Summary
We have previously reported that a significant improvement can be obtained in rheumatoid arthritis patients by fasting followed by an individually adjusted vegetarian diet for one year. The patients who changed their diet could be divided into diet responders and diet nonresponders. After the clinical trial the patients were free to change diet or medication and after approximately one year they were asked to attend a new clinical examination. We compared the change from baseline (i.e. at the time of study entry) to the time of the follow-up examination for diet responders, diet nonresponders and controls who ate an omnivorous diet. The following variables favoured diet responders: pain score, duration of morning stiffness, Stanford Health Assessment Questionnaire index, number of tender joints, Ritchie's articular index, number of swollen joints, ESR, platelet count and white blood cell count. The difference between the three groups were significant for all the clinical variables, except for grip strength. There was no significant difference between the groups with regard to laboratory or anthropometric variables. At the time of the follow-up examination all diet responders but only half of the diet nonresponders still followed a diet. Our findings indicate that a group of patients with rheumatoid arthritis benefit from dietary manipulations and that the improvement can be sustained through a two-year period.
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Parke, A.L., Hughes, G.R.V. Rheumatoid arthritis and food: a case study. Br Med J 1981, 282, 2027–2029.
Williams, R. Rheumatoid arthritis and food: a case study. Br Med J 1981, 283, 563.
Darlington, L.G., Ramsey, N.W., Mansfield, J.R. Placebo-controlled, blind study of dietary manipulation therapy in rheumatoid arthritis. Lancet 1986, 1, 236–238.
Panush, R.S., Stroud, R.M., Webster, E.M. Food-induced (allergic) arthritis. Inflammatory arthritis exacerbated by milk. Arthritis Rheum 1986, 29, 220–226.
Beri, D., Malaviya, A.N., Shandilya, R., Singh, R.R. Effect of dietary restrictions on disease activity in rheumatoid arthritis. Ann Rheum Dis 1988, 47, 69–72.
Lunardi, C., Bambara, L.M., Biasi, D., Venturini, G., Nicolis, F., Pachor, M.L., de Sandre, G. Food allergy and rheumatoid arthritis. Clin Exp Rheumatol 1988, 6, 423–424.
Panush, R.S. Food induced (“allergic”) arthritis: clinical and serologic studies. J Rheumatol 1990, 17, 291–294.
Kjeldsen-Kragh, J., Haugen, M., Borchgrevink, C.F., Laerum, E., Eek, M., Mowinkel, P., Hovi, K., Førre, Ø. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. Lancet 1991, 338, 899–902.
van de Laar, M.A.F.J., van der Korst, J.K. Food intolerance in rheumatoid arthritis. I. A double blind, controlled trial of the clinical effects of elimination of milk allergens and azo dyes. Ann Rheum Dis 1992, 51, 298–302.
van de Laar, M.A.F.J., Aalbers, M., Bruins, F.G., van Dinther-Janssen, A.C.H., van der Korst, J.K., Meijer, C.J.L. Food intolerance in rheumatoid arthritis. II. Clinical and histological aspects. Ann Rheum Dis 1992, 51, 303–306.
Ropes, M.W., Bennett, G.A., Cobb, S., Jacox, R., Jessar, R.A. 1958 revision of diagnostic criteria for rheumatoid arthritis. Bull Rheum Dis 1958, 9, 175–176.
Fries, J.F., Spitz, P., Kraines, R.G., Holman, H.R. Measurement of patient outcome in arthritis. Arthritis Rheum 1980, 23, 137–145.
Tugwell, P., Boers, M. for the OMERACT Committee. Developing consensus on preliminary core efficacy endpoints for rheumatoid arthritis clinical trials. J Rheumatol 1993, 20, 555–556.
Paulus, H.E., Egger, M.J., Ward, J.R., Williams, H.J. and the Cooperative Systematic Studies of Rheumatic Diseases Group. Analysis of improvement in individual rheumatoid arthritis patients treated with disease-modifying antirheumatic drugs, based on the findings in patients treated with placebo. Arthritis Rheum 1990, 33, 477–484.
Steinbrocker, O., Traeger, C.H., Batterman, R.C. Therapeutic criteria in rheumatoid arthritis. JAMA 1949, 140, 659–662.
Ritchie, D.M., Boyle, J.A., McInnes, J.M., Jasani, M.K., Dalakos, T.G., Grieveson, P., Buchanan, W.W. Clinical studies with an articular index for the assessment of joint tenderness in patients with rheumatoid arthritis. Q J Med 1968, 37, 393–406.
Heymsfield, S.B., McManus, C., Smith, J., Stevens, V., Nixon, D.W. Anthropometric measurements of muscle mass: revised equations for calculating bone-free arm muscle area. Am J Clin Nutr 1982, 36, 680–690.
Midtvedt, T., Johansson, G., Carlstedt-Duke, B., Midtvedt, A-C., Norin, K.E., Gustafsson, J.-Å. The effect of a shift from a mixed to a lacto-vegetarian diet on some intestinal microflora associated characteristics. Microb Ecol Health Dis 1990, 3, 33–38.
Peltonen, R., Ling, W-H., Hänninen, O., Eerola, E. An uncooked vegan diet shifts the profile of human fecal microflora: computerized analysis of direct stool sample gas-liquid chromatography profiles of bacterial cellular fatty acids. Appl Environ Microbiol 1992, 58, 3660–3666.
Olhagen, B., Månsson, I. IntestinalClostridium perfringens in rheumatoid arthritis and other collagen diseases. Acta Med Scand 1968, 184, 395–402.
Shinebaum, R., Neumann, V.C., Cooke, E.M., Wright, V. Comparison of faecal florae in patients with rheumatoid arthritis and controls. Br J Rheumatol 1987, 26, 329–333.
Eerola, E., Möttönen, T., Hannonen, P., Luukkainen, R., Kantola, I., Vuori, K., Toivanen, P. The anaerobic intestinal flora in newly diagnosed rheumatoid arthritis. Scand J Rheumatol 1992, 21, 158.
Severijnen, A.J., Kool, J., Swaak, A.J.G., Hazenberg, M.P. Intestinal flora of patients with rheumatoid arthritis: induction of chronic arthritis in rats by cell wall fragments from isolatedEubacterium aerofaciens strains. Br J Rheumatol 1990, 29, 433–439.
Peltonen, R., Kjeldsen-Kragh, J., Haugen, M., Tuominen, J., Toivanen, P., Førre, Ø, Eerola, E. Changes of faecal flora in rheumatoid arthritis during fasting and one-year vegetarian diet. Br J Rheumatol 1994, 33, 638–643.
Borg, G., Allander, E., Lund, B., Berg, E., Brodin, U., Pettersson, H., Trang, L. Auranofin improves outcome in early rheumatoid arthritis. Results from a 2-year, double-blind, placebo-controlled study. J Rheumatol 1988, 15, 1747–1754.
Wilske, K.R., Healey, L.A. Remodeling the pyramid — a concept whose time has come. J Rheumatol 1989, 16, 565–567.
Fries, J.F. Reevaluating the therapeutic approach to rheumatoid arthritis: the “sawtooth” strategy. J Rheumatol 1990, 17 (Suppl 22), 12–15.
Pincus, T. The case for early intervention in rheumatoid arthritis. J Autoimmun 1992, 5 (Suppl A), 206–226.
Haugen, M., Kjeldsen-Kragh, J., Skakkebaek, N., Landaas, S., Sjaastad, Ø., Movinkel, P., Førre, Ø. The influence of fast and vegetarian diet on parameters of nutritional status in patients with rheumatoid arthritis. Clin Rheumatol 1993, 12, 62–69.
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Kjeldsen-Kragh, J., Haugen, M., Borchgrevink, C.F. et al. Vegetarian diet for patients with rheumatoid arthritis — Status: Two years after introduction of the diet. Clin Rheumatol 13, 475–482 (1994). https://doi.org/10.1007/BF02242946
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DOI: https://doi.org/10.1007/BF02242946