Wednesday, October 14, 2015

The Norwegian Arthritis Diet

How could you be scientifically sure a diet relieved rheumatoid arthritis? The first factor you would want to exclude would be wishful thinking. That is, the diet you test could not be a plan that had ever been described in a book or in a news report.

The second factor you would want to exclude is food allergies. Sensitivities and allergies to foods can be very important to individuals who have rheumatoid arthritis, but you would not want to make a recommendation for millions of arthritis sufferers on the basis of what works for a few.

Finally, you would want to meet the modern standards of good science. You would want to have a control group that did not change diet, an experimental group that did change diet, and “blinding” so that the patients involved in the experiment knew who was on which diet so no one could influence (or sabotage) the results.

There have been over 100 studies of the role of food in treating rheumatoid arthritis, but only two have met these rigorous scientific standards. One of the studies was performed in the early 1980s. The other was conducted in 1999. Let’s take a look at the more recent study.

In the late 1990’s, Jens Kjeldsen-Kragh of the Ullevaal University Hospital in Oslo conducted a year-long study in which rheumatoid arthritis patients were treated with three approaches in succession, fasting, gluten-free diet, and then ovolactovegetarian diets (a plant food diet permitting eggs and dairy products) customized to individual needs.

The first step of the study was a 7 to 10 day “modified fast.” No one can stay on a fast forever, but Dr. Kjeldsen-Kragh thought that the immediate relief from symptoms brought about by fasting would encourage his patients to stick to the diet for the entire year of the trial.

The fast was not a total fast. Permitted foods included vegetable broth, boiled potatoes with a little parsley, beet juice, carrot juice, celery, juice, and herbal tea. The fast diet did not allow any fruit juices.

The second step of the study was an elimination diet. The study participants were basically given the beets, carrots, celery, parsley, and potatoes they had received as liquid foods during the fast as solid foods for the rest of the study.
And to make sure there were no “problem foods” even on this diet, the doctor used an elimination strategy.

In addition the five basic five vegetables and herbal teas, every study participant introduced one food item every other day. If they felt unusual or increased swelling, stiffness, or pain within 2 to 48 hours, that food was omitted from the diet for at least a week before being reintroduced.

If their symptoms flared up again, that food item was excluded from the diet for the rest of the study. No patient was permitted to try to add eggs, fish, meat, citrus, or white sugar. They were also counseled to avoid preservatives, strong spices, and salt, as well as coffee, tea, and alcohol.

How did the participants do on the experimental diet? The diet wasn’t a cure. The most dramatic change in symptoms for most people on the diet was morning stiffness. Before the diet, the participants reported that morning stiffness lasted an average of 3 hours. After the 10-day fast and the first two weeks on a strict vegan diet, the average reported morning stiffness was just 1 hour. As more and more foods were added back into the diet, reported morning stiffness crept back up to 90 minutes a day.

Another, objective measurement of success, grip strength, was also dramatically improved by diet. During the first month of treatment, average grip strength rose from 55 to 75 kPs. When participants went from vegan to vegetarian (in this case, plant foods plus eggs and dairy) diets, grip strength was slightly worse for a few weeks but then the improvement returned. And another, objective measurement of change, Ritchie’s articular index, was similarly improved during the fast. The flexibility of joints was slightly less on vegetarian diet than during the fast or the vegan diet, but still lastingly and dramatically improved.

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