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Arthritis
Arthritis
(McDougall)
http://drmcdougall.com/med_hot_arthritis.htm
Painful
joints can be divided into "degenerative" and "inflammatory" forms of
arthritis. Osteoarthritis is the name often given to the degenerative form and this kind
is helped with weight loss, a change in diet, glucosamine, and acupuncture. Inflammatory
forms of arthritis, like rheumatoid, Lupus, psoriatic, and ankylosing spondylitis are very
responsive to the McDougall Program. To be more specific, about 70% of people with the
most common form of inflammatory arthritis, rheumatoid arthritis, can expect dramatic
benefits, and often a cure, in less than 4 weeks of diet change. The diet must be followed
strictly – medications are reduced and stopped as improvements occur.
How
to Prevent and Treat Degenerative (Osteo) Arthritis
The
most common form of arthritis afflicting humans is osteoarthritis, often referred to as
"degenerative arthritis," because the joints slowly deteriorate as a result of
"normal wear and tear associated with aging." Doctors commonly advise people to
lose weight, especially if they have disease of the joints of the lower extremities, and
to avoid prolonged and strenuous use of the affected joints.
Beyond
this commonsense advice, if you see a doctor for a painful joint condition you will almost
certainly receive a prescription for a "pain-killer." More specifically, you
will be given non-steroidal antiinflammatory drugs (NSAIDs). Common, over-the-counter
varieties you may be familiar with are Motrin and Advil. Unfortunately, many of these same
drugs have been shown to damage the very joints that they are supposed to help. Obviously,
there is a need for better approaches to this common condition.
A
Healthier Diet, First
Osteoarthritis is not an inevitable part of growing older –
people can live a lifetime with pain-free, fully-functional joints – actually, I
think that is the way it is supposed to be. However, commonly, in developed (Western)
countries the joints of people worsen with age. Only 2% of women less than 45 years old in
the United States show signs of osteoarthritis; eventually this form of crippling
arthritis is seen in x-rays of the hands of over 70% of people age 65 years and older. However, this same disease is
comparatively rare in African and Asian countries, where people physically labor to
survive.2
The difference is that the diet of these arthritis-free people is based on
unrefined plant foods with few animal products and added fats. In Western societies,
joints wear out while doing such usual activities as driving a car past a drive-through
window at McDonald’s and lifting a fork full of cheese to the lips.
The
typical American diet damages the joints in several ways. Over two-thirds of the people on
this high-fat, high-calorie diet are overweight and almost one-third are obese. This extra
weight damages the joints of the lower extremities (hips, knees, ankles, and feet) simply
through excess stress (the exaggerated effects of gravity). But there are other reasons an
unhealthy diet injures joints:
Malnourishment from the Western diet deprives the bones and
joints of the raw materials they need to become strong enough to resist the normal wear
and tear of daily activities.
Circulation
to these joints is also compromised by fat floating around in the bloodstream after a
typical meal.
Possibly
the most damaging effect is from the components of the Western diet, that cause
inflammation which damages the joints, especially the proteins from dairy products –
causing arthritis and eventually permanent destruction of these moving parts.
The
overall benefits of a healthier diet and weight loss were shown in a recent study
published in the American Journal of Clinical Nutrition.3 Three-hundred and sixteen
older, overweight or obese, sedentary men and women with x-ray evidence of knee
osteoarthritis were randomly assigned to one of four 18-month treatments: healthy
lifestyle control, diet-induced weight loss, exercise, and diet plus exercise. Those who
lost weight due to an improved diet showed a decrease in inflammation measured by a
variety of tests. Exercise did not seem to make a positive difference in this study.
At least 25 studies have been published to date that show the
benefits of a low-fat, plant-based diet on inflammatory arthritis (see my home page article "Diet: Only
Hope for Arthritis"). Most of this research has been done on people who have been
told they have rheumatoid arthritis, which is an arthritis characterized by severe
inflammation. In reality, all arthritis conditions have elements of both inflammation and
destruction – and the overall condition of the patient can range from one end of this
spectrum to the other.
There is hope for people suffering from osteoarthritis, because
the inflammation component can be reduced or stopped with corrective measures, such as a
healthy diet and accompanying weight loss. I believe a low-fat, pure-vegetarian diet, combined with
non-injurious physical activity, provides the best chance to avoid osteoarthritis later in
life; and even help those who already suffer with this condition. But there is another
"medication" approach that should be used when further benefits are needed.
A
"Natural" Arthritis Medication that Really Works
The
joints are the locations in the body where bones make their connections. Cartilage covers
the connecting surfaces of two bones where they join, allowing them to effortlessly glide
one bone over the other. This articular cartilage is made of two types of large molecules,
proteoglycans and collagen. Proteoglycans provide elasticity and stiffness on
compression; collagen provides the strength. Substrates for the building blocks of joint
proteoglycans can be provided in the form of a nutritional supplement made from seashells,
called glucosamine. Medical benefits for glucosamine have been reported in the
scientific literature for more than 35 years.4 This medication can lead to long-lasting
pain reduction and functional improvement by increasing cartilage building activities,
reducing enzymatic destruction of the cartilage, and by providing anti-inflammatory
effects. Glucosamine also acts to prevent the death of cartilage cells – not only
halting joint destruction, but reversing it.
Researchers
reporting in the April 2004 issue of the journal Menopause found (for the first
time in a properly executed study) that the use of this seashell-derived supplement will
stop the progression of osteoarthritis (degenerative arthritis) of the knee of
postmenopausal women. 5 In fact, there was actually a small improvement, on average, in
the joints of the 319 women studied. The placebo group showed a small amount of worsening.
Three times as many in the placebo group showed narrowing (evidence of destruction) of
their joints compared to the glucosamine group (33 vs. 11). A dosage of 1500 mg was given
once daily by mouth. Two other recent and important studies have also shown improvement in
pain and halting of progression of the joint deterioration.6,7
Glucosamine
is very well tolerated by patients of all ages under short- and long-term treatment. At
the very most, mild gastrointestinal upset, drowsiness and headache may occur – in
most research, this medication has been found to have no more adverse effects than
placebo. Glucosamine comes in a sulfate and hydrochloride form – both are equally
effective. Cost of this medication is less than $20 a month for 1500 mg daily. Often you
will find glucosamine packaged with chondroitin – a byproduct of cow cartilage. My
concern is that this cow material may contain infectious microbes, such as those that have
been found to cause mad cow disease.8 You will also find combinations of glucosamine with
calcium, magnesium, boron and other minerals. The effects of these minerals have not been
determined and they may cause unwanted imbalances in your system. Therefore, I recommend
that you purchase a product that is made only of glucosamine. Finally, people with healthy
joints should not be taking glucosamine in order to prevent a future problem that may
never occur, since we really do not know for sure whether or not there are any long-term
adverse effects from taking daily doses of powdered seashells.
Diet:
Only Hope for Arthritis
http://www.drmcdougall.com/res_arthritis.html
A dentist writes, "In April of 1994 I met you briefly at
the Michigan Dental Association Annual Meeting in Grand Rapids. During this seminar, I
asked you about my 4-year-old son having juvenile rheumatoid arthritis. Bryan was on 35 mg
of prednisone (a powerful steroid) and 1200 mg of Advil daily. He was in so much pain he
screamed and cried day and night. In one year he lost weight and did not grow one inch.
His blood work reflected a sed rate of over 40 (This is a measurement of severity of
inflammation and should be below 5). The suggestions you gave me that day lead me to
remove all animal products from his diet, as well as refined carbohydrates."
"Within six months, we had Bryan off all his medication. He was free of pain, gaining
weight and growing again. His last blood work was superb with a sed rate of 1 - can you
believe it!"
That's how bad it can get. But for millions arthritis is much more subtle. Marvin Burk
(Louise's husband--Louise works in the McDougall Health Center office) couldn't hardly get
out of the chair. Then he would walk straddle-legged halfway across the room until he
could loosen up enough to get his joints moving. His hands were so stiff he could not use
his tools and he often dropped things. He figured a man of 65 shouldn't be so crippled and
decided he'd do whatever it takes to get well. He changed his diet 8 years ago with
immediate and dramatic results. Now he pops out of the chair, walks without a bit of
stiffness or pain and he handles his tools with no trouble. Many of us can relate to
Marvin's troubles.
People's
Most Common Affliction
Diseases of the muscles and bones are among the most common of all human afflictions,
affecting all ages, but becoming more prevalent with years. Government surveys indicate in
the United States approximately 33% of adults currently suffer from troublesome arthritis
with symptoms of swelling, limitation of motion, or pain. Approximately half of all people
over 65 years report having arthritis. The regions of the body most affected are the neck,
lower back, hip and shoulder.
Arthritis means inflammation of a joint--no more, no less. The fact that a person has
arthritis tells nothing about the cause or the cure. Joints can be inflamed as a result of
an injury, such as from tripping and spraining an ankle. That's called traumatic
arthritis. Joints can be infected with bacteria resulting in suppurative arthritis. Uric
acid crystals can accumulate in the joints causing gouty arthritis. The causes of all
three of these forms of arthritis are known and once the causes are stopped the joints
heal. Unfortunately, most forms of arthritis are said by doctors to have "no known
cause." And whether or not they will admit it, there is no cure to be found in modern
drug therapy either.
Degenerative and Inflammatory
Arthritis of "no known cause" can be divided into two broad categories:
degenerative arthritis and inflammatory arthritis. Degenerative arthritis most commonly
represents a condition known as osteoarthritis. This is the most common arthritis found in
people living in Western civilizations--seen in x-rays of the hands of over 70% of people
65 years and older. However,
this same disease is comparatively rare in African and Asian countries, where people
physically labor to survive (Br J Rheumatol 24:321, 1985). How can that be? Osteoarthritis
is said to be due to wear and tear on the joints, so why is it less common among hard
working people of underdeveloped countries? Nor does it explain why with light use, the
hands of women often become twisted and deformed with age.
The inflammatory forms of arthritis include juvenile rheumatoid arthritis, rheumatoid
arthritis, psoriatic arthritis, lupus, and ankylosing spondylitis. These aggressive
diseases affect less than 5% of the people living in the United States today. Classifying
these inflammatory diseases by different names, such as rheumatoid or lupus provides no
further benefits to the patient, because it does not lead to better understanding of the
cause of the inflammation, or to the successful treatment of the disease.
People diagnosed with degenerative arthritis (osteoarthritis) have inflammation in their
joints in addition to the long-standing damage (degeneration). This inflammation can often
be stopped with a change in diet and the swelling, pain, and stiffness relieved. What
won't change in either form of arthritis is the permanent destruction left by years of
disease, leaving deformity, stiffness and pain. To understand how most people with
arthritis can be helped by a healthy diet, I will focus on the more aggressive
inflammatory forms of arthritis.
Hope for Arthritis Sufferers
Arthritis is not a
genetic disease, nor is it an inevitable part of growing older--there are causes for these
joint afflictions, and they lie in our environment--our closest contact with our
environment is our food. Some researchers believe rheumatoid arthritis did not exist
anywhere in the world before 1800 (Arthritis Rheum 34:248, 1991). It is well documented
that these forms of arthritis were once rare to nonexistent in rural populations of Asia
and Africa (Chung Hua Nei Ko Tsa Chih 34:79, 1995; Arthritis Rheum 34:248, 1991). As
recently as 1957, no case of rheumatoid arthritis could be found in Africa. That was a
time when people in Africa followed diets based on grains and vegetables.
These once unknown
joint diseases are now becoming common as people migrate to wealthier nations or move to
the big cities in their native countries. With these changes they abandoned their
traditional diets of grains and vegetables for meat, dairy products, and highly processed
foods (J Rheumatol 19:2, 1992; Ann Rheum Dis 49:400, 1991). For example, although unknown
in Africa before 1960, African-Americans lead in the incidence of lupus in the US (J Am
Med Women's Assoc 1998;53(1):9-12). The mechanisms by which an unhealthy diet causes inflammatory
arthritis are complex and poorly understood, but involve our intestine and immune system.
Intestine and Immune System
Increased Intestinal Permeability
The intestine forms an effective barrier to separate and exclude intestinal contents from
the interior of the body. Only a single layer separates the individual from enormous
amounts of antigens (foreign proteins) both of dietary and microbial origin. The
intestinal mucosa absorbs and digests nutrients, turning large complex molecules into
small simple ones. Normally, only the small molecules are allowed to pass through the
intestinal wall, while the large ones that can act as antigens, causing immune reactions,
have a limited ability to pass through. Infections and toxins can cause gaps in this
barrier and allow large molecules to pass into the blood. This condition of increased
intestinal permeability is referred to as a "leaky gut." Patients with
inflammatory arthritis have been shown to have inflammation of the intestinal tract
resulting in increased permeability (Baillieres Clin Rheumatol 10:147, 1996).
The largest amount of lymphoid tissue in the body is associated with the gut. This tissue
protects the body from antigens that do get through the intestinal barrier. Unfortunately,
an unhealthy diet--too high in fat, cholesterol, and animal protein--can compromise the
capacities of the lymphoid tissue to destroy invading antigens that make it through the
intestinal wall.
Fasting is known to decrease intestinal permeability, thus making the gut "less
leaky." This may be one of the reasons fasting has been shown to dramatically benefit
patients with rheumatoid arthritis (Scand J Rheumatol 1982;11(1):33-38). When patients
return after the fast to a diet with dairy products, the gut becomes more permeable and
the arthritis returns. An unhealthy diet containing dairy and other animal products causes
inflammation of the intestinal surfaces and thereby increases the passage of dietary
and/or bacterial antigens (Br J Rheumatol 33:638, 1994). A vegan diet (one with no animal
products) has been found to change the fecal microbial flora in rheumatoid arthritis
patients, and these changes in the fecal flora are associated with improvement in the
arthritis activity (Br J Rheumatol 36:64, 1997).
In addition to being
devoid of animal products, the diet needs to be very low in fat for maximum benefits. Dietary fat has a toxic effect on the
intestine of experimental animals, causing injury that increases the permeability of the
gut allowing more antigens to enter the body (Pediatr Res 33:543, 1993). Feeding high
cholesterol diets to young animals also increases their "leaky gut" (J Pediatr
Gastroenterol Nutr 9:98, 1989; Pediatr Res 21:347, 1987). Those vegan diets that have
failed to help arthritis patients have been high in vegetable oils, which are know to
damage intestinal integrity.
One dangerous paradox in arthritis treatment is that the drugs most commonly used to treat
arthritis are toxins to this intestinal barrier. All commonly used nonsteroidal
antiinflammatory drugs (like Advil, Motrin, Naprosyn, etc.), apart from aspirin and
nabumetone (Relafen), are associated with increased intestinal permeability in man. While
reversible in the short term, it may take months to improve the barrier following
prolonged use. (Baillieres Clin Rheumatol 10:165, 1996).
Foreign Protein in the Body
Through the "leaky gut" pass foreign proteins from foods and bacteria into the
blood stream. The food proteins are recognized by the body as "not self,"-- as
something harmful, just like it recognizes the proteins of viruses, parasites, and
bacteria as foreign. Then it makes antibodies against these invaders. Elevated levels of
antibodies to gut bacteria and to food have been found in various forms of inflammatory
arthritis (Rheumatol Int 1997;17(1):11-16; Clin Chim Acta 203:153, 1991).
Antigen-Antibody Complexes
A "leaky gut" can lead to the formation of large complexes, made up of
antibodies and the foreign protein (antigens) in the blood (Curr Opin Rheumatol 10:58,
1998; Ann Prog Clin Immunol 4:63, 1980). The healthy body has mechanisms that easily
remove these large complexes from the blood. In some people, however, these complexes
survive--because they are formed too rapidly for complete removal and/or the removal
mechanisms are insufficient to handle the load. The persistent complexes are then filtered
out by the smallest capillaries of the body which are found in the joints, skin, and
kidneys. Stuck in the capillaries these complexes cause an inflammatory reaction, like a
sliver of wood stuck in the skin.
Molecular Mimicry
Another fate of the foreign proteins is they can cause the body to make antibodies that
are not solely specific to that foreign protein, but also interact with similar human
proteins. This mechanism is known as molecular mimicry. The body attacks itself and the
resulting diseases are referred to as autoimmune diseases. Rheumatoid arthritis, lupus,
psoriatic arthritis, ankylosing spondylitis, and the other inflammatory forms of arthritis
are autoimmune diseases.
Molecular mimicry in rheumatoid arthritis has been identified with cow's milk. One
analysis showed that the amino acid residues 141-157 of bovine albumin were essentially
the same as the amino acids found in human collagen in the joints (Clin Chim Acta 203:153,
1991). The antibodies synthesized to attack the foreign cow's milk proteins, end up
attacking the joint tissues because of shared sequences of amino acids between the
cartilage and the milk proteins, that the antibody is directed to attack.
The Defense System
A healthy diet allows the defense systems to work to its full capacity removing antigens
that enter the system and removing immune-complexes from the blood. Components of the rich
American diet are known to impair its function. Vegetable oils, including those of the
omega-3 and omega-6 variety, are particularly strong suppressors of the immune system.
This immune suppressing quality of oils (for example, fish oil and primrose oil) has been
used to suppress the pain and inflammation of arthritis, but like too many drug therapies
the ultimate outcome may not be best for the patient. Suppression of the immune system
prevents it from doing its work of removing invading foreign proteins. Low-fat diets have been shown to retard
the development of autoimmune diseases, similar to lupus and rheumatoid arthritis, in
experimental animals (Ann Rheum Dis 48:765, 1989).
A healthy diet also supplies antioxidants and other phytochemicals that keep the joints
strong and repair damage (Am J Clin Nutr 53(1 Suppl):362S, 1991). Animal studies have
shown that the foods consumed on the rich American diet fail to provide adequate
antioxidants to destroy the damaging free radicals that form in the joint tissues (J
Orthop Res 8:731, 1990).
Treatment of arthritis with diet became fashionable in the 1920s and many studies over the
last 20 years have shown a healthy diet, one very different from the typical American
diet, can be a very effective treatment of inflammatory arthritis for many people.
In
1979, Skoldstam fasted 16 patients with rheumatoid arthritis for 7-10 days with a
fruit-and vegetable juice fast, followed by a lactovegetarian diet for 9 weeks. One-third
of the patients improved during the fast, but all deteriorated when the milk products were
reintroduced (a lactovegetarian diet) (Scan J Rheumatol 8:249, 1979).
In
1980, Hicklin reported clinical improvement in 24 of 72 rheumatoid patients on an
exclusion diet. Food sensitivities were reported to: grains in 14, milk in 4, nuts in 8,
beef in 4, cheese in 7, eggs in 5, and one each to chicken, fish, potato, and liver (Clin
Allergy 10:463, 1980).
In
1980, Stroud reported on 44 patients with rheumatoid arthritis treated with the
elimination of food and chemical avoidance. They were then challenged with foods. Wheat,
corn, and beef were the greatest offenders (Clin Res 28:791A, 1980).
In
1981, Parke described a 38-year-old mother with 11-years of progressive erosive
seronegative rheumatoid arthritis who recovered from her disease, attaining full mobility,
by stopping all dairy products. She was then hospitalized and challenged with 3 pounds of
cheese and seven pints of milk over 3 days. Within 24 hours there was a pronounced
deterioration of the patient's arthritis (BMJ 282:2027, 1981).
In
1981, Lucas found a fat-free diet produced complete remission in 6 patients with
rheumatoid arthritis. Remission was lost within 24-72 hours of eating a high-fat meal,
such as one containing chicken, cheese, safflower oil, beef, or coconut oil. The authors
concluded, "...dietary fats in amounts normally eaten in the American diet cause the
inflammatory joint changes seen in rheumatoid arthritis." (Clin Res 29:754, 1981).
In
1982 Sundqvist studied the influence of fasting with 3 liters of fruit and vegetable juice
daily and lactovegetarian diet on intestinal permeability in 5 patients with rheumatoid
arthritis. Intestinal permeability decreased after fasting, but increased again during a
subsequent lactovegetarian diet regime (dairy products and vegetables). Concomitantly it
appeared that disease activity first decreased and then increased again. The authors
conclude, "The results indicate that, unlike a lactovegetarian diet, fasting may
ameliorate the disease activity and reduce both the intestinal and the non-intestinal
permeability in rheumatoid arthritis." (Scand J Rheumatol 11:33, 1982.)
In
1983, Lithell studied twenty patients with arthritis and various skin diseases on a
metabolic ward during a 2-week period of modified fast on vegetarian broth and drinks,
followed by a 3-week period of a vegan diet (no animal products). During fasting, joint
pains were less intense in many subjects. In some types of skin diseases (pustulosis
palmaris et plantaris and atopic eczema) an improvement could be demonstrated during the
fast. During the vegan diet, both signs and symptoms returned in most patients, with the
exception of some patients with psoriasis who experienced an improvement. The vegan diet
was very high-fat (42% fat). (Acta Derm Venereol 63:397, 1983).
In
1984 Kroker described 43 patients from three hospital centers who underwent a 1-week water
fast, and overall the group improved significantly during the fast. In 31 patients
evaluated, 25 had "fair" to "excellent" responses and 6 had
"poor" responses. Those with more advanced arthritis had the poor responses.
(Clin Ecol 2:137, 1984).
In
1985, Ratner removed all dairy products from the diet of patients with seronegative
rheumatoid arthritis, 7 out of 15 went into remission when switched to milk-free diets
(Isr J Med Sci 21:532, 1985)
In
1986, Panush described a challenge of milk in a 52-year-old white woman with 11 years of
active disease with exacerbations allegedly associated with meat, milk, and beans. After
fasting (3 days) or taking Vivonex (2 days) there was no morning stiffness or swollen
joints. Challenges with cow's milk (blinded in a capsule) brought all of her pain,
swelling and stiffness back (Arthritis Rheum 29:220, 1986).
In
1986, Darlington published a 6-week, placebo-controlled, single-blinded study on 48
patients. Forty-one patients identified foods producing symptoms. Cereal foods, such as
corn and wheat gave symptoms in more than 50% of patients (Lancet 1:236, 1986).
In
1986, Hanglow performed a study of the comparison of the arthritis-inducing properties of
cow's milk, egg protein and soy milk in experimental animals. The 12-week cow's milk
feeding regimen produced the highest incidence of significant joint lesions. Egg protein
was less arthritis-inducing than cow's milk, and soy milk caused no reaction. (Int Arch
Allergy Appl Immunol 80:192, 1986).
In
1987, Wojtulewski reported on 41 patients with rheumatoid arthritis treated with a 4-week
elimination diet. Twenty-three improved. (Food allergy and intolerance. London: Bailliere
Tindall 723, 1987).
In
1988, Beri put 14 patients with rheumatoid arthritis on a diet free from pulses, cereals,
milk, and non-vegetarian protein foods. Ten (71%) showed significant clinical improvement.
Only three patients (11%) adhered to the diet for a period of 10 months (Ann Rheum Dis
47:69, 1988.)
In
1988, Hafstrom fasted 14 patients with water only for one week. During fasting the
duration of morning stiffness, and number and size of swollen joints decreased in all 14
patients. No adverse effects of fasting were seen except transient weakness and
lightheadedness. The authors consider fasting as one possible way to induce rapid
improvement in rheumatoid arthritis (Arthritis Rheum 31:585, 1988).
In
1991, Kjeldsen-Kragh put 27 patients on a modified fast with vegetable broths, followed by
a vegan diet, and then a lacto-ovovegetarian diet. Significant improvement occurred in
objective and subjective parameters of their disease (Lancet 2:899, 1991) A two-year
follow-up examination found all diet responders but only half of the diet nonresponders
still following the diet, further indicating that a group of patients with rheumatoid
arthritis benefit from dietary manipulations and that the improvement can be sustained
through a two-year period (Clin Rheumatol 13:475, 1994.) Patients dropping out with
arthritic flares in the diet group left the study mainly when the lactovegetarian diet
(dairy products) were introduced (Lancet 338:1209, 1991).
In
1991 Darlington reported on 100 patients who had undergone dietary manipulation therapy in
the past decade, one-third were still well and controlled on diet alone without any
medication up to 7 ½ years after starting the diet treatment. They found most patients
reacted to cereals and dairy products (Lancet 338:1209, 1991).
In
1991, Skoldstam fasted 15 patients for 7 to 10 days. Almost all of the patients showed
remarkable improvement. Many patients felt the return of pain and stiffness on the day
after returning to their "normal" eating and all benefit was lost after a week
(Rheum Dis Clin North Am 17:363, 1991).
In
1992, Sheignalet reported on 46 adults with rheumatoid arthritis who eliminated dairy
products and cereals. Thirty-six patients (78%) responded favorably with 17 clearly
improved, and 19 in complete remission for one to five years. Eight of those 19 stopped
all medications with no relapse. Favorable benefits appeared before the end of the third
month in 32 of the patients (Lancet 339:68, 1992).
In
1992, van de Laar showed benefits of a hypoallergenic, artificial diet in six rheumatoid
patients. Placebo controlled rechallenges showed intolerance for specific foodstuffs in
four patients. In two patients, biopsy of the joints showed specific (IgE) antibodies to
certain foods (Ann Rheum Dis 51:303, 1992).
In
1992, Shigemasa reported a 16-year-old girl with lupus who changed to a pure vegetarian
diet (no animal foods) and stopped her steroids without her doctor's permission. After
starting the diet her antibody titers (a reflection of disease activity) fell to normal
and her kidney disease improved (Lancet 339:1177, 1992).
In
1995, Kavanaghi showed an elemental diet (which is an hypoallergenic protein-free
artificial diet consisting of essential amino acids, glucose, trace elements and vitamins)
when given to 24 patients with rheumatoid arthritis improved their strength and arthritic
symptoms. Reintroduction of food brought the old symptoms back (Br J Rheumatol 34:270,
1995).
In
1998, Nenonen tested the effects of an uncooked vegan diet, rich in lactobacilli, in
rheumatoid patients randomized into diet and control groups. The intervention group
experienced subjective relief of rheumatic symptoms during intervention. A return to an
omnivorous diet aggravated symptoms. The results showed that an uncooked vegan diet, rich
in lactobacilli, decreased subjective symptoms of rheumatoid arthritis (Br J Rheumatol
37:274, 1998).
It's the Whole Diet
The importance of
the overall diet cannot be overemphasized. Proper foods keep the intestinal barriers
strong and the immune system in a fighting condition. Those foods are whole starches,
vegetable, and fruits. In addition to being free of animal products, the diet must be low
in fat of all kinds--vegetable oil (even olive oil, corn, safflower, and flaxseed oil) and
animal fat. When it comes to blaming individual foods, dairy products seem to be the most
troublesome foods, causing the most common and severe reactions. Many reports indicate
grains, such as corn and wheat can also aggravate of symptoms. The truth seems to be
almost any food can cause trouble, but few people react to vegetable foods.
My experience and
this research has lead me to prescribe for the past 22 years a starch-based diet with the
addition of fruits, and vegetables (low-fat and devoid of all animal products). If no improvement is seen within 2 weeks,
I suggest wheat and corn be eliminated. The final step is to follow an elimination diet
based on the foods least likely to cause problems, such as sweet potatoes and brown rice
with the addition of noncitrus fruits, and green and yellow vegetables. All thoroughly
cooked. Water is the beverage. If improvement is found (usually within 1 to 2 weeks), then
foods are added back one at a time to see if there is an adverse reaction. (A complete
description of this diet can be found in the McDougall Program--12 days to Dynamic
Health). Nonsteroidal antiinflammatory drugs should be stopped, and if necessary, replaced
by aspirin or nabumetone (Relafen). Other medications are reduced and/or discontinued as
the symptoms improve.
I have just finished a study on 28 patients with rheumatoid arthritis using the McDougall
Diet (with corn and wheat included) and the results were remarkable. Full publication will
appear this fall.
For
Whole Body Benefits
By no small coincidence the same diet that keeps the joints healthy also keeps the rest of
the body sound. Diane of Walnut Creek wrote to me last year. "I had what I can only
call a miserable life until about five years ago. Nothing seemed to go right for me. In
late 1991 I was diagnosed with spinal stenosis and degenerative arthritis. I was declared
permanently disabled and left my job as a daily newspaper journalist. My therapist gave me
a wonderful gift--she suggested I try your program. I shrugged off her suggestion at
first. I swore that I ate well anyway: only dairy and shellfish and white meats. Only! She
did not push the point, wisely waiting for me to think about the idea. I did wait for two
years. Then two years ago she suggested your program again. I told her I didn't believe it
would work, but agreed to try it for two months. I was overweight, very overweight, by 100
pounds, most of my life--carrrying all that poundage caused a lot of wear on my joints.
That was two years ago, and I'm a lifelong convert."
"Of course what you predicted happened: My migraines went away completely; I stopped
swelling in my joints; I could sleep easily; I had no indigestion problems of any kind;
and I began to drop weight. As you probably know, it was a lot easier than I thought it
would be. Before I started the McDougall plan, I was losing weight slowly. Afterward, the
weight loss was dramatic. After about six months, people started noticing and commenting.
They kept saying things like ‘you look ten years younger,' or most often, ‘You
look great. What did you do?' I no longer take the anti-inflammatory drugs and painkillers
that I was taking before the McDougall way. My knee and low-back are virtually pain-free.
Now, what I've found is that nobody believes it can be as simple as eating carefully and
exercising. They all want some magic or some pill."
All
of the above information and more can be found on Dr. McDougalls's fantastic website. His
website has information that will help you improve the health of your entire body. http://www.drmcdougall.com
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