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Rheumatoid arthritis is estimated
to affect up to 1% of the entire population.
It is painful and often debilitating
talking inflammation in the joints,
the likes of which unless you have it,
sometimes you just can't believe.
And the flare ups with aura seem to come out of nowhere.
What triggers them?
Oftentimes it's a mystery, and that is what researchers
at the Physicians Committee wanted to figure out.
And today,
we're joined
by one of the lead
researchers of a brand new groundbreaking study
that analyzes the effect of diet on rheumatoid arthritis.
We welcome the director of clinical research
for the Physicians Committee, Dr.
Hana Kahleova.
Dr. Kahleova, thanks for being back here.
Thanks for having me, Chuck.
So good to see you again.
So good to be here.
Oftentimes
when you're on the show, we talk about diabetes,
but today we're talking about R.A.
And the thing that I know about R.A.
is that when I said it was painful, just a minute ago,
I've seen people just literally crippled over, crippled over
and have their days just ruined by it.
So when we're talking about pain
and R.A., I mean, how painful is this condition?
Yeah, that's exactly right.
Like, it affects the small joints in
the hands in the wrists,
the knees, but also other joints in the body.
And they're not only painful, but also swollen
and eventually over the course of many years
of the disease, there may be a permanent damage.
So it may be disability and disease also
you know, a big cause of disability. So
this is no fun.
We know that there's genetic factors
but also environmental factors.
And, you know, among the factors that we can influence,
diet seems to be one of them.
It's an autoimmune condition, which means that
it may be triggered by certain proteins.
And that's why we were trying to figure out,
you know, if we modified the diet, could we
could we help these people
with their pain and with their swollen joints?
And that's exactly why we conducted a clinical trial.
And let me share my screen with you and just tell you
a little bit about the study.
Yeah, by all means.
And we see the screen up on there right now.
Wonderful.
So we were looking into the effects
of a plant-based diet for rheumatoid arthritis.
And the findings have just been published
in the American Journal of Lifestyle Medicine.
And, you know, when
when people come in with their joint pain,
I need to say not all joint
pain is due to rheumatoid arthritis.
So in our study, we had a rheumatologist
who verified the diagnosis of rheumatoid arthritis, and
he was also making sure
to do the count of the joints
and all of the assessments that rheumatologists do
without knowing which group the participants were
in, both at baseline and then and then at midpoint.
And then at the end of the study,
we recruited 44 people with rheumatoid arthritis
and they were randomly assigned to either
the diet phase
or the supplement phase.
For sixteen weeks.
And then after the sixteen weeks were over,
we re-assessed their joint pain
and we were using questionnaires
and also the rheumatologist met with them and
we drew their labs.
And after a four week washout
period, four, four week of a break,
they switched over to the opposite intervention.
So those who were on the diet previously went on a supplement
and those who were on
a supplement went on the diet for another six weeks.
And then we did all the final assessments again.
Now, let me describe the diet.
What what exactly was the diet about
for the first four weeks?
It was a low fat vegan diet.
That means no animal product, no meat, no dairy,
no cheese, no eggs for four weeks.
Then for another three weeks
on the top of eliminating all the animal foods,
we also eliminated certain plant foods,
for example, gluten containing grains.
So foods and certain vegetables and fruits.
And for the
last nine weeks, we were reintroducing
the eliminated foods one by one back into the diet.
And if the introduced foods didn't cause any problems,
the participants just kept them in the diet
and kept adding new and new foods.
However, if, let's say
introducing potatoes back to the diet
caused a lot of joint pain and so,
you know, the joints were swollen again,
then the potato was just out of the diet again.
And we were testing other foods which provided each participant
with individualized food triggers that would cause
the joint pain and and swelling.
Here's the list of all the eliminated foods
on the elimination diet.
So in addition to eliminating all the animal foods
during the after four weeks,
during the subsequent three weeks week, we excluded
all the gluten containing grains.
Some vegetables such as potatoes and sweet potatoes,
and onions and tomatoes and eggplants and celery.
Only a couple
of fruits such as apples and bananas and citrus fruit,
nuts and peanuts,
soy foods and chickpea and also chocolate,
coffee, sugar, alcohol and nutritional yeast.
So these foods were eliminated for three weeks,
and then they were introduced one by one every two days.
The participants added another food from this
from this elimination diet list.
Now, the disease activity
measured by the DAS 28 score,
which is one of the the major
rheumatologist assessments
didn't change significantly
on the supplement or which was a placebo
but was reduced substantially during the diet
by 2.1 points.
And I need to say that we also did another analysis
looking at people who increased their medications
during the study.
When we excluded them, we we got similarly results.
And also when we took participants with no medication
changes whatsoever during the study and left
only them then and the results were comparable as well.
And another significant
finding from the study was the number of swollen joints
which was reduced by 3.7 during the diet phase
and did not change significantly on the placebo
So in conclusion, it looks like the elimination
plant based diet really work for rheumatoid arthritis
and can be definitely tried out if you have
rheumatoid arthritis.
I'd like to encourage you to give it a try
and we will post the whole
the whole paper with the list of the foods
that that were eliminated on the elimination diet
so that you can you can do it yourself.
Those are really fascinating results. Dr.
Kahleova.
What was your hypothesis going into this?
I mean, we know that plant-based
diets, by and large are anti-inflammatory.
So was it your suspicion that this
probably would be helpful to a lot of these study participants?
Yeah, exactly.
Our thought was let
let's try out how a plant-based diet can help these people.
We know that plant-based diets in general are
anti-inflammatory.
But then
also we realize that there are certain triggers
beyond the animal foods that are excluded from from
the plant, plant-based diet.
That's why we also included the elimination phase.
Unfortunately, the individual foods