Diet, Arthritis and Autoimmune Diseases

UPDATED: April 19, 2018

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Ask these two questions to most physicians in practice today and the likely answer you’ll receive is, “The cause of arthritis and autoimmune diseases is unknown, and nothing that you eat, nor any supplement that you take, will make any difference at all.”

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Yet, it has long been known that many factors can affect arthritis – physical activity, emotions, even the weather. However, prevailing medical thought still holds that food has little or no effect upon joint pain. The diet-arthritis connection is often disdainfully dismissed as “unscientific” or as “magical thinking.” Fortunately for the millions who suffer from arthritic pain, recent medical studies indicate that relief can be as close as their dinner plate.

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Numerous articles published in prominent medical journals confirm what I have witnessed for years in my medical practice: many people with rheumatoid arthritis and other forms of inflammatory joint disease really ARE reacting to substances in their food (1). The studies also demonstrate that identification and elimination of the offending foods – a therapy completely free of cost and risk – often provides dramatic improvement, or even complete remission of joint pain and disability.

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Why are physicians so reluctant to consider the possible connections between painful joints and what the owner of the joints has been eating for breakfast, lunch and dinner? A major reason is that in medical school, most physicians-to-be learn that fragments of food proteins are simply too large to be absorbed from the intestine into the bloodstream, and thus cannot be involved in inflammatory reactions in distant organs, like the joints.

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Consequently, the patient’s diet as a causative factor is usually discounted and instead, powerful (and expensive) anti-inflammatory medications are prescribed as the foundation of therapy. Both physician and patient can then settle for mere suppression of inflammatory symptoms while overlooking a possibly treatable cause that may be as close as the patient’s dinner plate. This “relief” can often inflict severe side effects, such as intestinal bleeding, inflammation of the liver, depression of bone marrow function (where new blood is made) and, of great concern, injury to the wall of the intestine. Why is this important?

IS YOUR GUT LEAKY?

Ignoring the effect of the diet of the patient with inflammatory arthritis is scientifically short-sighted; it is now clear that in most people with these conditions, fragments of protein from foods and from organisms living in the gut certainly DO leak into the bloodstream after most every meal. In reaction to these foreign substances, antibodies in the blood are commonly produced against components of egg protein, chicken protein, milk protein, and wheat protein within hours after eating these foods.

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This phenomenon of the “leaky gut” is present in everyone to some degree, but is far more pronounced in those whose intestinal walls are inflamed for any reason, such as in people with chronic parasite infestation, diarrhea of bacterial or viral origin, inflammation of the large intestine (colitis) or small intestine (enteritis or Crohn’s disease,) as well as in many allergic/atopic conditions, like asthma and eczema.

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Non-steroidal anti-inflammatory drugs (NSAIDS), including ibuprofen (Advil) and naproxen (Aleve) can injure the intestinal wall directly (more about those later) and, ironically, contribute to the gut inflammation they are taken to treat!

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Our food choices can injure our gut lining directly by their physical or chemical properties (fatty, acidic, nutrient poor, etc.) but also indirectly by unbalancing the micro-biome – the trillions of microbes that live in the mucus layer lining our intestine and form part of the functional barrier of our gut.

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Fatty foods, especially saturated fats, reduce bacterial populations while high-meat diets spawn bacteria that can tolerate lots of bile in the intestine – and promote DNA damage and cancer growth (2).

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People drink chlorinated drinking water, sodas with phosphoric acid, coffee, black and herbal teas and, of course, alcohol in wine, beer and other drinks – all of which kill beneficial bacteria!

Foods are sprayed with pesticides that alter the bacterial balance and most commercial flesh foods contain residues of antibiotics fed to the animals, which then concentrate in their tissues. 

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And of course, people often go to their doctor with a viral cold and ask for a prescription for antibiotics, “just in case” which inevitably unbalances the micro-biome – NOT a good idea!

All these agents and actions can reduce the numbers of beneficial organisms in the gut lining. This allows more unfriendly, harmful microbes to “set up housekeeping” in the mucus layer – which then proceed to injure the integrity of the intestinal wall. This makes the gut more permeable (“leaky”) to molecules that should never enter the bloodstream – and this is just what happens.

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Once in the bloodstream, these small fragments of foreign proteins can lodge in sensitive tissues – like the delicate synovial membranes that line the joints. There, they can incite significant reactions, ranging from subtle but uncomfortable inflammation of connective fibers to hot, painful swelling and distention of the joints, as in acute rheumatoid arthritis.

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Chronic inflammation of the joints – or any tissue – over the years can result in tissue scarring, contracture, loss of function and ultimately, destruction of the joint. Many other organs in the body – heart, lung, eye, kidney, muscle – can also suffer damage from repeated inflammation: failing “rheumatoid heart,” fibrous “rheumatoid lung,” bleeding kidneys in lupus nephritis, etc.

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Chronic inflammation is energetically expensive and ultimately harmful for the body to sustain – yet, our Standard American Diet (“S.A.D.”) is filled with a daily deluge of meats, dairy products, processed foods, concentrated sugars, preservatives, colorings, flavorings and other chemicals may foster that very process.

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So, the various kinds of joint inflammations, including some forms of rheumatoid arthritis, systemic lupus erythematosus, ankylosing spondylitis and others, may, indeed, have nutritional components and may greatly improve when offending foods are eliminated from the diet and other measures taken. 

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Not surprisingly, other inflammatory conditions including asthma, psoriasis, eczema, and related disorders also can involve the so-called “leaky gut syndrome,” and so, too, frequently respond to the same therapies outlined below.

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THE MOST LIKELY CULPRITS

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Almost any protein or other food substance can set off adverse reactions in the joints; however, in my clinical experience, the foods most likely to trigger joint inflammation are (in order):

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1. Milk proteins (especially casein and lactalbumin) in dairy products – including whey, buttermilk solids, skim milk solids, “calcium caseinate,” “sodium caseinate,” all milk-derived cheeses, yogurt, ice cream, chocolate, etc.

2. Chicken protein – including the “light meat” and “dark meat,” as well as egg whites.

3. Wheat protein – including breads, pastas, wheat cereals, etc.

4. Beef and other red meats.

5. Soy protein – including tofu, tempeh, etc. including meat analogues, which often contain soy and wheat proteins.

6. Corn protein.

7. and, to a MUCH lesser extent, “nightshade” vegetables – tomatoes, (white) potatoes, eggplants, green (bell) peppers. These four plants all contain anmolecule called solanum that, in a small number of people, may cause inflammation in the tissues – hence the shady reputation of these otherwise nutritious foods. 

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In my experience, less than 10% of people with an autoimmune disease have any problem when they eat any of the above nightshade foods.

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I find that after 4 – 6 months, when most or all of the inflammatory symptoms have subsided, the above four “nightshade” vegetables can be reintroduced into the diet, one at a time, in the manner suggested below, assuming the person desires to eat them.

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The following food plan will fully nourish your body while helping to you identify problem foods.

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“THE BASELINE SAFETY DIET”

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Note: The following has been modified to incorporate the very useful analysis and guidelines of Clint Paddison who has been successful in helping thousands of patients with inflammatory arthritis overcome their painful symptoms.

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For 2 days, consume only fresh vegetable juice made of celery and cucumber only.

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From day 2 – 12, reintroduce foods according to the following “Paddison Program” protocol (link opens in a new tab or window):