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  • Rheumatoid arthritis is estimated

  • to affect up to 1% of the entire population.

  • It is painful and often debilitating

  • talking inflammation in the joints,

  • the likes of which unless you have it,

  • sometimes you just can't believe.

  • And the flare ups with aura seem to come out of nowhere.

  • What triggers them?

  • Oftentimes it's a mystery, and that is what researchers

  • at the Physicians Committee wanted to figure out.

  • And today,

  • we're joined

  • by one of the lead

  • researchers of a brand new groundbreaking study

  • that analyzes the effect of diet on rheumatoid arthritis.

  • We welcome the director of clinical research

  • for the Physicians Committee, Dr.

  • Hana Kahleova.

  • Dr. Kahleova, thanks for being back here.

  • Thanks for having me, Chuck.

  • So good to see you again.

  • So good to be here.

  • Oftentimes

  • when you're on the show, we talk about diabetes,

  • but today we're talking about R.A.

  • And the thing that I know about R.A.

  • is that when I said it was painful, just a minute ago,

  • I've seen people just literally crippled over, crippled over

  • and have their days just ruined by it.

  • So when we're talking about pain

  • and R.A., I mean, how painful is this condition?

  • Yeah, that's exactly right.

  • Like, it affects the small joints in

  • the hands in the wrists,

  • the knees, but also other joints in the body.

  • And they're not only painful, but also swollen

  • and eventually over the course of many years

  • of the disease, there may be a permanent damage.

  • So it may be disability and disease also

  • you know, a big cause of disability. So

  • this is no fun.

  • We know that there's genetic factors

  • but also environmental factors.

  • And, you know, among the factors that we can influence,

  • diet seems to be one of them.

  • It's an autoimmune condition, which means that

  • it may be triggered by certain proteins.

  • And that's why we were trying to figure out,

  • you know, if we modified the diet, could we

  • could we help these people

  • with their pain and with their swollen joints?

  • And that's exactly why we conducted a clinical trial.

  • And let me share my screen with you and just tell you

  • a little bit about the study.

  • Yeah, by all means.

  • And we see the screen up on there right now.

  • Wonderful.

  • So we were looking into the effects

  • of a plant-based diet for rheumatoid arthritis.

  • And the findings have just been published

  • in the American Journal of Lifestyle Medicine.

  • And, you know, when

  • when people come in with their joint pain,

  • I need to say not all joint

  • pain is due to rheumatoid arthritis.

  • So in our study, we had a rheumatologist

  • who verified the diagnosis of rheumatoid arthritis, and

  • he was also making sure

  • to do the count of the joints

  • and all of the assessments that rheumatologists do

  • without knowing which group the participants were

  • in, both at baseline and then and then at midpoint.

  • And then at the end of the study,

  • we recruited 44 people with rheumatoid arthritis

  • and they were randomly assigned to either

  • the diet phase

  • or the supplement phase.

  • For sixteen weeks.

  • And then after the sixteen weeks were over,

  • we re-assessed their joint pain

  • and we were using questionnaires

  • and also the rheumatologist met with them and

  • we drew their labs.

  • And after a four week washout

  • period, four, four week of a break,

  • they switched over to the opposite intervention.

  • So those who were on the diet previously went on a supplement

  • and those who were on

  • a supplement went on the diet for another six weeks.

  • And then we did all the final assessments again.

  • Now, let me describe the diet.

  • What what exactly was the diet about

  • for the first four weeks?

  • It was a low fat vegan diet.

  • That means no animal product, no meat, no dairy,

  • no cheese, no eggs for four weeks.

  • Then for another three weeks

  • on the top of eliminating all the animal foods,

  • we also eliminated certain plant foods,

  • for example, gluten containing grains.

  • So foods and certain vegetables and fruits.

  • And for the

  • last nine weeks, we were reintroducing

  • the eliminated foods one by one back into the diet.

  • And if the introduced foods didn't cause any problems,

  • the participants just kept them in the diet

  • and kept adding new and new foods.

  • However, if, let's say

  • introducing potatoes back to the diet

  • caused a lot of joint pain and so,

  • you know, the joints were swollen again,

  • then the potato was just out of the diet again.

  • And we were testing other foods which provided each participant

  • with individualized food triggers that would cause

  • the joint pain and and swelling.

  • Here's the list of all the eliminated foods

  • on the elimination diet.

  • So in addition to eliminating all the animal foods

  • during the after four weeks,

  • during the subsequent three weeks week, we excluded

  • all the gluten containing grains.

  • Some vegetables such as potatoes and sweet potatoes,

  • and onions and tomatoes and eggplants and celery.

  • Only a couple

  • of fruits such as apples and bananas and citrus fruit,

  • nuts and peanuts,

  • soy foods and chickpea and also chocolate,

  • coffee, sugar, alcohol and nutritional yeast.

  • So these foods were eliminated for three weeks,

  • and then they were introduced one by one every two days.

  • The participants added another food from this

  • from this elimination diet list.

  • Now, the disease activity

  • measured by the DAS 28 score,

  • which is one of the the major

  • rheumatologist assessments

  • didn't change significantly

  • on the supplement or which was a placebo

  • but was reduced substantially during the diet

  • by 2.1 points.

  • And I need to say that we also did another analysis

  • looking at people who increased their medications

  • during the study.

  • When we excluded them, we we got similarly results.

  • And also when we took participants with no medication

  • changes whatsoever during the study and left

  • only them then and the results were comparable as well.

  • And another significant

  • finding from the study was the number of swollen joints

  • which was reduced by 3.7 during the diet phase

  • and did not change significantly on the placebo

  • So in conclusion, it looks like the elimination

  • plant based diet really work for rheumatoid arthritis

  • and can be definitely tried out if you have

  • rheumatoid arthritis.

  • I'd like to encourage you to give it a try

  • and we will post the whole

  • the whole paper with the list of the foods

  • that that were eliminated on the elimination diet

  • so that you can you can do it yourself.

  • Those are really fascinating results. Dr.

  • Kahleova.

  • What was your hypothesis going into this?

  • I mean, we know that plant-based

  • diets, by and large are anti-inflammatory.

  • So was it your suspicion that this

  • probably would be helpful to a lot of these study participants?

  • Yeah, exactly.

  • Our thought was let

  • let's try out how a plant-based diet can help these people.

  • We know that plant-based diets in general are

  • anti-inflammatory.

  • But then

  • also we realize that there are certain triggers

  • beyond the animal foods that are excluded from from

  • the plant, plant-based diet.

  • That's why we also included the elimination phase.

  • Unfortunately, the individual foods

  • that need to be eliminated in

  • in each single person,

  • they are completely different from one person to another.

  • So there is no way how to predict whether a person

  • will be reacting to a potato or a tomato

  • or an apple or onion.

  • Every person just needs to try these foods out.

  • So one part one part is eliminating

  • all the animal products.

  • And most participants reported significant improvement

  • of their joint pain even after the first four weeks.

  • But there was still some remaining pain

  • in some of the participants, and that's

  • where the elimination diet came into play.

  • Interesting.

  • I find it really interesting how wide of a variation

  • there was as far as the trigger foods.

  • So what you're saying is

  • you can't exactly say that while, you know,

  • fruits are more likely to be triggers or potatoes,

  • as you said, or onions or whatever

  • the case may be, you can't say

  • any of that is more likely to be a trigger than another food.

  • Do we have any sort of understanding as to why

  • it varies so widely from person to person?

  • Our body, it's an autoimmune condition

  • and it's triggered by certain proteins.

  • And it also depends on your genetic

  • background and also your early, early life exposures.

  • So let's say people who were not breastfed

  • and where cows and milk was introduced early, early in life,

  • they may react to dairy much stronger

  • than a person who was breastfed, for example.

  • You know, there's different

  • there's different foods that are being introduced

  • into the diet in the early life.

  • And some of them just turn out to be to be triggers.

  • It's it's also the case

  • with meat and

  • with eggs.

  • You know, the earlier the exposure in life,

  • the higher the probability that the body will be reacting

  • to these foods later in life.

  • So that's also

  • stressing a

  • point for all our mothers

  • who have small babies to be really careful

  • about the diet of their babies.

  • You know, make sure they breastfeed them long enough

  • and also that they introduce foods that are not

  • not any of these triggers too early in life.

  • And I'm looking at the list of foods

  • that were part of the elimination diet.

  • There were three in particular that stood out to me

  • that I'm like, hmm, I wonder if some people had a hard time

  • eliminating these completely I'm talking about coffee

  • and I'm talking about sugar and I'm talking about chocolate.

  • Weren't did any of the participants say, hey, look, Dr.

  • Kahelova, this is like so hard to take out of my life?

  • Absolutely.

  • There were a few people who were like,

  • How am I going to survive without my coffee?

  • But they did it.

  • You know, you can you can do everything

  • if you put your mind to it, like

  • going through the elimination diet.

  • Gave the study

  • participants unique information for the rest of their life.

  • Let's say,

  • you know, you're

  • you're experiencing some pain in your joints, Chuck,

  • and you don't know where the pain is coming from.

  • And someone will tell you, you know, let's let's figure it out.

  • Over the next six weeks, we will know exactly

  • what triggers your pain.

  • Then you might be up for that.

  • You know

  • what? You might be willing to eliminate

  • all your sugar in coffee.

  • The strict elimination phase was only for three weeks.

  • So, you know, it's not too bad.

  • And also, eliminating chocolate doesn't mean eliminate the

  • chocolate taste, and the eliminating sugar

  • doesn't mean eliminating the sweet taste either.

  • So there's ways how you can somehow make it work.

  • So. Okay, so you're talking about sugar?

  • Are we just talking about added refined sugar or.

  • Okay, and so but the fruits that were not on that

  • elimination list, they they could still freely eat

  • as much as they wanted.

  • Exactly.

  • So berries and grapes, for example, they can they

  • they they were able to eat as much as they wanted.

  • All right.

  • Well, that's a sweet relief right there.

  • Not too bad.

  • Okay.

  • And how confident are we given the fact that this is an

  • autoimmune disorder, that

  • other autoimmune disorders might also see

  • the same type of benefit?

  • I mean, obviously, they're all a little bit different.

  • But, you know, so we've got R.A.

  • here and other autoimmune disorders, say,

  • like Sjogren syndrome or something like that.

  • Are we confident that,

  • you know, looking at a nutritional intervention

  • might also prove helpful for those other conditions?

  • It might.

  • We just don't have the exact information.

  • And some some studies need to be conducted.

  • We're currently running a study for people

  • with type one diabetes, which is also an autoimmune condition.

  • So see how we can help these people with with with a diet,

  • you know, and if that can make a difference in their life.

  • Also.

  • And what final question?

  • I mean, what was the takeaway for the participants?

  • I mean,

  • was it really kind of EYE-OPENING for them

  • if they saw

  • real positive results

  • like, wow, I've been looking

  • for something like this my entire life and now

  • oh my goodness,

  • it's it's not medicine, it's not this, it's not that.

  • It's it's food.

  • Food seems to be kind of like something

  • that can really help me out here.

  • Was there a lot of surprise among them?

  • Absolutely.

  • For the first time in their life, you know, they saw relief

  • by something as simple as a as nutrition.

  • And, you know, most of them were super grateful

  • for this experience

  • because that informed them for the rest of their life.

  • Dr. Kahleova, medicine woman, I love it.

  • You always bring the knowledge.

  • So today is no different.

  • So thank you very much for being here.

  • Thank you so much.

  • If your health

  • IQ is a couple of points higher than it was a few minutes ago,

  • go ahead and like this video or subscribe

  • to the YouTube channel and to take it even higher.

  • Head over to Apple Podcasts

  • or wherever you get your favorite shows.

  • Look for the exam room by the Physicians Committee.

  • Hit the subscribe button

  • there as well and help to make your world a healthier place.

Rheumatoid arthritis is estimated

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A Diet For Rheumatoid Arthritis Relief | Dr. Hana Kahleova

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    林宜悉 發佈於 2022 年 10 月 31 日
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