Three months into a vegan, grain free diet, no one was more surprised than me when a lifetime of terrible knee pain abruptly vanished. Whilst I caught my autoimmune conditions early, my knees (and sometimes my shoulders) had been plaguing me since I was a teenager. The pain was so chronic I had always assumed that I had created permanent damage at some point in my life. It has now been a year pain free and I’m able to run and use the eliptical with no issues. The issue was so bad, I specifically bought a house with few stairs.
During the last year I have met many people who have improved or eliminated rheumatoid arthritic conditions through diet. I just posted Carrie’s story on my blog, who was almost crippled with arthritis that improved tremendously on a raw vegan diet. I have even met people in their 70s who were lucky enough to reverse joint issues.
Fascinated, I researched everything I could find on the topic and I was surprised to find that many studies have been done, linking RA to various food items. On John McDougall’s website, I found a collection of published studies from across the last 40 years. I point this out, because most meat and dairy was “organic” and GMO’s did not exist at that time.
Ÿ In 1979, Skoldstam fasted 16 patients with rheumatoid arthritis for 7-10 days with a fruit-and vegetable juice fast, followed by a lactovegetarian diet for 9 weeks. One-third of the patients improved during the fast, but all deteriorated when the milk products were reintroduced (a lactovegetarian diet) (Scan J Rheumatol 8:249, 1979).
Ÿ In 1980, Hicklin reported clinical improvement in 24 of 72 rheumatoid patients on an exclusion diet. Food sensitivities were reported to: grains in 14, milk in 4, nuts in 8, beef in 4, cheese in 7, eggs in 5, and one each to chicken, fish, potato, and liver (Clin Allergy 10:463, 1980).
Ÿ In 1980, Stroud reported on 44 patients with rheumatoid arthritis treated with the elimination of food and chemical avoidance. They were then challenged with foods. Wheat, corn, and beef were the greatest offenders (Clin Res 28:791A, 1980).
Ÿ In 1981, Parke described a 38-year-old mother with 11-years of progressive erosive seronegative rheumatoid arthritis who recovered from her disease, attaining full mobility, by stopping all dairy products. She was then hospitalized and challenged with 3 pounds of cheese and seven pints of milk over 3 days. Within 24 hours there was a pronounced deterioration of the patient’s arthritis (BMJ 282:2027, 1981).
Ÿ In 1981, Lucas found a fat-free diet produced complete remission in 6 patients with rheumatoid arthritis. Remission was lost within 24-72 hours of eating a high-fat meal, such as one containing chicken, cheese, safflower oil, beef, or coconut oil. The authors concluded, “…dietary fats in amounts normally eaten in the American diet cause the inflammatory joint changes seen in rheumatoid arthritis.” (Clin Res29:754, 1981).
Ÿ In 1982 Sundqvist studied the influence of fasting with 3 liters of fruit and vegetable juice daily and lactovegetarian diet on intestinal permeability in 5 patients with rheumatoid arthritis. Intestinal permeability decreased after fasting, but increased again during a subsequent lactovegetarian diet regime (dairy products and vegetables). Concomitantly it appeared that disease activity first decreased and then increased again. The authors conclude, “The results indicate that, unlike a lactovegetarian diet, fasting may ameliorate the disease activity and reduce both the intestinal and the non-intestinal permeability in rheumatoid arthritis.” (Scand J Rheumatol 11:33, 1982.)
Ÿ In 1983, Lithell studied twenty patients with arthritis and various skin diseases on a metabolic ward during a 2-week period of modified fast on vegetarian broth and drinks, followed by a 3-week period of a vegan diet (no animal products). During fasting, joint pains were less intense in many subjects. In some types of skin diseases (pustulosis palmaris et plantaris and atopic eczema) an improvement could be demonstrated during the fast. During the vegan diet, both signs and symptoms returned in most patients, with the exception of some patients with psoriasis who experienced an improvement. The vegan diet was very high-fat (42% fat). (Acta Derm Venereol 63:397, 1983).
Ÿ In 1984 Kroker described 43 patients from three hospital centers who underwent a 1-week water fast, and overall the group improved significantly during the fast. In 31 patients evaluated, 25 had “fair” to “excellent” responses and 6 had “poor” responses. Those with more advanced arthritis had the poor responses. (Clin Ecol 2:137, 1984).
Ÿ In 1985, Ratner removed all dairy products from the diet of patients with seronegative rheumatoid arthritis, 7 out of 15 went into remission when switched to milk-free diets (Isr J Med Sci 21:532, 1985)
Ÿ In 1986, Panush described a challenge of milk in a 52-year-old white woman with 11 years of active disease with exacerbations allegedly associated with meat, milk, and beans. After fasting (3 days) or taking Vivonex (2 days) there was no morning stiffness or swollen joints. Challenges with cow’s milk (blinded in a capsule) brought all of her pain, swelling and stiffness back (Arthritis Rheum 29:220, 1986).
Ÿ In 1986, Darlington published a 6-week, placebo-controlled, single-blinded study on 48 patients. Forty-one patients identified foods producing symptoms. Cereal foods, such as corn and wheat gave symptoms in more than 50% of patients (Lancet 1:236, 1986).
Ÿ In 1986, Hanglow performed a study of the comparison of the arthritis-inducing properties of cow’s milk, egg protein and soy milk in experimental animals. The 12-week cow’s milk feeding regimen produced the highest incidence of significant joint lesions. Egg protein was less arthritis-inducing than cow’s milk, and soy milk caused no reaction. (Int Arch Allergy Appl Immunol 80:192, 1986).
Ÿ In 1987, Wojtulewski reported on 41 patients with rheumatoid arthritis treated with a 4-week elimination diet. Twenty-three improved. (Food allergy and intolerance. London: Bailliere Tindall 723, 1987).
Ÿ In 1988, Beri put 14 patients with rheumatoid arthritis on a diet free from pulses, cereals, milk, and non-vegetarian protein foods. Ten (71%) showed significant clinical improvement. Only three patients (11%) adhered to the diet for a period of 10 months (Ann Rheum Dis 47:69, 1988.)
Ÿ In 1988, Hafstrom fasted 14 patients with water only for one week. During fasting the duration of morning stiffness, and number and size of swollen joints decreased in all 14 patients. No adverse effects of fasting were seen except transient weakness and lightheadedness. The authors consider fasting as one possible way to induce rapid improvement in rheumatoid arthritis (Arthritis Rheum 31:585, 1988).
Ÿ In 1991, Kjeldsen-Kragh put 27 patients on a modified fast with vegetable broths, followed by a vegan diet, and then a lacto-ovovegetarian diet. Significant improvement occurred in objective and subjective parameters of their disease (Lancet 2:899, 1991) A two-year follow-up examination found all diet responders but only half of the diet nonresponders still following the diet, further indicating that a group of patients with rheumatoid arthritis benefit from dietary manipulations and that the improvement can be sustained through a two-year period (Clin Rheumatol 13:475, 1994.) Patients dropping out with arthritic flares in the diet group left the study mainly when the lactovegetarian diet (dairy products) were introduced (Lancet 338:1209, 1991).
Ÿ In 1991 Darlington reported on 100 patients who had undergone dietary manipulation therapy in the past decade, one-third were still well and controlled on diet alone without any medication up to 7 ½ years after starting the diet treatment. They found most patients reacted to cereals and dairy products (Lancet 338:1209, 1991).
Ÿ In 1991, Skoldstam fasted 15 patients for 7 to 10 days. Almost all of the patients showed remarkable improvement. Many patients felt the return of pain and stiffness on the day after returning to their “normal” eating and all benefit was lost after a week (Rheum Dis Clin North Am 17:363, 1991).
Ÿ In 1992, Sheignalet reported on 46 adults with rheumatoid arthritis who eliminated dairy products and cereals. Thirty-six patients (78%) responded favorably with 17 clearly improved, and 19 in complete remission for one to five years. Eight of those 19 stopped all medications with no relapse. Favorable benefits appeared before the end of the third month in 32 of the patients (Lancet 339:68, 1992).
Ÿ In 1992, van de Laar showed benefits of a hypoallergenic, artificial diet in six rheumatoid patients. Placebo controlled rechallenges showed intolerance for specific foodstuffs in four patients. In two patients, biopsy of the joints showed specific (IgE) antibodies to certain foods (Ann Rheum Dis 51:303, 1992).
Ÿ In 1992, Shigemasa reported a 16-year-old girl with lupus who changed to a pure vegetarian diet (no animal foods) and stopped her steroids without her doctor’s permission. After starting the diet her antibody titers (a reflection of disease activity) fell to normal and her kidney disease improved (Lancet 339:1177, 1992).
Ÿ In 1995, Kavanaghi showed an elemental diet (which is an hypoallergenic protein-free artificial diet consisting of essential amino acids, glucose, trace elements and vitamins) when given to 24 patients with rheumatoid arthritis improved their strength and arthritic symptoms. Reintroduction of food brought the old symptoms back (Br J Rheumatol 34:270, 1995).
Ÿ In 1998, Nenonen tested the effects of an uncooked vegan diet, rich in lactobacilli, in rheumatoid patients randomized into diet and control groups. The intervention group experienced subjective relief of rheumatic symptoms during intervention. A return to an omnivorous diet aggravated symptoms. The results showed that an uncooked vegan diet, rich in lactobacilli, decreased subjective symptoms of rheumatoid arthritis (Br J Rheumatol 37:274, 1998).
– Whilst the items that flared patients were different, a significant percentage of people improved in trials that were very short – 7-10 days in duration mostly. Those who did not improve, had the most chronic conditions. (Mine took 3 months, so I would guess that more could have improved over a longer time period)
– Dairy, Gluten, Meat, Corn, Cerials/Grains (all) and in one case, Nuts were identified as problem foods.
– Fat dramatically flared symptoms in sufferers.
– Patients got sick when they went back to their original diets. It’s therefore counterproductive to do a cleanse or a fast unless you plan on changing your diet permanently.
– Other autoimmune conditions such as psoriasis and lupus improved with the same dietary modification.
The Science Behind Autoimmune Conditions
Although many doctors and The Arthritis Foundation claim there is no special diet for arthritis, where does that leave me and others who were able to reverse their symptoms by removing problematic foods? My arthritis hasn’t vanished, because if I ingest grains or alcohol, it returns.
For answers, I turned to Dr Fuhrman’s first book, Fasting and Eating for Health.
As a MD who reversed his own foot injury through fasting, Dr Joel Fuhrman is my go to when I need to understand the mechanics of diet.
He explains that although we need an immune system, an immune disease such as Rheumatoid Arthritis occurs when our immune system attacks the body, rather than foreign invaders. Therefore the body’s own cells are attacked. In arthritis, this is the the cells and tissue in our joints, which causes massive inflammation and pain. Many of us often have multiple immune disorders all at once, so many sets of cells are coming under attack. For example, in MS, it is the nerve sheaths that are attacked.
Diet can aggravate these conditions in two ways.
The first, is that over years and years of a poor diet, exposure to toxins and dietary chemicals that impede or overload the body’s ability to self clean, cells literally become so toxic and filled with metabolic wastes that they accumulate on the cell wall, making the cell look abnormal, like an invader. The interstitial fluid (fluid around the cell) may be very toxic making the cell no longer able to excrete any waste, much like a baby left in a nasty diaper. This waste is often acidic and may even burn and poison tissues, creating even more inflammation. This can make an essential cell appear unhealthy to the body’s immune system, so first antibodies will tag it, and then it will become be a target for the larger proponents of the body’s immune system.
Reverse It – By removing toxins from the diet, the body will begin to detoxify and regenerate itself. Over the last year, I have experienced very strange events when very acidic wastes have left my body en masse. It’s pretty gross but I will share the details with anyone who asks me privately. Although the body maintains a steady pH, it’s possible that these toxins are stored in pockets around the body, (as part of the body’s efforts to maintain a steady balance) which inhibit cellular cleansing. People have reported very strange things being ejected from the body during cleansing, even a pack of 30 year old melted crayons eaten as a child on a colon cleanse! We may also be bombarding our bodies with so many toxic foods and chemicals that it cannot handle the toxic load. To detox, check out my transition guide and decide what level feels comfortable for you. Water fasting should only be done at True North, in California.
The second issue is the concept of “leaky gut” – initially a subject of ridicule in mainstream medicine but now getting attention as more and more doctors are transitioning to Paleo (well it’s a start) including my own Functional MD who told me that many of her clients improve autoimmune conditions simply by removing gluten and dairy. As we see above, dairy seems to be a massive issue.
So why do animal products and grains specifically bother leaky gut? Leaky gut is a condition where because of genetic or abuse to the digestive system, food passes through the gut wall into the blood steam before it is digested. This launches the creation of many immune complexes which will go crazy attacking the problem foods. Proteins are usually broken into amino acids (how protein is found in plants) before passing through the gut wall. Protein, or smaller petides entering the blood early cause Star Wars in our blood, with a war between the immune system and the invading particles. Gluten, found in all grains but most inflammatory in wheat, barley and rye has the same effect on the immune system.
So our leaky gut has created all these new immune complexes, where do they do? Normally, they would be reabsorbed by the body, limiting pain and inflammation to the gut area. However as meat and dairy have a high fat content, there is an issue. Excess fat, from animals or plants literally stays in the blood for hours. The issue with this, is it impedes the body’s ability to clear the immune complexes created. So they add to the attacks already being made on damaged cells.
Excess dietary fat also impedes the body’s ability to keep the blood oxygenated. After a fatty meal, such as cheese, a hamburger or even a raw nut cheesecake, the red blood cells clump together, reducing the amount of oxygen administered to all tissues. For joints, which have a marginal blood supply to begin with, reduced oxygen alone can cause inflammation. Poor blood supply makes it harder for tissues to remove metabolic wastes, thus leading to the damaged cells we met in the first place.
Healing Leaky Gut
Having healed my gut issues and then recreated them with orange juice and nuts, I feel like a seasoned warrior when it comes to the topic. Although there may be non vegan diets that claim to heal this issue, the two universal offenders are dairy and gluten. Second biggest offenders are grains and meat. If you can live without these four things, your health will blossom.
Please see my transition guide for a healthy way to change your diet. Shocking your system by jumping onto fruits ends in someone saying, I feel bad, this doesn’t work in 90% of cases. We are told to slowly change a pet’s diet and this goes for you too. Your body isn’t used to high fiber, fruits or vegetables. Take steps and eliminate one new thing each week. However, I do think this is the fastest way to get well, and I have seen many people do it successfully. Adding anything else may slow your healing.
What I do for leaky gut as a raw vegan: 3-6 months no overt fat, (greens have your omega 3’s – enough for a few months) green juices that do not burn the mouth (limit citrus in green juices), green smoothies (tender lettuce, water and bananas – keep it digestible), bananas, mangoes and papaya. Celery juice. Sweet fruits only!!!! Then acid fruits in moderation for life!
Supplements: B12, D3, L-Glutamine and Primal Defense Probiotics (you may need iron and magnesium too, get a blood test as leaky gut causes absorption issues)
What you can do for leaky gut: 3-9 months no overt fats, (yes that means nuts and seeds! if you must, avocado is way more digestible in small amounts and eat it alone or with greens but I would keep it out if possible) sweet fruits only (bananas, melons, papaya), lots of green smoothies and juices (you are probably way deficient in many key minerals).
Cooked additions: do not add salt, buy Mrs Dash. Blended vegetable soups (no legumes or grains), steamed carrots, steamed greens, steamed squashes, oversteamed brocolli, cauliflower etc. Green, low protein, non starchy vegetables. Limit starches to one cup a day unless they are squashes. No white potato. Herbal teas and salt free vegetable broth are fine. No processed anything including coffee, sugar and booze, Booze in particular flares leaky gut.
If my diet plan completely horrifies you, at least try an elimination diet to see if grains, dairy, meat or gluten flare your immune conditions. Living without gluten or dairy may be enough to see significant difference in some cases (with less gut damage) and for others, grain free (ie the Paleo diet) has provided relief. I would at least try something because living pain free is amazing. Some people may not be able to achieve full remission depending on the damage done when joints grind on each other. However, a low inflammation diet such as doing Joel Fuhrman’s Eat To Live grain free may soothe symptoms.
We can see that although RA affects our joints, it is not merely a joint disease. The body is a complex system that requires our love and care to function properly. RA is common simply because the joints are delicate. I started with that before progressing to fibro and SLE. Love yourself more than foods that you know cause you pain. Focus on the things you enjoy/miss doing when you are tempted to go through the Drive In. Try 6 months gluten and dairy free. At the very worst, those foods will still be available for purchase at a later date if it doesn’t work.
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Eating and Fasting For Health by Dr Joel Fuhrman