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Vegan Diet for Rheumatoid Arthritis: What Does the Science Suggest?

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Introduction

I recently came across a study that suggested a vegan diet can help treat rheumatoid arthritis. At first, I was intrigued, but then I read an interview with the lead author of the study, who claimed that people with rheumatoid arthritis should try changing their diets before turning to medication.

Hold on a second. Decades of research have demonstrated the importance of early medication treatment for rheumatoid arthritis to prevent permanent joint damage. It seems a bit risky to suggest that changing your diet alone can do the trick, especially when so many effective medications are available now.

The idea that a vegan diet can effectively treat rheumatoid arthritis is not new. A recent study explored the potential benefits of such a diet, and the results are controversial. In this article, we delve into the debate surrounding the use of a vegan diet to treat rheumatoid arthritis.

The Study

The study in question explored the effects of a vegan diet on rheumatoid arthritis symptoms. While the study did find some positive results, including reduced inflammation and improved physical function, the sample size was small and the study was not randomized or blinded.

The Controversy

One of the most controversial claims made by the study's lead author was that physicians should encourage patients with rheumatoid arthritis to try changing their eating patterns before turning to medication. Many in the medical community have met this claim with skepticism, as decades of research have shown the importance of early medication treatment for preventing permanent joint damage in rheumatoid arthritis patients.

Details of the Study

The study involved 44 female participants with rheumatoid arthritis who were randomly assigned to one of two groups. The first group followed a vegan diet for four weeks, followed by additional food restrictions for another three weeks. The restricted foods were considered to be common triggers of arthritis symptoms. These foods were reintroduced one at a time, and any that seemed to cause pain or other symptoms were eliminated for the rest of the 16-week period. The second group followed their usual diet and took a placebo capsule each day for 16 weeks.

After the first 16 weeks, the groups swapped dietary assignments for an additional 16 weeks. The study found that participants who followed the vegan diet experienced a reduction in inflammation and improved physical function. However, the study had some limitations, including a small sample size and lack of randomization and blinding.

What Were the Findings?

According to the study, the vegan diet appeared to have a positive impact on arthritis symptoms. Participants who followed the vegan diet reported improvement in their symptoms, while no improvement was reported during the placebo phase. For instance, the number of swollen joints decreased from 7 to 3.3 in the vegan diet group, whereas it increased from 4.7 to 5 in the placebo group. Additionally, participants on the vegan diet lost an average of 14 pounds, while those on the placebo gained nearly 2 pounds. It's important to note, however, that the study had some limitations, including a small sample size and lack of randomization and blinding.

Considerations and Limitations of the Data

While the results of the study are promising, there are several limitations that need to be considered.

  • Small sample size of only 44 participants enrolled and 32 completing the study.
  • Lack of diversity, as the study only included women, mostly white and highly educated.
  • No standard diagnosis of rheumatoid arthritis, with no requirement for standard criteria to be met.
  • Short study duration of four months for a chronic disease like rheumatoid arthritis.
  • Self-reported diet of study participants, making it unclear how well they stuck to their assigned diets.
  • Medication use by study participants, though no information on specific drugs is offered.
  • Weight loss rather than a vegan diet might have contributed to symptom improvement.
  • No assessment of joint damage, making it impossible to assess the true benefit or risk of relying on a vegan diet to treat rheumatoid arthritis.
  • It's unclear how a vegan diet would improve rheumatoid arthritis, raising the possibility that the findings may not hold up.

Is the Vegan Diet Right for Everyone with Arthritis?

No, it's not recommended that everyone with rheumatoid arthritis becomes vegan, as there isn't enough evidence to support this recommendation. While a plant-rich diet can be healthy for most people, it's important that the diet is nutritionally balanced and palatable. An anti-inflammatory diet can be considered, but it should not be used as a substitute for medication to prevent joint damage in rheumatoid arthritis. Rather, diet should be combined with medication for the best possible outcome.

Final Thoughts

While there is growing evidence to suggest that diet can play a role in treating rheumatoid arthritis, it's important to note that diet alone is not enough to treat the disease. Unlike high cholesterol or high blood pressure, where dietary changes are the first choice of treatment, rheumatoid arthritis can cause disabling joint damage early in the disease. Therefore, it's crucial to start taking effective medications as soon as possible to prevent this.

Although more research is needed to explore the impact of diet on rheumatoid arthritis and other autoimmune disorders, it's not yet clear whether a vegan diet or any other dietary intervention can replace medications in some people. It's possible that future studies may provide further insights, but for now, it's essential to follow a comprehensive treatment plan that includes medication and a balanced diet.

William H. McDaniel, MD

Dr. Robert H. Shmerling is the former clinical chief of the division of rheumatology at Beth Israel Deaconess Medical Center (BIDMC), and is a current member of the corresponding faculty in medicine at Harvard Medical School.

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