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Date: 23.04.2015
From: Alice

Subject: Effect of diet on rheumatoid arthritis symptoms

Hello, I'm a medical student currently doing some research into the effect of diet on rheumatoid arthritis symptoms.


I became interested in this subject after a family friend (who has been diagnosed with rheumatoid arthritis) told me that certain foods cause flare-ups in her condition.

From the research I have conducted so far it appears that many sources recommend a Mediterranean-style diet (rich in fruit, vegetables, fish oils, nuts etc.) or a gluten-free vegan diet. However, results from these studies is variable.


I wondered whether any of you have had personal experiences (either as a patient or professional) in experimenting with changes in diet (either excluding or incorporating certain foods or food groups) and whether this has had a positive or negative effect on rheumatoid arthritis symptoms?

Thank you so much for your help - it is greatly appreciated!
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Date: 23.04.2015
From: suz

Subject: Re: Effect of diet on rheumatoid arthritis symptoms

yes I feel I get flare and swollen joints when consuming, raw tomatoes, cows milk, gluten and red meat.
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Date: 23.04.2015
From: Julie

Subject: Re: Effect of diet on rheumatoid arthritis symptoms

I am diagnosed Rheumatoid Arthritis and I get flares if I eat raw and cooked tomatoes, oranges and worst of all strawberries, just 2 strawberries can give me the most horrendous pain in my hands.

This will be a really interesting subject to read I hope you get a lot of suggestions.
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Date: 24.04.2015
From: Sean

Subject: Re: Effect of diet on rheumatoid arthritis symptoms

Hi Alice

I have been strictly wheat, corn free and try to avoid cow dairy (especially milk and cream) for 23 years. I describe my improvement / recovery as at least 75% better most of the time.

I don't believe that diet is the be all and end all of arthritis treatment - as I strongly prescribe to the theories that infection (often minor & dormant) can also be a big factor too. They have also know for over 100 years that dental health (sugars / carbohydrate related) - is one of the factors in arthritis - gingivitis bacteria having a capability to bind to proteins and promote citrullination.

> Rheumatoid Arthritis is an Autoimmune Disease Triggered by Proteus Urinary Tract Infection

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2270745/

In autoimmune disease proteins present in bacteria cross react create an immune response against our own tissues - and also interfere with how of bodies then react to food proteins.

I am aware of the studies that you are mentioning here - I've always found the study here a bit non-scientific

http://rheumatology.oxfordjournals.org/content/40/10/1175.full

The comparison was a vegan diet without gluten compared to a normal diet with all food groups. There was no comparison to a normal diet without gluten!

I am aware from other papers like this one -

http://www.altmedrev.com/publications/3/2/90.pdf

...that eggs and some meats especially pork and beef are high up the list of foods that people with arthritis react to. So my view is that the vegan thing is a red herring.

When you look further back at the history of medical practice in to dietary treatment of arthritis - it goes back a long way and showed some considerable success!

1944 John Turnbull - Study of one hundred and twenty-seven cases of arthritis (with notes on gastro-intestinal features) Unfortunately its pay for view but the summary tells the main story -

http://link.springer.com/article/10.1007%2FBF03011637

This followed on from work he did in 1924 - almost 100 years ago!

Turnbull, John A. (1924) The relation of anaphylactic disturbances to arthritis.
Turnbull, John A. (1924) Food allergens in connection with arthritis.

The second of these papers is truly fascinating as he identified that people food intolerance and arthritic reactions changed over time - he kicks of the paper saying "It has been known for a long time (before 1924!) that in some individuals certain foods...."

Turnbull identified allergens by the cutaneous method - Skin prick testing similar to those used today. Wheat, corn, pork get a mention.. what I find charming is the statement about one of his patients now being able to "hold her hat on whilst driving" :)

http://www.nejm.org/doi/full/10.1056/NEJM192409041911003

Turnbull's work is cited in papers in more recent years too - leading to work by Seignalet, Dr. John Mansfield (once briefly my Doctor), Dr. Gail Darlington (I had a conversation with her last year).

Lastly - .. if you are truly wanting to study the causes of autoimmune diseases you should look at papers and lectures on YouTube by Alessio Fasano - Professor of Gastroenterology at University of Maryland - then this completes the picture as to why we develop food allergies and how we develop autoimmune reactions to bacterial and food proteins.

https://www.youtube.com/watch?v=wha30RSxE6w
https://www.youtube.com/watch?v=VvfTV57iPUY

No one food causes arthritis - but proteins in almost any food can either create an immune response either independently - or by homology (similarity) to bacterial proteins to which the immune system are reacting to.

So we only react to foods where larger undigested proteins have leaked through our gut - and this is likely to have a genetic link based on protein sequences.

Best of luck! There's lots of good information to get you teeth in to out there.
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