Benefits of Vegan and Vegetarian Diets for Arthritis Sufferers
Rheumatoid arthritis (RA) is a debilitating chronic disease characterized by inflammatory changes in joints and related structures that can result in deformities, pain and stiffness in the joints. The exact etiology of rheumatoid arthritis is unknown, but it is believed to be an autoimmune disease.
Some RA sufferers have reported less pain and improved vitality after switching to a plant-based diet, but what does science say about the benefits of vegetarian or vegan diets for people with RA or other types of arthritis, such as osteoarthritis? Let's find out.
Studies Examining the Effects of Vegetarian and Vegan Diets in Arthritis Sufferers
An Italian survey of 46,693 people observed a strong correlation between vegetable consumption and a decreased incidence of rheumatoid arthritis (1), but there have also been a number of intervention studies that have directly examined the effects of vegetarian and vegan diets in arthritis sufferers.
In one randomized, single-blind controlled trial rheumatoid arthritis patients were put on a dietary regime that started with fasting and was followed by an individually adjusted gluten-free vegan diet for three and a half months, after which it was gradually changed to a lacto-vegetarian diet for the remaining nine months of the trial.
For all clinical variables and most of the laboratory variables measured, the 27 patients in the fasting/vegetarian diet group improved significantly compared with the 26 patients in the control group who followed their usual omnivorous diet. (2)
Another study, published in the journal Rheumatology, compared rheumatoid arthritis patients who adopted a gluten-free, vegan diet with patients who ate a well-balanced standard diet. Nearly 41% of the 22 people who followed the vegan diet for at least nine months experienced significant improvement in their arthritis symptoms compared with only 4% in the control group. (3)
In yet another study people with moderate-to-severe rheumatoid arthritis who switched to a low-fat, vegan diet experienced significant reductions in their RA symptoms, with the exception of morning stiffness. This single-blind study involved 24 free-living subjects. (4)
And, there's more. A study published in the journal Toxicology found that rheumatoid arthritis patients eating a raw vegan diet experienced reduced joint stiffness and pain. The raw vegan diet used in this study consisted of vegetables, fruits, berries, nuts, germinated seeds and sprouts. (5)
And, last but not least, a study published in the journal Arthritis found that adopting a plant-based whole foods diet significantly improved self-assessed measures of functional status among osteoarthritis patients. This six-week prospective, randomized study involved 37 osteoarthritis patients. (6)
Possible Mechanisms Behind the Anti-Arthritic Effects of Plant-Based Diets
Epidemiological studies suggest that saturated fat, which is primarily found in animal-based products, promotes inflammation (7). This may at least partially explain why vegan and vegetarian diets have been shown to reduce arthritis symptoms in some studies and why anti-inflammatory diets typically limit the amount of fatty animal-based products.
In addition, red meat contains arachidonic acid, a type of polyunsaturated omega-6 fatty acid that the body uses, among other things, for making hormones called eicosanoids. Research suggests that many eicosanoids can be pro-inflammatory when chronically or excessively produced (8).
Yet another compound that frequently pops up in discussions about the inflammatory nature of red meat is heme iron (plant-based sources of iron only contain non-heme iron which is not as bioavailable as heme iron). It has been proposed that the high amounts of heme iron found in red meat might be problematic because heme iron increases oxidative stress in the body, which in turn promotes inflammation (9).
Interestingly, however, a study that examined a potential association between heme iron intake and rheumatoid arthritis found no link between the two (10).
Finally, a high intake of fruit and vegetables—a characteristic of healthy vegan and vegetarian diets—has been inversely associated with plasma concentrations of C-reactive protein (CRP), a key marker of inflammation (11).
Why it Might Not Be Necessary to Adopt a (Strict) Vegetarian Diet
If you suffer from rheumatoid arthritis, pescetarian diets—which include fish and other seafood but not the flesh of land-based animals—might have some advantages over strict vegetarian diets.
A study published in the journal Epidemiology found that a high intake of oily fish was associated with a decreased risk of developing rheumatoid arthritis (12). This is not surprising considering that oily fish—such as salmon, mackerel, sardines, pilchard, kipper and herrings—are rich in omega-3 fatty acids which are famous for their anti-inflammatory properties.
What's more, it seems that not even all meat is pro-inflammatory. A Dutch study found that high CRP levels were positively associated with processed meat intake, but not with red meat or poultry intake (13).
And another study found that when some carbohydrates in the diet were replaced with unprocessed lean red meat, markers of chronic inflammation actually went down (14).
In addition, many arthritis sufferers have reportedly experienced great results on the Paleo Autoimmune Protocol (aka the AIP Diet). Outlined in Sarah Ballantyne's New York Times bestselling book The Paleo Approach, the AIP Diet has been specifically designed to help those suffering from autoimmune diseases, such as rheumatoid arthritis or psoriatic arthritis, to put their condition into remission.
On this diet, arthritis sufferers eat plenty of meat, but only unprocessed, preferably grass-fed meat which is typically much leaner than conventional meat. (You can read testimonials from arthritis sufferers who have had success on Ballantyne's AIP on this page Amazon page.)
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Written by Kim Arrey, RD, and practising rheumatologist Dr. Michael Starr, MD, FRCPC, this science-based all-in-one guide explains how specific medications, nutritional supplements, foods, and lifestyle factors affect the pain and inflammation associated with rheumatoid arthritis. Packed with invaluable tips and tasty anti-inflammatory recipes and sample menus, this meticulously-researched guide and cookbook is a must-have for all RA-sufferers. To learn more, or to order a copy from your local Amazon store, click here.
