Feeding a high-fat diet to animals who are susceptible to autoimmune disease has increased the severity of RA. People with RA have been reported to eat more fat, particularly animal fat, than those without RA. In short-term studies, diets completely free of fat have helped people with RA. Since at least some dietary fat is essential for humans, though, the significance of this finding is not clear.
Strictly vegetarian diets that are also very low in fat have been reported to reduce RA symptoms. In the 1950s through the 1970s, Max Warmbrand, a naturopathic doctor, used a very low-fat diet to treat people with RA. He recommended a diet free of meat, dairy, chemicals, sugar, eggs, and processed foods. A short-term (ten weeks) study employing a similar approach failed to produce beneficial effects. Long before publication of that negative report, however, Dr. Warmbrand had claimed that his diet took at least six months to achieve noticeable results. In one trial lasting 14 weeks—still significantly less than six months—a pure vegetarian, gluten-free (no wheat, rye, or barley) diet was gradually changed to permit dairy, leading to improvement in both symptoms and objective laboratory measures of disease. The extent to which a low-fat vegetarian diet (or one low in animal fat) would help people with RA remains unclear.
Preliminary evidence suggests that consumption of olive oil, rich in oleic acid, may decrease the risk of developing RA. One trial in which people with RA received either fish oil or olive oil, found that olive oil capsules providing 6.8 grams of oleic acid per day for 24 weeks produced modest clinical improvement and beneficial changes in immune function. However, as there was no placebo group in that trial, the possibility of a placebo effect cannot be ruled out.
Fasting has been shown to improve both signs and symptoms of RA, but most people have relapsed after the returning to a standard diet. When fasting was followed by a 12-month vegetarian diet, however, the benefits of fasting appeared to persist. It is not known why the combination of these dietary programs (i.e., fasting followed by a vegetarian diet) might be helpful, and the clinical trial that investigated this combination has been criticized both for its design and interpretation.
Food sensitivities develop when pieces of intact protein in food are able to cross through the intestinal barrier. Many patients with RA have been noted to have increased intestinal permeability, especially when experiencing symptoms, and RA has been linked to allergies and food sensitivities. In many people, RA worsens when they eat foods to which they are allergic or sensitive and improves by avoiding these foods. In one study, the vast majority of RA patients had elevated levels of antibodies to milk, wheat, or both, suggesting a high incidence of allergy to these substances. English researchers have reported that one-third of people with RA may be able to control their disease completely through allergy elimination. Identification and elimination of symptom-triggering foods should be done with the help of a physician.
Drinking four or more cups of coffee per day has been associated with an increased risk of developing rheumatoid arthritis in preliminary research.
Eric R. Braverman, M.D.
Dr. Braverman is a Summa Cum Laude and Phi Beta Kappa graduate of Brandeis University and NYU Medical School, did brain research at Harvard Medical School, and trained at an affiliate of Yale Medical School. He is acknowledged worldwide as an expert in brain-based diagnosis and treatment, and he lectures to and trains doctors in anti-aging medicine.