Fasting, followed by a plant-based diet, is put to the test for autoimmune inflammatory joint disease.
Fasting for Rheumatoid Arthritis
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
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 regard 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 percent, despite having the same genes––leaving 70 percent to be explained by nongenetic 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 neuroinflammation” 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.
Please consider volunteering to help out on the site.
- Gustafson C. Alan Goldhamer, dc: Water Fasting-The Clinical Effectiveness of Rebooting Your Body. Integr Med (Encinitas). 2014;13(3):52-7.
- Goldhamer A, Helms S, Salloum TK. Chapter 37 fasting. In: Pizzorno J, Murray M, eds. Textbook of Natural Medicine. 4th ed. Churchill Livingstone; 2013.
- Wilhelmi De Toledo F, Buchinger A, Burggrabe H, et al. Fasting therapy - An expert panel update of the 2002 consensus guidelines. Forsch Komplementarmed. 2013;20(6):434-43.
- Hare DC. A Therapeutic Trial of a Raw Vegetable Diet in Chronic Rheumatic Conditions: President’s Address. Proceedings of the Royal Society of Medicine. 1936;30(1):1-10.
- Müller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2001;30(1):1-10.
- Kjeldsen-Kragh J. Rheumatoid arthritis treated with vegetarian diets. Am J Clin Nutr. 1999;70(3):594s-600s.
- Fuhrman J, Sarter B, Calabro DJ. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med. 2002;8(4):112, 110-1.
- Palmblad J, Hafström I, Ringertz B. Antirheumatic effects of fasting. Rheum Dis Clin North Am. 1991;17(2):351-62.
- Porter DR, Capell HA. The 'natural' history of active rheumatoid arthritis over 3-6 months--an analysis of patients enrolled into trials of potential disease-modifying anti-rheumatic drugs, and treated with placebo. Br J Rheumatol. 1993;32(6):463-6.
- Kjeldsen-Kragh J, Borchgrevink CF, Laerum E, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. The Lancet. 1991;338(8772):899-902.
- Kjeldsen-Kragh J, Mellbye OJ, Haugen M, et al. Changes in Laboratory Variables in Rheumatoid Arthritis Patients During a Trial of Fasting and One-year Vegetarian Diet. Scand J Rheumatol. 1995;24(2):85-93.
- Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Førre Ø. Vegetarian diet for patients with rheumatoid arthritis - Status: Two years after introduction of the diet. Clin Rheumatol. 1994;13(3):475-82.
- Longo VD, Mattson MP. Fasting: Molecular Mechanisms and Clinical Applications. Cell Metab. 2014;19(2):181-92.
- Peltonen R, Kjeldsen-kragh J, Haugen M, et al. Changes of faecal flora in rheumatoid arthritis during fasting and one-year vegetarian diet. Br J Rheumatol. 1994;33(7):638-43.
- Sundqvist T, Lindström F, Magnusson K-E, Sköldstam L, Stjernström I, Tagesson C. Influence of Fasting on Intestinal Permeability and Disease Activity in Patients with Rheumatoid Arthritis. Scand J Rheumatol. 1982;11(1):33-8.
- Wang D, DuBois RN. Urinary PGE-M: A Promising Cancer Biomarker. Cancer Prev Res. 2013;6(6):507-10.
- Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc 2010 Oct;110(10):1477-84.
- Beezhold BL, Johnston CS, Daigle DR. Vegetarian diets are associated with healthy mood states: a cross-sectional study in seventh day adventist adults. Nutr J. 2010;9:26.
- Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: A pilot randomized controlled trial. Nutr Journal. 2012;11:9.
- Marcus B. How the Terrible, Insufferable Six-Day Water Fast Made Me a New Man. GQ. November 2013.
Video production by Glass Entertainment
Motion graphics by Avocado Video
- alternative medicine
- animal products
- arthritis
- autoimmune diseases
- blood pressure
- cardiovascular disease
- chicken
- chronic diseases
- complementary medicine
- diabetes
- eggs
- fasting
- gut flora
- heart disease
- heart health
- high blood pressure
- hypertension
- inflammation
- joint health
- lifestyle medicine
- meat
- microbiome
- pain
- Plant-Based Diets
- rheumatoid arthritis
- vegans
- vegetarians
Below is an approximation of this video’s audio content. To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring, watch the above video.
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 regard 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 percent, despite having the same genes––leaving 70 percent to be explained by nongenetic 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 neuroinflammation” 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.
Please consider volunteering to help out on the site.
- Gustafson C. Alan Goldhamer, dc: Water Fasting-The Clinical Effectiveness of Rebooting Your Body. Integr Med (Encinitas). 2014;13(3):52-7.
- Goldhamer A, Helms S, Salloum TK. Chapter 37 fasting. In: Pizzorno J, Murray M, eds. Textbook of Natural Medicine. 4th ed. Churchill Livingstone; 2013.
- Wilhelmi De Toledo F, Buchinger A, Burggrabe H, et al. Fasting therapy - An expert panel update of the 2002 consensus guidelines. Forsch Komplementarmed. 2013;20(6):434-43.
- Hare DC. A Therapeutic Trial of a Raw Vegetable Diet in Chronic Rheumatic Conditions: President’s Address. Proceedings of the Royal Society of Medicine. 1936;30(1):1-10.
- Müller H, de Toledo FW, Resch KL. Fasting followed by vegetarian diet in patients with rheumatoid arthritis: a systematic review. Scand J Rheumatol. 2001;30(1):1-10.
- Kjeldsen-Kragh J. Rheumatoid arthritis treated with vegetarian diets. Am J Clin Nutr. 1999;70(3):594s-600s.
- Fuhrman J, Sarter B, Calabro DJ. Brief case reports of medically supervised, water-only fasting associated with remission of autoimmune disease. Altern Ther Health Med. 2002;8(4):112, 110-1.
- Palmblad J, Hafström I, Ringertz B. Antirheumatic effects of fasting. Rheum Dis Clin North Am. 1991;17(2):351-62.
- Porter DR, Capell HA. The 'natural' history of active rheumatoid arthritis over 3-6 months--an analysis of patients enrolled into trials of potential disease-modifying anti-rheumatic drugs, and treated with placebo. Br J Rheumatol. 1993;32(6):463-6.
- Kjeldsen-Kragh J, Borchgrevink CF, Laerum E, et al. Controlled trial of fasting and one-year vegetarian diet in rheumatoid arthritis. The Lancet. 1991;338(8772):899-902.
- Kjeldsen-Kragh J, Mellbye OJ, Haugen M, et al. Changes in Laboratory Variables in Rheumatoid Arthritis Patients During a Trial of Fasting and One-year Vegetarian Diet. Scand J Rheumatol. 1995;24(2):85-93.
- Kjeldsen-Kragh J, Haugen M, Borchgrevink CF, Førre Ø. Vegetarian diet for patients with rheumatoid arthritis - Status: Two years after introduction of the diet. Clin Rheumatol. 1994;13(3):475-82.
- Longo VD, Mattson MP. Fasting: Molecular Mechanisms and Clinical Applications. Cell Metab. 2014;19(2):181-92.
- Peltonen R, Kjeldsen-kragh J, Haugen M, et al. Changes of faecal flora in rheumatoid arthritis during fasting and one-year vegetarian diet. Br J Rheumatol. 1994;33(7):638-43.
- Sundqvist T, Lindström F, Magnusson K-E, Sköldstam L, Stjernström I, Tagesson C. Influence of Fasting on Intestinal Permeability and Disease Activity in Patients with Rheumatoid Arthritis. Scand J Rheumatol. 1982;11(1):33-8.
- Wang D, DuBois RN. Urinary PGE-M: A Promising Cancer Biomarker. Cancer Prev Res. 2013;6(6):507-10.
- Reedy J, Krebs-Smith SM. Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc 2010 Oct;110(10):1477-84.
- Beezhold BL, Johnston CS, Daigle DR. Vegetarian diets are associated with healthy mood states: a cross-sectional study in seventh day adventist adults. Nutr J. 2010;9:26.
- Beezhold BL, Johnston CS. Restriction of meat, fish, and poultry in omnivores improves mood: A pilot randomized controlled trial. Nutr Journal. 2012;11:9.
- Marcus B. How the Terrible, Insufferable Six-Day Water Fast Made Me a New Man. GQ. November 2013.
Video production by Glass Entertainment
Motion graphics by Avocado Video
- alternative medicine
- animal products
- arthritis
- autoimmune diseases
- blood pressure
- cardiovascular disease
- chicken
- chronic diseases
- complementary medicine
- diabetes
- eggs
- fasting
- gut flora
- heart disease
- heart health
- high blood pressure
- hypertension
- inflammation
- joint health
- lifestyle medicine
- meat
- microbiome
- pain
- Plant-Based Diets
- rheumatoid arthritis
- vegans
- vegetarians
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Fasting for Rheumatoid Arthritis
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Content URLDoctor's Note
For more on fasting, see:
- Benefits of Fasting for Weight Loss Put to the Test
- Is Fasting Beneficial for Weight Loss?
- Is Fasting for Weight Loss Safe?
- Alternate-Day Intermittent Fasting Put to the Test
- Is Alternate-Day Intermittent Fasting Safe?
- The 5-2 Diet and the Fasting-Mimicking Diet Put to the Test
- Time-Restricted Eating Put to the Test
- The Benefits of Early Time-Restricted Eating
- Benefits of Fasting for Healing
- World’s Largest Fasting Study
This video was originally part of my Fasting for Disease Reversal webinar. If you want to see all of the videos in one place, check it out here.
Stay tuned for Fasting for Autoimmune Diseases next.
For more on rheumatoid arthritis, see Turmeric Curcumin & Rheumatoid Arthritis and Why Do Plant-Based Diets Help Rheumatoid Arthritis?.
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