in this survey reported that food affects their rheumatoid arthritis symptoms. So what they said is there was some food that made their symptoms worse and some food then that made the symptoms better.

Which food worsened RA symptoms?

• Soda with sugar
• Desserts
• Beer
• Red Meat
• Eggplant
• Diet Soda
• Tomatoes

Sugar-containing food and inflammation:

So if you have any kind of pain or inflammatory condition, sugar is definitely not your friend and soda, of course, has its own whole host of other problems. So soda with sugar, desserts, again, something that contains sugar. Beer again is something that contains carbohydrates, which is indirectly sugar. And of course diet soda doesn’t contain sugar, but it does contain other harmful stuff.

So these are the stuff, the food basically I’ve been asking all of you to get off and this particular paper, of course, surveyed only sugar intake, but many of you know that I’ve also told you things like honey jaggery, maple syrup, they are also different forms of sugar. These are also different versions of sugar in some form or the other. So when you are looking at reducing your rheumatoid arthritis symptoms, it is much better to get rid of all kinds of sugar and sugar-sweetened beverages as well.

Nightshade Vegetables and Autoimmune Protocol

Eggplant, tomatoes, and bell peppers are food that people felt made the symptoms worse, and you know that in autoimmune diseases, we have something called the Autoimmune Protocol which would include excluding; I’m sorry, that sounds awful. So which means you also exclude certain vegetables, which are called the nightshade vegetables, and I will post more on food and its impact on autoimmune conditions on subsequent posts.

Which food helped improve symptoms?

• Spinach
• Strawberries
• Blueberries
• Fish

Berries, polyphenols, low sugar food

Spinach, strawberries, fish, blueberries. Now strawberries and blueberries. Berries have a whole lot of beneficial substances in them, which are polyphenols and a whole lot of clever-sounding names. But the other important thing is both strawberries and blueberries are very low in sugar. Spinach, of course, is low in sugar fish. Now fish, as many of you know, is a good source of Omega three fatty acids. Of course, it would depend on what kind of fish you’re having. So fatty fish would be a good one.

People were not asked about gluten

But isn’t it fascinating to see that though there is no specific rheumatoid arthritis diet, most of you have already figured out some of the foods that bother you? Now, incidentally, on this particular survey, they hadn’t specifically asked about gluten-containing food. And as you know, I have written about gluten and non-celiac gluten sensitivity before. And if you have worked with me, you know that I talk a lot about getting off of gluten. And there are various reasons for it.

Red meat and processed meat

So when it comes to red meat. So red meat includes beef, goat, lamb, mutton pork, veal,venison. However, one important aspect that I want to stress upon is we know that processed meat is something that is quite harmful and there are enough studies to tell us that. So what are the processed meat? Now you can see in that list. So processed meat is meat that has been preserved by adding preservatives, salting or smoking. And I have talked about preservatives before and the harmful effect that it has on health specifically to autoimmunity. Preservatives have been found to be associated with a higher risk of getting an autoimmune disease as well. So all those chemicals that are added to food to make them more palatable or have a longer shelf life.

Processed meat:

And I have talked to you numerous times about getting off of all kinds of processed food.

Processed meat is

• Bacon
• Corned beef
• Salami
• Ham
• Luncheon meats including those made from chicken and turkey (which are not red meat).
• Pate
• Sausages

Being on medications did not affect response to food

The authors of this paper thought that probably those patients have rheumatoid arthritis who are on these medications, they wouldn’t have as much of a response. But to their surprise, they found that there was no difference in response to food based on the type of medication use. So there was no difference between those who were using methotrexate versus methotrexate and steroids versus methotrexate or a combination of any of the other medications.

What other conditions did these people have?

When you have an autoimmune condition, your risks of developing cardiovascular disease, that is stroke, heart disease are much higher. So that is the reason I have told many of you we need to evaluate what is your risk for heart disease or stroke.

High reported gut-related symptoms: Gut and autoimmunity.

• 33.5% of the people in this survey had acid reflux or GERD or as some of you have described to me, you feel gassy or you feel that burning sensation in the chest.
• 13.1% had lactose intolerance
• 11.5% had a food allergy

Besides food what other lifestyle factors helped them?

• Exercising regularly —83.7% of the people who took part in that survey said it helps them.
• Getting a good night’s sleep: 86.5% of people have felt that getting good sleep helped them a lot.
• Warm room temperature
• Vitamins/minerals 34% (the survey didn’t specify which ones helped). Other studies have shown the benefits of Omega 3 fatty acids, vitamin D, natural anti-inflammatories like curcumin, bromelain, Boswellia. If you have worked with me, you know that I have talked about many of these, whether you should use all of them, some of them, some of them, some of the time that’s entirely dependent on what is going on with each one of you.

Switching off TV and getting off backlit devices to improve sleep.

So maybe you need to switch off the TV a little early and read a paper book. I’ve told many of you to do that. Switch the lighted backlit device, whether it’s your computer or a tablet, switch it, switch it off for a paper book, or maybe get one of those e-readers which are not backlit because those things impact your sleep as well.

In conclusion:

• 24% of people in this survey felt that food had an impact on their RA symptoms.
• DMARDs medications did not change the impact of food
• Troublesome food were sugar-containing food, soda, red meat a few nightshade vegetables.
• Beneficial food: Fish, berries, spinach.
• Exercise, sleep, warm room temperature and vitamins/minerals helped too.

Thank you for your encouraging messages!

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