How plant based diets can help people with rheumatoid arthritis

Rheumatoid arthritis — a chronic autoimmune condition that causes pain and stiffness in the joints — has a prevalence of between 0.3% and 1% among the world’s population, according to the World Health Organization (WHO).

The condition can become so debilitating as to stop people from continuing in full time work. As the WHO also note, within only 10 years from disease onset, at least 50% of individuals with rheumatoid arthritis in high income countries become “unable to hold down a full time job.”

Doctors usually prescribe a range of drugs and lifestyle adjustments to help people manage their rheumatoid arthritis and make disability less likely. Management strategies that healthcare providers might advise include increased physical activity and weight loss.

Now, a new review appearing in the journal Frontiers in Nutrition shows that following a plant based diet can be a useful intervention when it comes to coping with this condition, as it triggers some helpful biological changes.

‘Symptoms may improve or even disappear’

The review — conducted by specialists from the Physicians Committee for Responsible Medicine in Washington, DC — looked at recent studies that observed the impact of diet on biological mechanisms that are important in rheumatoid arthritis.

It concluded that plant based diets lead to specific changes that can help relieve the symptoms of this condition.

One key way in which plant based diets can be helpful is by reducing levels of inflammation. The review authors cite a study from 2015 that showed participants who ate a plant based diet for 2 months had lower inflammation than those who ate a diet that was high in fat and featured more animal products.

The team also notes that additional research has found an association between adherence to diets high in fat and processed meat and a rise in markers of inflammation. One of these markers is C-reactive protein, a protein present in the blood, and one which reacts to inflammation.

On the other hand, following plant based diets or diets that have a high content of fiber has an association with lower levels of C-reactive protein.

Another study that the review looked at was a randomized clinical trial showing that, after following a low fat vegan diet for 4 weeks, individuals with moderate-to-severe rheumatoid arthritis saw significant improvements in symptoms, including joint pain and stiffness, tenderness, and swelling.

People with rheumatoid arthritis can also benefit from losing extra weight. According to evidence from a 2018 study, overweight individuals with rheumatoid arthritis who shed in excess of 5 kilograms were three times more likely to have improvements in their symptoms compared to those who lost less weight.

The review authors explain that vegetarian and vegan diets appear to help people lose weight, more so than any other diet types.

Finally, the researchers explain that plant based diets also seem to promote a healthy gut environment, since many of these diets are high in fiber, which, as studies have shown, influences the composition of the gut microbiome.

Specifically, plant based diets seem to increase bacterial diversity in the gut, which could help people with rheumatoid arthritis, precisely because they tend to lack bacterial diversity.

The investigators who conducted the review suggest there is a need for further research into the benefits that plant based diets may afford to people with inflammatory autoimmune conditions, as well as their underlying mechanisms.

However, they note that, so far, the emerging evidence suggests that eating more fruits, vegetables, whole grains, and legumes could make a real difference for people with rheumatoid arthritis.

“A plant based diet comprised of fruits, vegetables, grains, and legumes may be tremendously helpful for those with rheumatoid arthritis. This study offers hope that with a simple menu change, joint pain, swelling, and other painful symptoms may improve or even disappear.”

Study co-author Dr. Hana Kahleova