"Fasting for Rheumatoid Arthritis"
Alan Goldhamer is the founder of the TrueNorth Health Center
in Santa Rosa, California, which has fasted 10,000 people for conditions
ranging from diabetes and cardiovascular disease to autoimmune diseases.
He noted that conditions that seem to be tied to dietary excess
tend to respond predictably to the use of fasting
followed by a health-promoting diet, which he describes as a low salt,
all plant, high fiber, low fat, low protein, and low sugar diet.
This approach offers people an option to eliminate the cause
of lifestyle diseases often to the point where the medication
is no longer needed, in contrast to conventional medicine,
which is more about the suppression of the symptoms
associated with the disease, rather than removing the underlying root cause.
Goldhamer put it this way: If you treat high blood pressure
or type 2 diabetes or autoimmune disease medically, they'll tell you,
"You'll be on these medications the rest of your life."
That’s them in effect promising you, if you follow their advice
to the letter, “you will be sick the rest of your life.”
Preliminary data suggests fasting may benefit metabolic diseases,
pain syndromes, high blood pressure, chronic inflammatory diseases,
allergic diseases, and psychosomatic disorders,
but the highest level of evidence we have for the benefits of fasting
are in regards to rheumatic diseases:
autoimmune inflammatory joint diseases, like rheumatoid arthritis.
Nearly a century ago it was written that “diet treatment
is not generally recognized by the medical profession…
as one of the weapons with which to attack [such diseases].”
This attitude persisted until relatively recently,
but a systematic review of controlled trials has since
“shown a statistically and clinically significant beneficial long-term effect.”
Rheumatoid arthritis has a well-known genetic component,
but the concordance rate, the chance that a pair of identical twins
both get it when one has it is probably under 30%,
despite having the same genes, leaving 70%
to be explained by non-genetic factors.
Even if we don't know exactly what those factors are,
“fasting [has been compared] to rebooting the hard drive in a computer.
Sometimes, the [drive] gets corrupted
and you don’t know exactly where the problem is.
But if you just turn it off and reboot it,…
that corruption [may get] cleared out.”
The evidence base started with case reports, fasting followed by
a plant-based diet, remarkable reports of years of pain and stiffness…
gone within a week, and, more importantly,
stayed gone on the healthier diet.
One after another like that, but case reports are just glorified anecdotes.
There have been studies going back decades suggesting
fasting may represent the most rapid, available way to induce relief
of arthritic pain and swelling for patients who have rheumatoid arthritis,
but the studies often failed to have control for the placebo effect,
which is especially important when it comes to relying on self-reported
subjective symptoms such as pain and general well-being.
But there are objective measures, lab tests of inflammation
that don’t appear to be affected by placebos,
and that’s what you can see in controlled trials,
starting immediately and remaining down for at least a year.
Ten different measures of inflammation significantly decreased
after the fasting and subsequent meat- and egg-free diet,
whereas none of the parameters budged in those disease victims
that continued to eat their regular diets.
And this squelching of inflammation translated into a significant reduction
in pain, morning stiffness, loss of grip strength,
and number of tender and swollen joints.
Even a year after the trial was over, those who benefited from the diet
continued to benefit in terms of pain, stiffness,
and tender and swollen joints,
presumably because they stuck with it.
There is little doubt that while fasting both inflammation and pain
are relieved, but if you go back to the same diet you were on before,
the inflammation returns—unless, evidently, the fasting period
is followed by a vegetarian diet. Why might that be?
It could be due to changes in the microbiome,
the improvement in symptoms coincided with a significant alteration
of the intestinal flora, which may somehow be beneficial,
perhaps by strengthening the gut barrier.
We know fasting can decrease the leakiness of the gut
in rheumatoid arthritis patients, but we don’t yet know what role,
if any, this plays in the disease process.
It could be as simple as eicosanoids, the mediators of inflammation
that are formed from arachidonic acid.
Arachidonic acid is a long-chain inflammatory omega-6 fatty acid
found in animal fats.
The biggest contributors are chicken and eggs,
which together contribute nearly half of American intake.
That’s been suggested as an explanation of why those eating
more plant-based appear to have better mental health;
they’re not suffering the “cascade of neuro-inflammation”
caused by arachidonic acid;
why removing eggs, chicken and other meat was shown in a randomized
controlled trial to improve mood, suggesting the arachidonic acid
might be negatively impacting mood states and may help explain
the impact of more plant-based diets on inflammatory diseases
like rheumatoid arthritis.
So, that may help explain why maintaining a plant-based diet
appears to be necessary “after the fast to prevent the recurrence
of symptoms and inflammatory activity,”
or as one popular press article put it,
fasting may just be a tool to get you to radically kickstart
a change in the way you eat.