Diet and Arthritis - Should Something be Dropped from The Diet?
Food allergies are widespread. An extremely conservative estimate is that about 2 percent of the populations have an unmistakable food allergy. Egg, wheat, milk, fish and selfish, nuts, chocolate and citrus fruits are some of the common offenders. Allergic symptoms cover a wide spectrum, from hay fever and asthma symptoms to skin rash, including hives, to gut upset and migraine, to muscle and joint aches and pains.
There have been clear cut instances where arthritis symptoms in patients diagnosed as having rheumatoid arthritis have come and gone in response to the addition and withdrawal of specific foods given in a “double blind” fashion. The foods varied by patient, and included corn, wheat, nitrate, shrimp and milk. Most of these patients appeared to be rheumatoid factor (RF) negative. But estimated of the number of RA patients whose symptoms are affected by food are well under 5 percent.
In isolated instances, flare up of childhood arthritis and lupus have been linked to specific foods. A different kind of example is celiac disease, a condition where people are quite intolerant of gluten, a wheat protein. Celiacs often have musculoskeletal symptoms – some quite severe which improve on gluten free diet. I well recall a young woman with intractable pain who, after several years of fruitless investigations and treatment at my hands, saw another doctor who made the correct diagnosis and cured her with diet.
A number of special diets have been studies. Most of these, done in patient with rheumatoid arthritis, started with a period of fasting (often up to a week) then various foods were reintroduced, with or without attempts to avoid specific items. In some instances, a tailored kind of diet was started. The result if these studies have been mixed. Some have shown no benefit. Many others have shown definite benefit, especially during the fasting phase.
One of the most convincing of these demonstrated that a small minority of patients were clearly helped by a diet that eliminated red meat, daily products, alcohol, preservatives, fruits, herbs and spices. A slightly different study showed that 17 patients put on a long term vegetarian diet improved and were able to maintain their improvement for at least a year. But nutritionists examining this study have criticized it for two reason: the number were very small, and the diet itself had nutritional deficiencies that could lead to difficulty over the long run.
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