Placebo-Controlled, Blind Study of Dietary Manipulation Therapy in Rheumatoid Arthritis

Darlington, L. Gail; Ramsey, N. W.; Mansfield, James R.

doi:10.1016/s0140-6736(86)90774-9

Cited by 134 publications

(52 citation statements)

References 7 publications

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“…Benefits from dietary manipulation have been observed with water-only fasts (Hafstrom et al, 1988;Kroker et al, 1984;Panush et al, 1986), vegetable and fruit juice fasts (Lithell et al, 1983;Skoldstam et al, 1979Skoldstam et al, , 1991Sundqvist et al, 1982), lactovegetarian diets (Kjeldsen-Kragh et al, 1991;Skoldstam et al, 1979;Sundqvist et al, 1982), pure vegetarian (vegan) diets (Beri et al, 1988;Darlington et al, 1991;Kjeldsen-Kragh et al, 1991;Nenonen et al, 1998;Parke et al, 1981;Ratner et al, 1985;Seignalet, 1992), and elimination diets (Darlington et al, 1986;Hicklin et al, 1980;Kavanaghi et al, 1995;van de Laar et al, 1992). By their very nature of limited calorie intake, fasts can only be sustained for short periods of time and with return to usual eating, the arthritis symptoms have been shown to return in almost every case.…”

Section: Introduction Tmentioning

confidence: 99%

Effects of a Very Low-Fat, Vegan Diet in Subjects with Rheumatoid Arthritis

McDougall

Bruce

Spiller

et al. 2002

The Journal of Alternative and Complementary Medicine

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Objective: To demonstrate the effects of a very low-fat, vegan diet on patients with rheumatoid arthritis (RA).Design: Single-blind dietary intervention study. Subjects and study interventions:This study evaluated the influence of a 4-week, very lowfat (,10%), vegan diet on 24 free-living subjects with RA, average age, 56 6 11 years old.Outcome measurements: Prestudy and poststudy assessment of RA symptomatology was performed by a rheumatologist blind to the study design. Biochemical measures and 4-day diet data were also collected. Subjects met weekly for diet instruction, compliance monitoring, and progress assessments.Results: There were significant (p , 0.001) decreases in fat (69%), protein (24%), and energy (22%), and a significant increase in carbohydrate (55%) intake. All measures of RA symptomatology decreased significantly (p , 0.05), except for duration of morning stiffness (p . 0.05). Weight also decreased significantly (p , 0.001). At 4 weeks, C-reactive protein decreased 16% (ns, p . 0.05), RA factor decreased 10% (ns, p . 0.05), while erythrocyte sedimentation rate was unchanged (p . 0.05).Conclusion: This study showed that patients with moderate-to-severe RA, who switch to a very low-fat, vegan diet can experience significant reductions in RA symptoms. 71

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Section: Introduction Tmentioning

confidence: 99%

Effects of a Very Low-Fat, Vegan Diet in Subjects with Rheumatoid Arthritis

McDougall

Bruce

Spiller

et al. 2002

The Journal of Alternative and Complementary Medicine

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“…The relation between dietary factors and rheumatoid arthritis is becoming more evident.7 8 Furthermore, patients with rheumatoid arthritis (RA) show a notable increase of arachidonate metabolism via lipoxygenase, leading to leucotrienes B4 or D4.9…”

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confidence: 99%

Influence of diet with different lipid composition on neutrophil chemiluminescence and disease activity in patients with rheumatoid arthritis.

Magarò

Altomonte

Zoli

et al. 1988

Annals of the Rheumatic Diseases

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SUMMARY Neutrophil chemiluminescence was determined in patients with active rheumatoid arthritis. Twelve patients were randomly assigned either to a diet high in polyunsaturated fatty acids supplemented with eicosapentaenoic and docosahexaenoic acids or to a diet high in saturated fatty acids. A correlation with clinical and laboratory parameters is also reported. No statistical difference was observed in neutrophil chemiluminescence and in clinical parameters in the group of patients treated with a diet high in saturated fatty acids. Fish oil ingestion resulted in subjective alleviation of active rheumatoid arthritis and reduction of neutrophil chemiluminescence. This study corroborates the hypothesis of an anti-inflammatory role for polyunsaturated fatty acids in patients with chronic inflammatory diseases.Dietary composition has been shown to influence the immune response both in animals and in humans.' Therefore dietary manipulations may form the basis for a nutritional approach to treating autoimmune disorders.The regulatory effect of dietary lipid composition on many biological processes is well known.24 The ratio polyunsaturated:saturated fatty acids (P:S ratio) and the n-3 fatty acid amount are the important factors. Whereas the P:S ratio regulates the concentration of plasma cholesterol,S the n-3 fatty acids (eicosapentaenoate 20:5, docosahexaenoate 22:6) are mainly involved in the regulation of arachidonate metabolism.6The main source of eicosapentaenoic acid and docosahexaenoic acid is fish derived oil and an adequate dietary content seems to be 2-5 g/day.The relation between dietary factors and rheumatoid arthritis is becoming more evident.7 8 Furthermore, patients with rheumatoid arthritis (RA) show a notable increase of arachidonate metabolism via lipoxygenase, leading to leucotrienes B4 or D4.9Recently, Lee et al presented evidence for an inhibitory effect on polymorphonuclear activity of a diet rich in n-3 fatty acids.10

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“…In addition, the caloric restriction results in a decrease in the age-dependent accumulation of glycoxidation products, such as the pentosidine, in tissue (Cefalu et al, 1995;Iqbal et al, 1999;Reiser et al, 1994;Sell et al, 1997;Sell et al, 1996). Furthermore, the fasting reduces food intolerance (Panush, 1986), diminishes the gastrointestinal permeability (Sundqvist, 1982) and decreases the intake of inflammatory mediators, prostaglandins and leukotrienes (Darlington, 1986). Further, the foodstuffs used in this study were rich in antioxidant.…”

Section: Discussionmentioning

confidence: 80%

Calorie Restricted Diet and Urinary Pentosidine in Patients with Rheumatoid Arthritis

Iwashige

Kouda

Kouda³

et al. 2004

J. Physiol. Anthropol.

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Low-energy diets and fasting have suppressive effects on rheumatoid arthritis. It was reported recently that urine levels of pentosidine (i.e., an advanced glycation end product formed by glycosylation) is associated with the activity of rheumatoid arthritis. We conducted a regimen of caloric restriction combined with fasting in patients with rheumatoid arthritis, and then evaluated urinary pentosidine levels. Ten patients with rheumatoid arthritis underwent a 54-day caloric restriction program. Urinary pentosidine levels were measured and the Lansbury Index were determined by examining the clinical features, blood biochemistry and the inflammation activity of rheumatoid arthritis on days 0, 25 and 54. On day 0, the mean urinary pentosidine level of patients with rheumatoid arthritis was significantly higher than that of the control subjects. On day 54, the mean body weight had reduced due to caloric restriction. The mean values of the erythrocyte sedimentation rate and the Lansbury Index of patients both significantly decreased during the study. In addition, although the urinary pentosidine levels showed no significant difference between day 0 and 25, it was significantly decreased at the end of the study (day 54). The study showed that under a low energy diet a reduction of disease activity in rheumatoid arthritis was accompanied with a reduction of the urinary pentosidine.

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Placebo-Controlled, Blind Study of Dietary Manipulation Therapy in Rheumatoid Arthritis

Cited by 134 publications

References 7 publications

Effects of a Very Low-Fat, Vegan Diet in Subjects with Rheumatoid Arthritis

Effects of a Very Low-Fat, Vegan Diet in Subjects with Rheumatoid Arthritis

Influence of diet with different lipid composition on neutrophil chemiluminescence and disease activity in patients with rheumatoid arthritis.

Calorie Restricted Diet and Urinary Pentosidine in Patients with Rheumatoid Arthritis

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